[Federal Register Volume 80, Number 50 (Monday, March 16, 2015)]
[Notices]
[Pages 13569-13573]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-05989]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Community Living


Proposed Priority--National Institute on Disability, Independent 
Living, and Rehabilitation Research--Rehabilitation Research and 
Training Centers

AGENCY: Administration for Community Living, Department of Health and 
Human Services.

ACTION: Notice of Proposed Priority.

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

CFDA Number: 84.133B-6.

SUMMARY: The Administrator of the Administration for Community Living 
proposes a priority for the Rehabilitation Research and Training Center 
(RRTC) Program administered by the National Institute on Disability, 
Independent Living, and Rehabilitation Research (NIDILRR). 
Specifically, this notice proposes a priority for an RRTC on Outcomes 
Measurement for Home and Community Based Services. We take this action 
to focus research attention on an area of national need. We intend this 
priority to contribute to improved home and community based services 
for individuals with disabilities.

DATES: We must receive your comments on or before April 15, 2015.

ADDRESSES: Address all comments about this notice to Carolyn Baron, 
U.S. Department of Health and Human Services, 550 12th Street SW., Room 
5134, PCP, Washington, DC 20202-2700.
    If you prefer to send your comments by email, use the following 
address: [email protected]. You must include the phrase ``Proposed 
Priorities for RRTCs'' and the priority title in the subject line of 
your electronic message.
    We will not accept comments submitted by fax or those submitted 
after the comment period. To ensure that we do not receive duplicate 
copies, please submit your comments only once.
     Postal Mail or Commercial Delivery: If you mail or deliver 
your comments about these proposed regulations, address them to Carolyn 
Baron, U.S. Department of Health and Human Services, 400 Maryland 
Avenue SW., Room 5134, Potomac Center Plaza (PCP), Washington, DC 
20202-2700.
    Privacy Note: The Department's policy is to make all comments 
received from members of the public available for public viewing in 
their entirety. Therefore, commenters should be careful to include in 
their comments only information that they wish to make publicly 
available.

FOR FURTHER INFORMATION CONTACT: Carolyn Baron. Telephone: (202) 245-
7244 or by email: [email protected].
    If you use a telecommunications device for the deaf (TDD) or a text 
telephone (TTY), call the Federal Relay Service (FRS), toll free, at 1-
800-877-8339.

SUPPLEMENTARY INFORMATION: This notice of proposed priority is in 
concert with NIDILRR's currently approved Long-Range Plan (Plan). The 
Plan, which was published in the Federal Register on April 4, 2013 (78 
FR 20299), can be accessed on the Internet at the following site: 
www.ed.gov/about/offices/list/osers/nidrr/policy.html.

[[Page 13570]]

    The Plan identifies a need for research and training that can be 
used to improve outcomes of individuals with disabilities. To address 
this need, NIDILRR seeks to: (1) Improve the quality and utility of 
disability and rehabilitation research; (2) foster an exchange of 
research findings, expertise, and other information to advance 
knowledge and understanding of the needs of individuals with 
disabilities and their family members, including those from among 
traditionally underserved populations; (3) determine effective 
practices, programs, and policies to improve community living and 
participation, employment, and health and function outcomes for 
individuals with disabilities of all ages; (4) identify research gaps 
and areas for promising research investments; (5) identify and promote 
effective mechanisms for integrating research and practice; and (6) 
disseminate research findings to all major stakeholder groups, 
including individuals with disabilities and their family members in 
formats that are appropriate and meaningful to them.
    This notice proposes one priority that NIDILRR intends to use for 
one or more competitions in fiscal year (FY) 2015 and possibly later 
years. NIDILRR is under no obligation to make an award under this 
priority. The decision to make an award will be based on the quality of 
applications received and available funding. NIDILRR may publish 
additional priorities, as needed.
    Invitation to Comment: We invite you to submit comments regarding 
this proposed priority. To ensure that your comments have maximum 
effect in developing the final priority, we urge you to identify 
clearly the specific topic within the priority that each comment 
addresses.
    We invite you to assist us in complying with the specific 
requirements of E.O. 12866 and 13563 and their overall requirement of 
reducing regulatory burden that might result from this proposed 
priority. Please let us know of any further ways we could 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 sent to NIDILRR in Room 5142, 550 12th Street SW., PCP, 
Washington, DC, between the hours of 8:30 a.m. and 4:00 p.m., 
Washington, DC time, Monday through Friday of each week except Federal 
holidays.
    Assistance to Individuals With Disabilities in Reviewing the 
Rulemaking Record: On request we will provide an appropriate 
accommodation or auxiliary aid to an individual with a disability who 
needs assistance to review the comments or other documents in the 
public rulemaking record for this notice. If you want to schedule an 
appointment for this type of accommodation or auxiliary aid, please 
contact the person listed under FOR FURTHER INFORMATION CONTACT.
    Purpose of Program: The purpose of the Disability and 
Rehabilitation Research Projects and Centers Program is to plan and 
conduct research, demonstration projects, training, and related 
activities, including international activities, to 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, and to improve the effectiveness of services authorized 
under the Rehabilitation Act of 1973, as amended (Rehabilitation Act).

