[Federal Register Volume 67, Number 81 (Friday, April 26, 2002)]
[Notices]
[Pages 20871-20873]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-10356]



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Part I

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I





Department of Education





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Office of Special Education and Rehabilitative Services, National 
Institute on Disability and Rehabilitation Research; Notice

  Federal Register / Vol. 67, No. 81 / Friday, April 26, 2002 / 
Notices  
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DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research

AGENCY: Office of Special Education and Rehabilitative Services, 
Department of Education.

ACTION: Notice of proposed priorities.

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SUMMARY: The Assistant Secretary for Special Education and 
Rehabilitative Services proposes funding a priority for a Persons Aging 
with Hearing and Vision Loss project and a priority on the Evaluation 
of the Changing Universe of Disability and Systems Change Activities 
under the Disability and Rehabilitation Research Projects (DRRP) 
Program for the National Institute on Disability and Rehabilitation 
Research (NIDRR) for fiscal years (FY) 2002-2004. The Assistant 
Secretary takes this action to focus research attention on an 
identified national need. We intend these priorities to improve the 
rehabilitation services and outcomes for individuals aging with hearing 
and vision loss or individuals with disabilities.

DATES: We must receive your comments on or before May 28, 2002.

ADDRESSES: Address all comments about these proposed priorities to 
Donna Nangle, U.S. Department of Education, 400 Maryland Avenue, SW., 
room 3412, Switzer Building, Washington, DC 20202-2645. If you prefer 
to send your comments through the Internet, use the following address: 
[email protected]
    You must include the term Persons Aging with Hearing and Vision 
Loss or Evaluation of the Changing Universe of Disability and Systems 
Change Activities in the subject line of your electronic message.

FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 205-
5880.
    If you use a telecommunications device for the deaf (TDD), you may 
call the TDD number at (202) 205-4475 or via the Internet: 
[email protected]
    Individuals with disabilities may obtain this document in an 
alternative format (e.g., Braille, large print, audiotape, or computer 
diskette) on request to the contact person listed under FOR FURTHER 
INFORMATION CONTACT.

SUPPLEMENTARY INFORMATION:

Invitation To Comment

    We invite you to submit comments regarding these proposed 
priorities.
    We invite you to assist us in complying with the specific 
requirements of Executive Order 12866 and its overall requirement of 
reducing regulatory burden that might result from the proposed 
priorities. Please let us know of any further opportunities we should 
take to reduce potential costs or increase potential benefits while 
preserving the effective and efficient administration of the program.
    During and after the comment period, you may inspect all public 
comments about these priorities in room 3412, Switzer Building, 330 C 
Street SW., Washington, DC, between the hours of 8:30 a.m. and 4:00 
p.m., Eastern time, Monday through Friday of each week except Federal 
holidays.

Assistance to Individuals With Disabilities in Reviewing the 
Rulemaking Record

    On request, we will supply an appropriate aid, such as a reader or 
print magnifier, to an individual with a disability who needs 
assistance to review the comments or other documents in the public 
rulemaking record for the proposed priorities. If you want to schedule 
an appointment for this type of aid, please contact the person listed 
under FOR FURTHER INFORMATION CONTACT.
    We will announce the final priorities in a notice in the Federal 
Register. We will determine the final priorities after considering 
responses to this notice and other information available to the 
Department. This notice does not preclude us from proposing or funding 
additional priorities, subject to meeting applicable rulemaking 
requirements.

    Note: This notice does not solicit applications. In any year in 
which we choose to use these proposed priorities, we invite 
applications through a notice published in the Federal Register. 
When inviting applications we designate each priority as absolute, 
competitive preference, or invitational.

