[Federal Register Volume 78, Number 29 (Tuesday, February 12, 2013)]
[Proposed Rules]
[Pages 9869-9876]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-03203]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF EDUCATION
34 CFR Chapter III
[CFDA Numbers: 84.133B-3, 84.133B-4, 84.133B-5, and 84.133B-6.]
Proposed Priorities--National Institute on Disability and
Rehabilitation Research--Rehabilitation Research and Training Centers
AGENCY: Office of Special Education and Rehabilitative Services,
Department of Education.
ACTION: Proposed priorities.
-----------------------------------------------------------------------
SUMMARY: The Assistant Secretary for Special Education and
Rehabilitative Services proposes four priorities for the Rehabilitation
Research and Training Center (RRTC) Program administered by the
National Institute on Disability and Rehabilitation Research (NIDRR).
Specifically, this notice proposes a priority for an RRTC on Community
Living and Participation for Individuals with Physical Disabilities
(priority 1), RRTC on Employment of Individuals with Physical
Disabilities (priority 2), RRTC on Health and Function of Individuals
with Intellectual and Developmental Disabilities (priority 3), and RRTC
on Community Living and Participation for Individuals with Intellectual
and Developmental Disabilities (priority 4). The Assistant Secretary
may use one or more of these priorities for competitions in fiscal year
(FY) 2013 and later years. We take this action to focus research
attention on areas of national need. We intend the priorities to
contribute to improved outcomes in these areas for individuals with
disabilities.
DATES: We must receive your comments on or before March 14, 2013.
ADDRESSES: Address all comments about this notice to Marlene Spencer,
U.S. Department of Education, 400 Maryland Avenue SW., room 5133,
Potomac Center Plaza (PCP), Washington, DC 20202-2700.
If you prefer to send your comments by email, use the following
address: marlene.spencer@ed.gov. You must include the phrase ``Proposed
Priorities for Combined RRTC Notice'' in the subject line of your
electronic message.
FOR FURTHER INFORMATION CONTACT: Marlene Spencer. Telephone: (202) 245-
[[Page 9870]]
7532 or by email: marlene.spencer@ed.gov.
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 priorities is in
concert with NIDRR's currently approved Long-Range Plan (Plan). The
Plan, which was published in the Federal Register on February 15, 2006
(71 FR 8165), can be accessed on the Internet at the following site:
www.ed.gov/about/offices/list/osers/nidrr/policy.html.
Through the implementation of the Plan, NIDRR seeks to: (1) Improve
the quality and utility of disability and rehabilitation research; (2)
foster an exchange of expertise, information, and training methods to
facilitate the advancement of knowledge and understanding of the unique
needs of traditionally underserved populations; (3) determine best
strategies and programs to improve rehabilitation outcomes for
underserved populations; (4) identify research gaps; (5) identify
mechanisms for integrating research and practice; and (6) disseminate
findings.
This notice proposes four priorities each of which NIDRR intends to
use for one or more competitions in FY 2013 and possibly later years.
However, nothing precludes NIDRR from publishing additional priorities,
if needed. Furthermore, NIDRR is under no obligation to make an award
using these priorities. The decision to make an award will be based on
the quality of applications received and available funding.
Invitation To Comment: We invite you to submit comments regarding
this notice. To ensure that your comments have maximum effect in
developing the notice of final priorities, we urge you to identify
clearly the specific topic that each comment addresses.
We invite you to assist us in complying with the specific
requirements of Executive Orders 12866 and 13563 and their overall
requirement of reducing regulatory burden that might result from these
proposed priorities. 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 about these proposed priorities in room 5133, 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 advanced research, training,
technical assistance, and dissemination activities in general problem
areas, as specified by NIDRR. These activities are designed to benefit
rehabilitation service providers, individuals with disabilities, and
the family members or other authorized representatives of individuals
with disabilities. Additional information on the RRTC program can be
found at: www.ed.gov/rschstat/research/pubs/res-program.html#RRTC.
Program Authority: 29 U.S.C. 762(g) and 764(b)(2).
Applicable Program Regulations: 34 CFR part 350.
Proposed Priorities:
Background:
This notice contains four proposed priorities. Each priority
reflects a major area or domain of NIDRR's research agenda (community
living and participation, health and function, and employment),
combined with a specific broad disability population (physical
disability or intellectual and developmental disability).
Definitions:
The research that is proposed under these priorities 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 progresses from one stage to another, those research
stages must be clearly specified. For purposes of these priorities, the
stages of research, which we published for comment on January 25, 2013,
are:
(i) 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.