Rehabilitation Research and Training Centers

    The purpose of the RRTCs, which are funded through the Disability 
and Rehabilitation Research Projects and Centers Program, is to achieve 
the goals of, and improve the effectiveness of, services authorized 
under the Rehabilitation Act through well-designed research, training, 
technical assistance, and dissemination activities in important topical 
areas as specified by NIDILRR. These activities are designed to benefit 
rehabilitation service providers, individuals with disabilities, family 
members, policymakers and other research stakeholders. Additional 
information on the RRTC program can be found at: http://www2.ed.gov/programs/rrtc/index.html#types.

    Program Authority: 29 U.S.C. 762(g) and 764(b)(2).

    Applicable Program Regulations: 34 CFR part 350.

Proposed Priority

    This notice contains one proposed priority.

RRTC on Outcomes Measurement for Home and Community Based Services

Background
    Approximately $140 billion is spent nationally on Medicaid long-
term services and supports (LTSS) (Eiken et al., 2014). States continue 
to rebalance their LTSS expenditures to decrease the reliance on 
nursing homes and other institutional services for individuals of all 
ages with disabilities. Nearly half of Medicaid's LTSS expenditures go 
toward home and community-based services (HCBS) compared to only 18% in 
1995 (Eiken et al., 2014). The aging of the population and growing 
consumer demand to live in home-based settings will continue to 
increase the need for home and community-based services (HCBS). As more 
people receive LTSS in the community, there is a need for validated 
measures of consumer outcomes and experiences that can be used as 
indicators of HCBS quality (Commission on Long Term Care, 2013; 
Disability Rights Education & Defense Fund, 2013). Compared to 
measurement efforts in clinical settings, non-medical performance 
measures in HCBS are in the early stages of development and 
standardization (National Quality Forum, 2012). Accordingly, NIDILRR is 
sponsoring a Rehabilitation Research and Training Center on Outcomes 
Measurement for Home and Community Based Services.
    Efforts to measure the quality of a wide variety of services, 
including home- and community-based LTSS, may include structural 
measures (whether a particular mechanism is in place), process measures 
(which track the performance of a particular action) and outcomes 
measures (the results of actions and mechanisms) (Disability Rights 
Education & Defense Fund, 2013; Booth & Fralich, 2006). In the long-
term care context, structural indicators of quality may include the 
ratio of service providers to consumers, for example, and process 
indicators of quality may include the skill levels of providers and the 
timeliness of the services they deliver (Disability Rights Education & 
Defense Fund, 2013). User outcomes are also important indicators of 
service quality. In the HCBS context, health status and levels of 
community integration, participation, and inclusion among service 
recipients can be important markers of HCBS quality (Disability Rights 
Education & Defense Fund, 2013).
    For decades, efforts to measure and improve long-term care quality 
have focused on nursing homes. Historically, the assessment of quality 
in nursing homes and other institutional long-term care settings 
emphasized the protection and safety of residents. As the delivery of 
LTSS is increasingly taking place in home and community-based settings, 
these institution-based quality measurement efforts have not been 
translated into measures that are relevant and important to individuals