    The New Freedom Initiative (NFI) emphasizes the importance of 
assistive and universally designed technologies, other employment 
initiatives, and promotion of full access to community-based living. 
The NFI can be accessed on the Internet at the following site: http://www.whitehouse.gov/news/freedominitiative/freedominitiative.html
    NIDRR's published Long-Range Plan (the Plan), focusing on both 
individual and systemic factors that impact functional capability, 
includes the following elements: employment outcomes, health and 
function, technology for access, community integration and independent 
living, and associated activities such as the development of outcome 
measures and disability statistics. The Plan can be accessed on the 
Internet at: http://www.ed.gov/offices/OSERS/NIDRR/Products

Disability and Rehabilitation Research Project (DRRP) Program

    The purpose of the DRRP Program is to plan and conduct research, 
demonstration projects, training, and related activities to:
    (a) 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; and
    (b) Improve the effectiveness of services authorized under the 
Rehabilitation Act of 1973 (the Act).

Priorities

Persons Aging With Hearing and Vision Loss

Background

    The primary study populations are older Americans who have 
experienced hearing or vision loss earlier in their lives and who, with 
advanced age, are experiencing the loss of the alternate sense. There 
is a need to identify individuals who are aging with hearing and vision 
loss from a broad and balanced sample of subjects, as exemplified by 
U.S. Census data.
    One of the most important changes in the United States over the 
last 50 years has been the rapid increase in the number of people 
living into their 70s, 80s and beyond. Today, average life expectancy 
is 78 years compared to 47 years in 1900 (Campbell, et al., 
(Surveillance for Sensory Impaired, Activity Limitations, and Health-
Related Quality of Life Among Older Adults, NHIS, National Center for 
Environmental Health, 1999). The number of Americans age 55 and over is 
projected to increase twice as fast as the population as a whole 
(Schmeider & Halfman, Statistics on visual impairment on older persons, 
disability in children, life expectancy, Journal of Visual Impairment 
and Blindness, Vol. 91, pgs. 602-606, 1997).
    Furthermore, a growing number of the people who are living longer 
are those who sustained a disability at some point earlier in their 
lives. Many of these individuals will remain in the workforce due to 
extensions of the traditional retirement age. The increase in longevity 
in this century brings with it an increase in the amount of time spent 
in all major activities, including work and retirement (Weinstein B.E., 
Geriatric Audiology, Thieme Med. Publishers, Inc., NY, NY 2000).