(ii) 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 intervention
study. Results from this stage of research may be used to inform the
design of a study to test the efficacy of an intervention.
(iii) 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
[[Page 9871]]
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.
(iv) 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.
The project 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 1--RRTC on Community Living and Participation for
Individuals with Physical Disabilities.
NIDRR seeks to fund an RRTC that will generate new knowledge about
community living and participation for individuals with physical
disabilities and will serve as a national resource center for
individuals with physical disabilities and their families.
Of the 51.5 million American adults with a disability, 41.5 million
have disabilities in the physical domain (Brault, 2012). Despite the
U.S. Supreme Court's Olmstead decision, 527 U.S. 581 (1999), which
required States to provide services ``in the most integrated setting
appropriate to the needs of qualified individuals with disabilities,''
id. at 607, people with physical disabilities continue to encounter
significant barriers to living in the community and participating in
activities of their choice. These barriers contribute to economic
disadvantage and social isolation (Reinhard et al., 2011). Barriers to
community living and participation for people with physical
disabilities manifest themselves at both the individual and
environmental level. They include limited access to: Home and
community-based long-term services and supports, such as personal
assistance and family caregiving, assistive technologies and devices
and environmental modifications, medication management, and information
and referral. The barriers also include lack of access to affordable
and accessible housing and insufficient transportation services
(Reinhard et al., 2011).
In 2010, 8.09 million adults (3.66 million working-age adults ages
18 to 64 and 4.43 million adults 65 years and over) were estimated to
need personal assistance from a family member, friend, or paid helper
in order to live in the community due to difficulties in performing
basic activities of daily living (ADL), such as bathing, dressing,
toileting, and getting around in one's home (Center for Personal
Assistance Services, 2012). By 2030, the number of adults projected to
need personal assistance with ADLs is estimated to increase by as much
as 50 percent (Center for Personal Assistance Services, 2012). While
studies show that the home is the setting of choice for the vast
majority of people with physical disabilities and older adults who need
assistance with daily activities (Salomon, 2010), there is a growing
disparity between the demand for and supply of caregivers who are
available and trained to provide these services (PHI, 2008).
References:
Brault, M. W. (2012). Americans with Disabilities: 2010.
Washington, DC: Department of Commerce, Economics and Statistics
Administration, U.S. Census Bureau.
PHI. (2008). Occupational projections for direct-care workers 2006-
2016, Facts 1. Bronx, NY: PHI (formerly the Paraprofessional Healthcare
Institute). Available from: www.directcareclearinghouse.org/download/BLSfactSheet4-10-08.pdf.
Reinhard, S. C., Kassner, E., Houser, A., and Mollica, R.
(September 2011). Raising expectations: A State scorecard on long-term
services and supports for older adults, people with physical
disabilities, and family caregivers. The AARP Foundation: Washington,
DC. Available from: http://assets.aarp.org/rgcenter/ppi/ltc/ltss_scorecard.pdf.
Salomon, E. (March 2010). AARP Public Policy Institute: Housing
policy solutions to support aging in place. Fact Sheet 172. Washington,
DC: ARRP Center for Housing Policy. Available from: http://assets.aarp.org/rgcenter/ppi/liv-com/fs172-aging-in-place.pdf.
Center for Personal Assistance Services (2012). Projections for the
Population Needing Personal Assistance, 2015-2030, U.S. Available from:
www.pascenter.org/state_based_stats/disability_stats/adl_projections.php?state=us.
Proposed Priority:
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for an RRTC on Community Living and
Participation for Individuals with Physical Disabilities.
The RRTC must contribute to maximizing the community living and
participation outcomes of individuals with physical disabilities by:
(a) Conducting research activities in one or more of the following
priority areas, focusing on individuals with physical disabilities as a
group or on individuals in specific disability or demographic
subpopulations of individuals with physical disabilities:
(i) Technology to improve community living and participation
outcomes for individuals with physical disabilities.
(ii) Individual and environmental factors associated with improved
community living and participation outcomes for individuals with
physical disabilities.
(iii) Interventions that contribute to improved community living
and participation outcomes for individuals with physical disabilities.
Interventions include any strategy, practice, program, policy, or tool
that, when implemented as intended, contributes to improvements in
outcomes for individuals with physical disabilities.
(iv) Effects of government practices, policies, and programs on
community living and participation outcomes for individuals with
physical disabilities.