[[Page 13571]]

who are receiving services at home (Commission on Long-Term Care, 
2013). While protection and safety are important to HCBS recipients, 
other factors are important and relevant in these settings, including 
levels of community integration, participation, and inclusion.
    As states continue to rebalance their LTSS expenditures to decrease 
reliance on nursing homes and increase service delivery in home and 
community-based settings, they have begun the process of developing 
person-centered HCBS measures that assess outcomes from the perspective 
of service users. The State of Wisconsin, for example, has developed 
and implemented a set of measures that assess ``person-centered quality 
of life'' outcomes that are important to HCBS users (Karon & Schlaak, 
2012). By seeking extensive input from service users and other 
stakeholders, Wisconsin has developed quality of life concepts and 
measures that are used to assess the extent to which (1) individuals 
have choice over their living arrangements and services, (2) 
individuals have desired social relationships and participate in 
meaningful ways in society, and (3) individuals are healthy and safe 
(Wisconsin Department of Health Services, 2014). Within this person-
centered outcomes measurement system, service users are able to choose 
the specific outcomes that are the most important to them and describe 
the extent to which the long-term care services they are receiving 
support their achievement of those outcomes. With this outcomes 
assessment system Wisconsin has developed state-wide quality of life 
outcomes reports that aggregate findings for all of its HCBS users, as 
well as reports that provide comparisons of outcomes across different 
HCBS programs and subpopulations (Karon & Schlaak, 2012).
    Recent efforts at the Federal level have begun to address the need 
for HCBS quality measures. For example, the Administration for 
Community Living (ACL) is contracting with the National Quality Forum 
(NQF) to create a conceptual framework for HCBS quality measurement and 
to make recommendations for HCBS measure development efforts. Through 
this work, ACL aims to create a conceptual foundation for the 
development of measures that can be used to assess and ultimately 
support independence and community living outcomes of HCBS recipients 
(National Quality Forum, 2015). Much work remains to conceptualize and 
measure HCBS quality in terms of the outcomes that are important to 
long-term care recipients. These outcomes include adequacy and 
appropriateness of care, as well as the consumers' level of control, 
social integration, social participation, and general quality of life 
(Kaye, 2014).
    Another foundation for the development of person-centered HCBS 
outcomes measures is the ongoing work of rehabilitation researchers to 
create valid and reliable measures of community participation of people 
with disabilities (Walker, Mellick, Brooks, & Whiteneck, 2003; Hammel, 
Magasi, Heinemann, Whiteneck, Bogner & Rodriguez, 2012; Whiteneck & 
Dijkers, 2009; Heinemann, 2010). These research and development efforts 
include the application of advanced item-scaling and person-centered 
measurement techniques that can be implemented as computerized adaptive 
tests (CAT) (Haley et al., 2008), thus reducing data collection burden 
on people with disabilities. These efforts to develop participation 
outcome measures for people with disabilities are highly relevant to 
the applied efforts to develop person-centered HCBS outcome measures.
    These and other Federal and state efforts provide a strong 
foundation for further research on and development of person-centered 
HCBS outcomes measures and measurement systems that assess and promote 
community living, independent living and social integration of HCBS 
users. Accordingly, NIDILRR aims to support a Rehabilitation Research 
and Training Center on Outcomes Measurement for Home and Community 
Based Services. This RRTC will conduct research and development 
activities in this critical area and will serve as a national resource 
center on HCBS outcomes measurement for Federal and state-level 
policymakers, people with disabilities and other key stakeholders.