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    However, as people age, one of the most significant problems that 
they face is the presence of a disability. For example, loss of vision 
and hearing become more prevalent with aging, affecting millions of 
Americans. When either of these disabilities is already present, the 
onset of a secondary disability is especially problematic, particularly 
when the individual is faced with additional age-related disabilities.
    One-third of persons over 65 years of age have a hearing loss 
sufficient to interfere with speech perception, and the prevalence 
rises with increasing age (A Report of the Task Force on the National 
Strategic Research Plan, NIDCD, 1989). There is also a growing number 
of under-served individuals with a combination of multiple sensory, 
physical, and cognitive impairments (Malakpa S., Job placement of blind 
and visually impaired people with additional disabilities, RE: View, 
Vol. 26, pgs. 67-77, 1994).
    Low vision or blindness frequently coexists with other disabilities 
including hearing loss, cognitive impairments, and mobility 
limitations. Individuals with multiple disabilities present 
technological challenges and require complex adjustments to achieve 
functionality in and across environments (Greenbaum, et al., Use of 
motorized wheelchair in conjunction with a guide dog for legally blind 
and disabled, Archives of Physical Medicine and Rehabilitation, Vol. 
79(2), pgs. 216-217, 1998). Functional status is diminished for sensory 
impaired subjects. Combined vision and hearing impairments have greater 
effect on function than single sensory impairments and influence 
functional status independent of mental status and co-morbid illness. 
For example, blind people who acquire significant hearing problems have 
the core of their already constrained communication system threatened. 
Persons with significant hearing loss, who lose visual acuity, are 
equally affected. Overall, this suggests that interventions to improve 
sensory function may improve functional independence (Keller, et al., 
The effect of visual and hearing impairment on functional status, 
Journal of Geriatric Sociology, 47(11), pgs. 1319-25, 1999).
    Data from the Survey of Income and Program Participation (SIPP), 
1997, indicate that 3.9 million (12.1 percent) persons age 65 and older 
had difficulty seeing the words and letters in newspapers even when 
wearing glasses or contact lenses; of that group, 1.1 million (3.3 
percent) were unable to see the words and letters at all, while 2.8 
million (8.8 percent) had visual problems that were not severe. The 
SIPP also measures hearing problems. Even when wearing a hearing aid, 
4.3 million (13.4 percent) had difficulty hearing normal conversation. 
Of that group, about 500,000 (1.5 percent) were unable to hear what was 
said in normal conversation while about 3.8 million (11.9 percent) had 
hearing problems that were not severe.
    The number of individuals with both severe hearing and visual 
impairments (deaf-blind) is small. But, just as the number of elders 
will be growing in absolute numbers and as an increasing proportion of 
the population, the number of elders experiencing severe sensory loss 
is likely to increase as well (Crews John E., Aging and Disability: The 
issues for 1990's, In Boone (ed.): Challenge to Independence, pgs. 47-
59, U. Arkansas Press, Little Rock, AR, 1998). The greatest challenges 
faced by multiple sensory impaired people are an absence of functional 
communication modes and access to information technology. Unlike 
individuals who, blind from an early age, learned Braille as part of 
their developmental language in special classes or in institutions for 
the blind, people who lose their vision in adulthood rarely master 
Braille for communication purposes. To date, technologies for such 
people have focused primarily on tactile interpreting for face-to-face 
communication (Engleman, et al., Deaf-blindness and communication: 
Practical knowledge and strategies, Journal of Visual Impairment and 
Blindness, Vol. 92(11) pgs. 783-798, 1999).
    In a recent report on data from the National Health Interview 
Survey (NHIS) study, Campbell, Mority, Zack and Blackman (1999) 
determined that older adults who reported vision and hearing 
impairments were two times more likely than their peers without 
impairments to report difficulty walking (48.3 percent vs. 22.2 
percent), three times more likely to report difficulty getting outside 
(32.8 percent vs. 11.9 percent), and almost 2.5 times more likely to 
report difficulty getting into or out of bed or a chair (25.0 percent 
vs. 10.4 percent). In addition, older adults who experience both vision 
and hearing impairments were three times more likely than their peers 
without impairments to report difficulty preparing meals (20.7 percent 
vs. 7.8 percent) and more likely to report difficulty managing 
medication (13.4 percent vs. 5.0 percent).
    Furthermore, older adults who reported both vision and hearing loss 
were more likely than those without either vision or hearing 
impairments to have: (a) fallen during the preceding year (37.4 percent 
vs. 19.8 percent), (b) broken a hip (7.6 percent vs. 4.5 percent), (c) 
reported a higher prevalence of hypertension (53.4 percent vs. 44.3 
percent), (d) reported heart disease (32.2 percent vs. 20.6 percent), 
or (e) are twice as likely to experience a stroke (17.4 percent vs. 7.3 
percent) (Campbell, et al., (Surveillance for Sensory Impaired, 
Activity Limitations, and Health-Related Quality of Life Among Older 
Adults, NHIS, National Center for Environmental Health, 1999).
    Untangling the relationships among sensory loss, co-morbidities and 
secondary conditions, and activity limitations poses an important 
challenge for public health, the development of public policy, 
vocational rehabilitation service providers, community integration 
efforts, and fulfillment of the NFI. For example, the relation between 
sensory limitations and activity limitations is not clearly understood, 
more information is needed about the relation between underlying 
conditions, activity limitations, and secondary conditions (Campbell, 
1999).
    In order to further our understanding of co-morbidity, studies that 
examine community planning efforts for housing and transportation, the 
effect of policy and planning efforts on the integration of older 
persons with vision and hearing problems into the community, and the 
influence of sensory and activity limitations in aging populations on 
rehabilitation outcomes are crucial. Finally, more information is 
needed regarding strategies that many older adults, who have a vision 
and hearing disability, employ to sustain participation in the 
community.