(v) Practices and policies that contribute to improved community
living and participation outcomes for transition-aged youth with
physical disabilities.
(b) Focusing its research on one or more specific stages of
research. If the RRTC is to conduct research that can be categorized
under more than one of the research stages, or research that progresses
from one stage to another, those stages must be clearly specified.
These stages and their definitions are provided at the beginning of the
Proposed Priorities section in this notice.
(c) Serving as a national resource center related to community
living and participation for individuals with physical disabilities,
their families, and other stakeholders by conducting knowledge
translation activities that include, but are not limited to:
(i) Providing information and technical assistance to service
providers, individuals with physical disabilities and their
representatives, and other key stakeholders:
(ii) Providing training, including graduate, pre-service, and in-
service training, to rehabilitation providers and other disability
service providers, to facilitate more effective delivery of services to
individuals with physical disabilities. This training may be provided
through conferences, workshops, public education programs,
[[Page 9872]]
in-service training programs, and similar activities:
(iii) Disseminating research-based information and materials
related to community living and participation for individuals with
physical disabilities; and
(iv) Involving key stakeholder groups in the activities conducted
under paragraph (a) in order to maximize the relevance and usability of
the new knowledge generated by the RRTC.
Proposed Priority 2--RRTC on Employment of Individuals with
Physical Disabilities.
Background:
NIDRR seeks to fund an RRTC that will generate new knowledge about
employment outcomes for individuals with physical disabilities and will
serve as a national resource center for individuals with physical
disabilities and their families. Despite the enactment of legislation
and the implementation of a variety of policy and program efforts at
the Federal and State levels to improve employment outcomes for
individuals with disabilities, the employment rate for individuals with
disabilities remains substantially lower than the rate for those
without disabilities.
Of the 51.5 million American adults with a disability, 41.5 million
have disabilities in the physical domain (Brault, 2012). Recent data
from the Survey of Income and Program Participation revealed that 40.8
percent of individuals with only physical disabilities were employed,
compared to 79.1 percent of individuals without a disability (Brault,
2012). Not only were people with physical disabilities much less likely
to be employed, their median earnings were $1,998 per month as compared
to $2,724 per month earned by people without a disability (Brault,
2012).
Previous research has demonstrated the importance of a variety of
factors relevant to hiring, job retention, and advancement for
individuals with physical disabilities. These include, but are not
limited to, (1) individual factors such as disability characteristics,
education, and age (Ottomanelli & Lind, 2009); (2) employer practices
and organizational culture, including diversity management practices
and the provision of accommodations such as assistive technology and
personal assistance services (Chan et al., 2010; Colella &
Bruy[egrave]re, 2011; Nafukho et al., 2010; Ottomanelli & Lind, 2009;
Stumbo et al., 2009); (3) government policies and programs, such as
transportation systems, benefit programs, and the Americans with
Disabilities Act (Colella & Bruy[egrave]re, 2011; Ottomanelli & Lind,
2009); (4) programs for individuals in transition from school to work
(Test et al., 2009); and (5) the effectiveness of vocational
rehabilitation and other employment support practices (Marini et al.,
2008; Ottomanelli & Lind, 2009).
References:
Brault, M. W. (2012). Americans with Disabilities: 2010. Household
economic studies. U.S. Census Bureau. Available from: www.census.gov/prod/2012pubs/p70-131.pdf.
Chan, F., Strauser, D., Maher, P., Lee, E-J., Jones, R., and
Johnson, E. T. (2010). Demand-side factors related to employment of
people with disabilities: A survey of employers in the Midwest region
of the United States. Journal of Occupational Rehabilitation, 20, 412-
419.
Colella, A., and Bruy[egrave]re, S. (2011). Disability and
employment: New directions for industrial/organizational psychology. In
American Psychological Association Handbook on Industrial
Organizational Psychology, vol. 1, 473-503. Washington, DC: American
Psychological Association.
Marini, I., Lee, G. K., Chan, F., Chapin, M. H., and Romero, M. G.
(2008). Vocational rehabilitation service patterns related to
successful competitive employment outcomes of persons with spinal cord
injury. Journal of Vocational Rehabilitation, 28, 1-13.
Nafukho, F. M., Roessler, R. T., and Kacirek, K. (2010). Disability
as a diversity factor: Implications for human resource practices.
Advances in Developing Human Resources, 12, 395-406.
Ottomanelli, L., and Lind, L. (2009). Review of critical factors
related to employment after spinal cord injury: Implications for
research and vocational services. Journal of Spinal Cord Medicine, 32,
503-531.