References

Booth, M., Fralich, J. (2006). Performance Measurement: Managing and 
Using Home and Community-Based Services Data for Quality 
Improvement. University of Southern Maine: Muskie School of Public 
Service. http://muskie.usm.maine.edu/Publications/DA/Performance-Measurement-HCBS.pdf.
Commission on Long Term Care. (September 30, 2013). Report to the 
Congress. http://ltccommission.lmp01.lucidus.net/wp-content/uploads/2013/12/Commission-on-Long-Term-Care-Final-Report-9-26-13.pdf.
Disability Rights Education & Defense Fund (2013). Identifying and 
Selecting Long Term Services and Supports Outcomes Measures. http://dredf.org/2013-documents/Guide-LTSS-Outcome-Measures.pdf.
Eiken, Steve, et al. (2014). Medicaid Expenditures for Long-Term 
Services and Supports for FFY 2012. http://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/downloads/ltss-expenditures-2012.pdf.
Haley, S., Gandek, B., Siebens, H., Black-Schaffer, R., Sinclair, 
S., Tao, W., Coster, W., Ni, P., & Jette, A. (2008). Computerized 
Adaptive Testing for Follow-Up After Discharge From Inpatient 
Rehabilitation: Participation Outcomes. Archives of Physical 
Medicine and Rehabilitation. 89(2): 275-283.
Hammel, J., Magasi, S., Heinemann, A., Whiteneck, G., Bogner, & 
Rodriguez, E. (2008). What Does Participation Mean? An Insider 
Perspective From People With Disabilities. Disability and 
Rehabilitation. 30(19): 1445-1460.
Heinemann, A. (2010). Measurement of Participation in Rehabilitation 
Research. Archives of Physical Medicine and Rehabilitation. 91(9): 
S1-S4.
Karon, S., and Schlaak, M. (2012). PEONIES Member Interviews, State 
Fiscal Year 2012, Final Report. Madison, WI: Center for Health 
Systems Research and Analysis. http://www.chsra.wisc.edu/peonies/documents/PEONIES%20Final%20Report%20SFY2012%20-%20rev%2011-9-2012.pdf.
Kaye, H. Stephen. Toward a Model Long-Term Services and Supports 
System: State Policy Elements. The Gerontologist. (October 2014). 
http://gerontologist.oxfordjournals.org/content/54/5/754.full.pdf+html.
National Quality Forum (2015). Home and Community Based Services 
Quality. http://www.qualityforum.org/ProjectDescription.aspx?projectID=77692.
National Quality Forum, ``Measuring Healthcare Quality for the Dual 
Eligible Beneficiary Population, Measure Application Partnership, 
Final Report to HHS,'' June, 2012.
Walker, N., Mellick, D., Brooks, CA, Whiteneck, G. (2003). Measuring 
Participation Across Impairment Groups Using the Craig Handicap 
Assessment Reporting Technique. American Journal of Physical 
Medicine and Rehabilitation. 82(12): 936-941.
Whiteneck, G., & Dijkers, M. (2009). Difficult to Measure 
Constructs. Conceptual and Methodological Issues Concerning 
Participation and Environmental Factors. Archives of Physical 
Medicine and Rehabilitation. 90(11) S22-S35.
Wisconsin Department of Health Services (2014). Measuring Person-
Centered Quality. November 11, 2014: https://www.dhs.wisconsin.gov/familycare/reports/peonies.htm.

Definitions

    The research that is proposed under this priority must be focused 
on one or more stages of research. If the RRTC is to conduct research 
that can be categorized under more than one research stage, or research 
that

[[Page 13572]]

progresses from one stage to another, those research stages must be 
clearly specified. For purposes of this priority, the stages of 
research are from the notice of final priorities and definitions 
published in the Federal Register on June 7, 2013 (78 FR 34261).
    (a) Exploration and Discovery means the stage of research that 
generates hypotheses or theories by conducting new and refined analyses 
of data, producing observational findings, and creating other sources 
of research-based information. This research stage may include 
identifying or describing the barriers to and facilitators of improved 
outcomes of individuals with disabilities, as well as identifying or 
describing existing practices, programs, or policies that are 
associated with important aspects of the lives of individuals with 
disabilities. Results achieved under this stage of research may inform 
the development of interventions or lead to evaluations of 
interventions or policies. The results of the exploration and discovery 
stage of research may also be used to inform decisions or priorities.
    (b) Intervention Development means the stage of research that 
focuses on generating and testing interventions that have the potential 
to improve outcomes for individuals with disabilities. Intervention 
development involves determining the active components of possible 
interventions, developing measures that would be required to illustrate 
outcomes, specifying target populations, conducting field tests, and 
assessing the feasibility of conducting a well-designed interventions 
study. Results from this stage of research may be used to inform the 
design of a study to test the efficacy of an intervention.
    (c) Intervention Efficacy means the stage of research during which 
a project evaluates and tests whether an intervention is feasible, 
practical, and has the potential to yield positive outcomes for 
individuals with disabilities. Efficacy research may assess the 
strength of the relationships between an intervention and outcomes, and 
may identify factors or individual characteristics that affect the 
relationship between the intervention and outcomes. Efficacy research 
can inform decisions about whether there is sufficient evidence to 
support ``scaling-up'' an intervention to other sites and contexts. 
This stage of research can include assessing the training needed for 
wide-scale implementation of the intervention, and approaches to 
evaluation of the intervention in real world applications.
    (d) Scale-Up Evaluation means the stage of research during which a 
project analyzes whether an intervention is effective in producing 
improved outcomes for individuals with disabilities when implemented in 
a real-world setting. During this stage of research, a project tests 
the outcomes of an evidence-based intervention in different settings. 
It examines the challenges to successful replication of the 
intervention, and the circumstances and activities that contribute to 
successful adoption of the intervention in real-world settings. This 
stage of research may also include well-designed studies of an 
intervention that has been widely adopted in practice, but that lacks a 
sufficient evidence-base to demonstrate its effectiveness.