Priority 1

    The Assistant Secretary proposes to establish a Disability and 
Rehabilitation Research Project on Persons Aging with Hearing and 
Vision Loss. The purpose of this absolute priority is to explore ways 
to improve outcomes for persons who are blind or who are deaf and who 
are now experiencing a secondary onset of hearing loss or vision 
impairment resulting from aging. The DRRP will conduct research, 
development, training, and dissemination activities and evaluate model 
approaches for improving employment and community integration options, 
including more viable communication systems, for such individuals who 
are 55 years of age, or older. In carrying out this purpose the DRRP 
must:
    (1) Investigate the prevalence of age-related onset of deafness 
among older American blind individuals and age-

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related onset of blindness among older American deaf individuals and 
the impact on the employment and community integration options, 
including more viable communication systems for each population;
    (2) Identify and evaluate technology and service delivery options, 
such as transportation, housing, and community integration activities 
for individuals with early onset deafness or blindness and late onset 
hearing or vision loss and their effectiveness with persons 
experiencing secondary sensory loss resulting from aging;
    (3) Identify and evaluate access to use of technologies, including 
assistive devices and telecommunication or other existing communication 
systems, such as tactile interpreter support, needed to assist persons 
with early onset deafness or blindness and late onset hearing or vision 
loss and their effectiveness with persons experiencing secondary 
sensory loss resulting from aging; and
    (4) Using available dissemination mechanisms, with appropriate 
assistive technical modification, disseminate findings, and develop 
strategies to educate both consumers and providers, especially 
vocational rehabilitation workers, in use of these techniques.
    In addition, the DRRP must:
     Coordinate the efforts of this DRRP with other NIDRR, 
Office of Special Education Programs (OSEP), and Rehabilitation 
Services Administration (RSA) projects that address related activities 
such as Blindness, Deafness, Deaf-Blind, Aging, Accessible Housing, 
Accessible Transportation, Telecommunication, Independent Living, and 
Interpreter Training programs;
     Solicit direct input from stakeholders (e.g., persons who 
are deaf, blind, and deaf-blind; service providers; and employers) as 
part of the ongoing planning, development, and implementation of the 
DRRP's research activities;
     Demonstrate efforts to secure supplementary funding that 
will permit the DRRP more latitude in exploring additional related 
studies, in addition to the Federal monies available from this NIDRR 
grant; and
     Identify and investigate a study population that includes 
a balanced sample of subjects representative of national demographics.

Evaluation of the Changing Universe of Disability and Systems 
Change Activities

Background

    Demographic, social and environmental trends affect the prevalence 
and distribution of various types of disabilities as well as the 
demands of those disabilities on social policy and service systems. 
Past studies related to the changing universe of disability have 
included, as one focus, those which can be identified on the basis of 
changing etiologies for existing disabilities, or the appearance of new 
disabilities.
    The changing universe of disability also refers to broader changes 
such as growth in segments of the population with higher prevalence 
rates for certain disabilities and the consequences of changes in 
public policy, health care services, and medical and assistive 
technologies. At the present time, significant policy changes at the 
Federal level and implementation of those policies promise a 
substantial and progressive impact on the provision of various services 
and supports to all people with disabilities. Recent major policy 
developments include the Supreme Court's Olmstead decision, the New 
Freedom Initiative (NFI), and the Workforce Investment Act (WIA).
    These new policies may provide additional opportunities for people 
with significant disabilities to remain in or enter the workplace, to 
live within the community, and to have increased access to assistive 
technologies. Development of plans to evaluate and monitor the course 
of these policies over time is critical for understanding the impact of 
systems change activities on the changing universe of disability. Such 
assessment requires the identification or development of appropriate 
sources of data and the analytic work required to identify the 
implications of policy changes for financing of, access to, and use of 
home- and community-based long-term care services, rehabilitation 
systems including vocational rehabilitation, and assistive technologies 
on a highly dynamic population.
    NIDRR-funded research on the changing universe of disabilities has 
assisted with better understanding of factors such as new etiologies, 
as mentioned earlier. In their early writing on the topic, Seelman and 
Sweeney had postulated that ``poverty is the primary screening 
indicator of the many variables that increase the risk of disability 
(Seelman K., and Sweeney S., The Changing Universe of Disability, 
American Rehabilitation, Autumn-Winter 1995).'' Subsequent analyses of 
relationships between poverty and disability have identified factors, 
such as access to health care, where one lives, and exposure to 
environmental risks, that influence prevalence and distribution 
(Fujiura G., Quality of Life and the Poverty Agenda; Emergent 
Disability in America, In press, 2000; Fujiura G., Yamaki K., 
Czechowicz S., Disability Among Ethnic and Racial Minorities in the 
United States, Journal of Disability Policy Studies, Issue 9, 1998). In 
identifying an array of factors associated with the ``changing causes 
and patterns of disabilities,'' one must also address ``the disability 
related consequences, including functional loss, employment, and social 
behavior (Seelman and Sweeney, 1995).'' Ultimately, the researcher must 
carefully focus on evaluation of the impact of policy or systems change 
while controlling for the range of other variables that affect 
disabilities, including those factors that are unique to underserved 
and unserved populations. With a carefully constructed analytic 
framework, research can address the paucity of information about the 
degree to which rehabilitation services are provided to unserved or 
underserved populations, within the context of the changing universe of 
disability. In addition, studies can illuminate how policies and 
systems change influence access, usage, and rehabilitation service 
outcomes for these populations.