Stumbo, N. J., Martin, J. K., and Hedric, B. N. (2009). Assistive
technology: Impact on education, employment and independence of
individuals with physical disabilities. Journal of Vocational
Rehabilitation, 30, 99-110.
Test, D. W., Mazzotti, V. L., Mustian, A. L., Fowler, C. H.,
Kortering, L., and Kohler, P. (2009). Evidence-based secondary
transition predictors for improving postschool outcomes for students
with disabilities. Career Development for Exceptional Individuals, 32l,
160-181.
Proposed Priority:
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for an RRTC on Employment of Individuals
with Physical Disabilities.
The RRTC must contribute to maximizing the employment outcomes of
individuals with physical disabilities by:
(a) Conducting research activities in one or more of the following
priority areas, focusing on individuals with physical disabilities as a
group or on individuals in specific disability or demographic
subpopulations of individuals with physical disabilities:
(i) Technology to improve employment outcomes for individuals with
physical disabilities.
(ii) Individual and environmental factors associated with improved
employment outcomes for individuals with physical disabilities.
(iii) Interventions that contribute to improved employment outcomes
for individuals with physical disabilities. Interventions include any
strategy, practice, program, policy, or tool that, when implemented as
intended, contributes to improvements in outcomes for individuals with
physical disabilities.
(iv) Effects of government practices, policies and programs on
employment outcomes for individuals with physical disabilities.
(v) Practices and policies that contribute to improved employment
outcomes for transition-aged youth with physical disabilities.
(vi) Vocational rehabilitation (VR) practices that contribute to
improved employment outcomes for individuals with physical
disabilities.
(b) Focusing its research on one or more specific stages of
research. If the RRTC is to conduct research that can be categorized
under more than one of the research stages, or research that progresses
from one stage to another, those stages must be clearly specified.
These stages and their definitions are provided at the beginning of the
Proposed Priorities section in this notice.
(c) Serving as a national resource center related to employment for
individuals with physical disabilities, their families, and other
stakeholders by conducting knowledge translation activities that
include, but are not limited to:
(i) Providing information and technical assistance to service
providers, individuals with physical disabilities and their
representatives, and other key stakeholders.
(ii) Providing training, including graduate, pre-service, and in-
service training, to rehabilitation providers and other disability
service providers, to facilitate more effective delivery of employment
services and supports to individuals with physical disabilities.
[[Page 9873]]
This training may be provided through conferences, workshops, public
education programs, in-service training programs, and similar
activities.
(iii) Disseminating research-based information and materials
related to employment for individuals with physical disabilities.
(iv) Involving key stakeholder groups in the activities conducted
under paragraph (a) in order to maximize the relevance and usability of
the new knowledge generated by the RRTC.
Proposed Priority 3--RRTC on Health and Function of Individuals
with Intellectual and Developmental Disabilities.
Background:
NIDRR seeks to fund an RRTC that will generate new knowledge about
health and function outcomes for persons with intellectual and
developmental disabilities across the lifespan and will serve as a
national resource center for persons with intellectual and
developmental disabilities and their families. Intellectual and
developmental disabilities are defined by limitations in adaptive
functioning associated with intellectual or physical impairments first
evident in childhood (Schalock et al., 2010; Developmental Disabilities
Assistance and Bill of Rights Act of 2000). It has been estimated that
about 1.6 percent of the U.S. population (about 5 million people) has
intellectual and developmental disabilities (Larson et al., 2001).
Findings from research on the health of persons with intellectual
and developmental disabilities in this country indicate substantially
higher than normal rates of (1) complex health conditions; (2) poorly
managed chronic conditions, such as diabetes, heart disease, sensory
impairments, or epilepsy; (3) health problems and use of psychotropic
medications; (4) limited access to and use of quality preventive health
care and health promotion programs; and (5) early onset of conditions
and impairments such as Alzheimer's disease among persons with Down
syndrome (Horwitz et al., 2000; Krahn et al., 2006; National Task Group
on Intellectual Disabilities and Dementia Practice, 2012).
While the health of the general population is routinely monitored
through national surveys, the health of individuals with intellectual
and developmental disabilities is not. As a result, significant health
problems among the population may remain largely undetected (U.S.