Proposed Priority

    The Administrator of the Administration for Community Living 
proposes a priority for the Rehabilitation Research and Training Center 
(RRTC) program administered by the National Institute on Disability, 
Independent Living, and Rehabilitation Research (NIDILRR). 
Specifically, this notice proposes a priority for an RRTC on Outcomes 
Measurement for Home and Community Based Services. The RRTC will engage 
in research, development, and testing of measures to assess the quality 
of HCBS in terms of the person-centered outcomes achieved by people 
with disabilities who use the services in home and community settings. 
The RRTC will also engage in knowledge translation, development of 
informational products, and dissemination to enhance the field's 
capacity to measure the extent to which HCBS leads to improved outcomes 
in community living and independent living areas that are important to 
people with disabilities and other stakeholders. Ultimately, the RRTC's 
development of non-medical, person-centered outcome measures is 
intended to inform the design, implementation, and continuous 
improvement of Federal and state policies and programs related to the 
delivery of HCBS to people with disabilities. The RRTC must contribute 
to these outcomes by:
    (a) Identifying or developing measures, and then testing the 
proposed measures to assess the person-centered outcomes of individuals 
with disabilities who are receiving home and community-based services. 
HCBS measures developed under this priority must be non-medical and 
must focus on the end-users' experience of community living, 
independent living, social integration, community participation, and 
other similar outcomes. The measures developed under this priority must 
also be designed to minimize data collection burden on HCBS recipients. 
Possible methods for minimizing this burden include, but are not 
limited to, use of relevant administrative data, modifying 
administrative data to include person-centered goals as well as fields 
to assess progress toward those goals, and use of advanced item-scaling 
and person-centered measurement techniques that can be implemented as 
computerized adaptive tests (CAT).
    (b) Increasing incorporation of the RRTC's HCBS outcome measures 
into practice and policy. The RRTC must contribute to this outcome by--
    (1) Working closely with NIDILRR and the Administration for 
Community Living (ACL) at each stage of the measure development and 
testing processes to ensure that its activities are informing and 
informed by other HCBS quality initiatives taking place within ACL and 
other relevant Federal and state agencies. This specifically includes 
the work taking place under the National Quality Forum's work with the 
Department of Health and Human Services (http://www.qualityforum.org/ProjectDescription.aspx?projectID=77692).
    (2) Developing procedures and mechanisms for applying HCBS outcome 
measures in policy and service delivery settings to maximize quality 
and appropriateness of HCBS from the end-user perspective.
    (3) Collaborating with stakeholder groups to develop, evaluate, or 
implement strategies to increase utilization of new HCBS outcome 
measures. Stakeholder groups include but, are not limited to, people 
with disabilities, Federal- and state-level policymakers; home and 
community based service providers; advocacy organizations; and Centers 
for Independent Living.
    (4) Collaborating with relevant NIDILRR-sponsored knowledge 
translation grantees to help promote the uptake of RRTC products by 
relevant stakeholders and embed the outcome measures into the overall 
health care measurement system.
    (c) Serving as a national resource center related to person-
centered measurement of HCBS outcomes:
    (1) Disseminating information and providing technical assistance 
related to HCBS outcome and quality measurement to policymakers, 
service providers, people with disabilities and their representatives, 
and other key stakeholders; and
    (2) Providing relevant and appropriate training, including 
graduate, pre-service, and in-service training, to HCBS providers, 
researchers and quality-measurement personnel, and other

[[Page 13573]]

disability service providers, to facilitate more effective delivery of 
HCBS to people with disabilities. This training may be provided through 
conferences, workshops, public education programs, in-service training 
programs, and similar activities.

Final Priority

    We will announce the final priority in a notice in the Federal 
Register. We will determine the final priority after considering 
responses to this notice and other information available to the 
Department. This notice does not preclude us from proposing additional 
priorities, requirements, definitions, or selection criteria, subject 
to meeting applicable rulemaking requirements.

    Note: This notice does not solicit applications. In any year in 
which we choose to use this priority, we invite applications through 
a notice in the Federal Register or in a Funding Opportunity 
Announcement posted at www.grants.gov.