Priority 2

    The Assistant Secretary proposes to establish a Disability and 
Rehabilitation Research Project on the Evaluation of the Changing 
Universe of Disability and Systems Change Activities. The purpose of 
the proposed absolute priority is to evaluate the implications over 
time of systems change activities for populations within the changing 
universe of disability. The DRRP must:
    (1) Identify and evaluate existing or proposed data systems that 
can be used to monitor systems change activities at the State or 
Federal level or both, including policy changes related to the NFI, the 
WIA, and the Olmstead decision;
    (2) Identify, evaluate, and project the impact of systems change 
activities and new policies for people with newly emergent disabilities 
or changing manifestations of disability or both, including those who 
are unserved and underserved;
    (3) Develop proposals for new systems or data variables, or 
changes, as necessary, to existing data systems that will facilitate 
use of such data to eliminate gaps in the availability of mechanisms to 
monitor the impact of systems change activities on people with newly 
emergent disabilities or changing manifestations of disability or both, 
including those who are unserved and underserved;

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    (4) Disseminate findings and recommendations to modify monitoring 
data systems or to institute new monitoring approaches; and
    (5) Conduct research to identify and evaluate the implications of 
policy changes or other systems change activities on public and private 
rehabilitation programs and services for persons with newly emergent 
disabilities or changing manifestations of disability or both, 
including those who are unserved and underserved.
    In carrying out these purposes the applicant must:
     Involve consumers or their families, as appropriate, in 
all stages of the research and demonstration endeavor;
     Demonstrate culturally appropriate and sensitive methods 
of data collection, measurements, and dissemination addressing needs of 
individuals with disabilities from diverse backgrounds;
     By the end of the fourth year, convene a national 
conference to disseminate and discuss information about the affect of 
systems change activities on persons with newly emergent disabilities 
or changing manifestations of disability or both including those who 
are unserved and underserved and proposals to address gaps in such 
activities; and
     Serve as a resource to researchers, consumers and consumer 
groups, planners, and policymakers for conceptual and statistical 
information that addresses the changing universe of disability, 
including systems change issues. Applicable Program Regulations: 34 CFR 
part 350.

Electronic Access to This Document

    You may review this document, as well as all other Department of 
Education documents published in the Federal Register, in text or Adobe 
Portable Document Format (PDF) on the Internet at the following site: 
www.ed.gov/legislation/FedRegister
    To use PDF you must have Adobe Acrobat Reader, which is available 
free at this site. If you have questions about using PDF, call the U.S. 
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    Note: The official version of this document is the document 
published in the Federal Register. Free Internet access to the 
official edition of the Federal Register and the Code of Federal 
Regulations is available on GPO access at: http://www.access.gpo.gov/nara/index.html


(Catalog of Federal Domestic Assistance Number 84.133A, Disability 
Rehabilitation Research Project.)

    Program Authority: 29 U.S.C. 762(g) and 764(b).

    Dated: April 23, 2002.
Loretta L. Petty,
Acting Assistant Secretary for Special Education and Rehabilitative 
Services.
[FR Doc. 02-10356 Filed 4-25-02; 8:45 am]
BILLING CODE 4000-01-P