Department of Health and Human Services, 2002; Centers for Disease
Control and Prevention, 2009). At the same time, it is clear that
persons with intellectual and developmental disabilities have poorer
health and function outcomes than the general population; have costs of
health and related care that are disproportionately higher than for
persons without intellectual and developmental disabilities; have
insufficient access to and use of preventive health services; and have
lifestyle and risk factors that are associated with poor health
outcomes and premature mortality (Kaiser Commission on Medicaid and the
Uninsured, 2006, 2011; Bershadsky et al., 2012; Krahn et al., 2006;
Stancliffe et al., 2011; U.S. Department of Health and Human Services,
2002).
References:
Bershadsky, J., Taub, S., Engler, J., Moseley, C., Lakin, K. C,
Stancliffe, R., Larson, S., Ticha, R., Bailey, C., and Bradley, V.
(2012). Place of residence and preventive health care for intellectual
and developmental disabilities services recipients in 20 states. Public
Health Reports, 127(5), 475-485.
Centers for Disease Control and Prevention. (2009). U.S.
Surveillance of Health of People with Intellectual Disabilities. A
White Paper. Available from: www.cdc.gov/ncbddd/disabilityandhealth/pdf/209537-A_IDmeeting%20short%20version12-14-09.pdf.
Developmental Disabilities Assistance and Bill of Rights Act of
2000 (Pub. L. 106-402).
Horwitz, S., Kerker, B., Owens, P., and Zigler, E. (2000). The
health status and needs of individuals with mental retardation. New
Haven: Yale University.
Kaiser Commission on Medicaid and the Uninsured. (2006). Profiles
of Medicaid's high cost populations. Menlo Park, CA: Kaiser Family
Foundation. Available from: www.kff.org/medicaid/upload/7565.pdf.
Kaiser Commission on Medicaid and the Uninsured. (2011). Medicaid
home and community-based service programs: Data update. Menlo Park, CA:
Kaiser Family Foundation. Available from: www.kff.org/medicaid/upload/7720-04.pdf
Krahn, G. L., Hammond, L., and Turner, A. (2006). A cascade of
disparities: Health and health care access for people with intellectual
disabilities. Mental Retardation and Developmental Disabilities
Research Reviews, 12, 22-27.
Larson, S. A., Lakin, K. C., Anderson, L., Lee, N. K., Lee, J. K.,
and Anderson, D. (2001). Prevalence of mental retardation and
developmental disabilities: Estimates from the 1994/1995 National
Health Interview Survey Disability Supplements. American Journal on
Mental Retardation, 106(3), 231-252.
National Task Group on Intellectual Disabilities and Dementia
Practice. (2012). ``My thinker's not working'': A national strategy for
enabling adults with intellectual disabilities affected by dementia to
remain in their community and receive quality supports. Available from:
www.aadmd.org/ntg/thinker.
Schalock, R. L., Borthwick-Duffy, S. A., Bradley, V. J., Buntinx,
W. H. E., Coulter, D. L., Craig, E. M., Gomez, S. C., Lachapelle, Y.,
Luckasson, R., Reeve, A., Shogren, K. A., Snell, M. E., Spreat, S.,
Tasse, M. J., Thompson, J. R., Verdugo-Alonso, M. A., Wehmeyer, M. L.,
and Yeager, M. H. (2010). Intellectual disability: Definition,
classification, and systems of supports (11th ed.). Washington, DC:
American Association on Intellectual and Developmental Disabilities.
Stancliffe, R., Lakin, K. C., Larson, S., Taub, S., Engler, J.,
Bershadsky, J., and Fortune, J., (2011). Overweight and obesity among
adults with intellectual disabilities who use intellectual disability/
developmental disability services in 20 U.S. States. American Journal
on Intellectual and Developmental Disabilities, 116(6), 401-418.
U.S. Department of Health and Human Services. (2002). Closing the
gap: A national blueprint to improve the health of persons with mental
retardation. Report of the Surgeon General's Conference on Health
Disparities and Mental Retardation. Washington, DC: U.S. Department of
Health and Human Services, Office of the Surgeon General.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for an RRTC on Health and Function of
Individuals with Intellectual and Developmental Disabilities.
The RRTC must contribute to maximizing the health and function
outcomes of individuals with intellectual and/or developmental
disabilities by:
(a) Conducting research activities in one or more of the following
priority areas, focusing on individuals with intellectual and
developmental disabilities as a group or on individuals in specific
disability or demographic subpopulations of individuals with
intellectual and developmental disabilities:
(i) Technology to improve health and function outcomes for
individuals with
[[Page 9874]]
intellectual and developmental disabilities.