Executive Orders 12866 and 13563

Regulatory Impact Analysis
    Under E.O. 12866, the Secretary must determine whether this 
regulatory action is ``significant'' and, therefore, subject to the 
requirements of the Executive Order and subject to review by the Office 
of Management and Budget (OMB). Section 3(f) of E.O. 12866 defines a 
``significant regulatory action'' as an action likely to result in a 
rule that may--
    (1) Have an annual effect on the economy of $100 million or more, 
or adversely affect a sector of the economy, productivity, competition, 
jobs, the environment, public health or safety, or State, local, or 
tribal governments or communities in a material way (also referred to 
as an ``economically significant'' rule);
    (2) Create serious inconsistency or otherwise interfere with an 
action taken or planned by another agency;
    (3) Materially alter the budgetary impacts of entitlement grants, 
user fees, or loan programs or the rights and obligations of recipients 
thereof; or
    (4) Raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles stated in the 
E.O.
    This proposed regulatory action is not a significant regulatory 
action subject to review by OMB under section 3(f) of E.O. 12866.
    We have also reviewed this regulatory action under E.O. 13563, 
which supplements and explicitly reaffirms the principles, structures, 
and definitions governing regulatory review established in E.O. 12866. 
To the extent permitted by law, E.O. 13563 requires that an agency--
    (1) Propose or adopt regulations only upon a reasoned determination 
that their benefits justify their costs (recognizing that some benefits 
and costs are difficult to quantify);
    (2) Tailor its regulations to impose the least burden on society, 
consistent with obtaining regulatory objectives and taking into 
account--among other things and to the extent practicable--the costs of 
cumulative regulations;
    (3) In choosing among alternative regulatory approaches, select 
those approaches that maximize net benefits (including potential 
economic, environmental, public health and safety, and other 
advantages; distributive impacts; and equity);
    (4) To the extent feasible, specify performance objectives, rather 
than the behavior or manner of compliance a regulated entity must 
adopt; and
    (5) Identify and assess available alternatives to direct 
regulation, including economic incentives--such as user fees or 
marketable permits--to encourage the desired behavior, or provide 
information that enables the public to make choices.
    E.O. 13563 also requires an agency ``to use the best available 
techniques to quantify anticipated present and future benefits and 
costs as accurately as possible.'' The Office of Information and 
Regulatory Affairs of OMB has emphasized that these techniques may 
include ``identifying changing future compliance costs that might 
result from technological innovation or anticipated behavioral 
changes.''
    We are issuing this proposed priority only upon a reasoned 
determination that its benefits would justify its costs. In choosing 
among alternative regulatory approaches, we selected those approaches 
that would maximize net benefits. Based on the analysis that follows, 
the Department believes that this proposed priority is consistent with 
the principles in E.O. 13563.
    We also have determined that this regulatory action would not 
unduly interfere with State, local, and tribal governments in the 
exercise of their governmental functions.
    In accordance with both Executive Orders, the Department has 
assessed the potential costs and benefits, both quantitative and 
qualitative, of this regulatory action. The potential costs are those 
resulting from statutory requirements and those we have determined as 
necessary for administering the Department's programs and activities.
    The benefits of the Disability and Rehabilitation Research Projects 
and Centers Program have been well established over the years. Projects 
similar to one envisioned by the proposed priority have been completed 
successfully, and the proposed priority would generate new knowledge 
through research. The new RRTC would generate, disseminate, and promote 
the use of new information that would improve outcomes for individuals 
with disabilities in the area of home and community based services.
    Intergovernmental Review: This program is not subject to E.O. 
12372.
    Electronic Access to This Document: 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 via the Federal Digital System 
at: www.gpo.gov/fdsys. At this site you can view this document, as well 
as all other documents of this Department published in the Federal 
Register, in text or Adobe Portable Document Format (PDF). To use PDF 
you must have Adobe Acrobat Reader, which is available free at the 
site.
    You may also access documents of the Department published in the 
Federal Register by using the article search feature at: 
www.federalregister.gov. Specifically, through the advanced search 
feature at this site, you can limit your search to documents published 
by the Department.

    Dated: March 11, 2015.
Kathy Greenlee,
Administrator.
[FR Doc. 2015-05989 Filed 3-13-15; 8:45 am]
 BILLING CODE 4154-01-P