(ii) Individual and environmental factors associated with improved
access to rehabilitation and health care and improved health and
function outcomes for individuals with intellectual and developmental
disabilities.
(iii) Interventions that contribute to improved health and function
outcomes for individuals with intellectual and developmental
disabilities. Interventions include any strategy, practice, program,
policy, or tool that, when implemented as intended, contributes to
improvements in outcomes for the specified population.
(iv) Effects of government practices, policies and programs on
health care access and on health and function outcomes for individuals
with intellectual and developmental disabilities.
(v) Practices and policies that contribute to improved health and
function outcomes for transition-aged youth with intellectual and
developmental disabilities.
(b) Focusing its research on one or more specific stages of
research. If the RRTC is to conduct research that can be categorized
under more than one of the research stages, or research that progresses
from one stage to another, those stages must be clearly specified.
These stages and their definitions are provided at the beginning of the
Proposed Priorities section in this notice.
(c) Serving as a national resource center related to health and
function for individuals with intellectual and developmental
disabilities, their families, and other stakeholders by conducting
knowledge translation activities that include, but are not limited to:
(i) Providing information and technical assistance to service
providers, individuals with intellectual and developmental disabilities
and their representatives, and other key stakeholders.
(ii) Providing training, including graduate, pre-service, and in-
service training, to rehabilitation providers and other disability
service providers, to facilitate more effective delivery of services to
individuals with intellectual and developmental disabilities. This
training may be provided through conferences, workshops, public
education programs, in-service training programs, and similar
activities.
(iii) Disseminating research-based information and materials
related to health and function for individuals with intellectual and
developmental disabilities.
(iv) Involving key stakeholder groups in the activities conducted
under paragraph (a) in order to maximize the relevance and usability of
the new knowledge generated by the RRTC.
Proposed Priority 4--RRTC on Community Living and Participation for
Individuals with Intellectual and Developmental Disabilities.
Background:
NIDRR seeks to fund an RRTC that will generate new knowledge about
community living and participation outcomes for individuals with
intellectual and developmental disabilities and will serve as a
national resource center on community living and participation for
individuals with intellectual and developmental disabilities and their
families. Intellectual and developmental disabilities are defined by
limitations in adaptive functioning associated with substantial
intellectual or physical impairments first evident in childhood
(Schalock et al., 2010; Developmental Disabilities Assistance and Bill
of Rights Act of 2000. It has been estimated that about 1.6 percent of
the U.S. population (about 5 million people) has intellectual and
developmental disabilities (Larson et al., 2001).
There have been significant changes in the nature of services
provided to individuals with intellectual and developmental disability
over the last four decades. Since the late 1960s, public institution
placements of individuals with intellectual and developmental
disabilities have decreased by more than 85 percent (Larson et al.,
2012). Individuals with intellectual and developmental disabilities
currently receive a wide range of community services. These include
personal care and other residential support; physical, occupational,
speech, and other therapies; vocational rehabilitation and other
employment supports; and respite care and other assistance to family
caregivers. These services are financed primarily through various
Medicaid programs, including Medicaid Home and Community Based
Services. Demand for these services outweighs supply. There are long
waiting lists, estimated to include 120,000 to 300,000 persons
nationally, depending on the definition of ``persons waiting'' (Larson
et al., 2012; Kaiser Family Foundation, 2009). In the past decade, most
of the growth in service recipients has come from persons living with
family members (Larson et al., 2012).
Research on outcomes for persons receiving community-based
supports, while consistently showing better outcomes than for persons
receiving institutional care (Stancliffe & Lakin, 2005), shows that
persons with intellectual and developmental disabilities receiving
community-based supports have less choice, less participation, fewer
relationships, and more loneliness than persons who do not have
intellectual and developmental disabilities (Stancliffe et al., 2007;
McVilly et al., 2006). Another major challenge relates to providing
appropriate support of all kinds, including ensuring availability of
well-trained direct support workers, for the steadily growing number of
individuals with intellectual and developmental disabilities who
continue to live with family members into adulthood.
References:
Developmental Disabilities Assistance and Bill of Rights Act of
2000 (Pub. L. 106-402).
Kaiser Family Foundation. (2009). Medicaid home and community-based
services: Data update. Washington, DC: Kaiser Commission on Medicaid
and the Uninsured.
Larson, S.A., Lakin, K.C., Anderson, L., Lee, N.K., Lee, J.K., and
Anderson, D. (2001). Prevalence of mental retardation and developmental
disabilities: Estimates from the 1994/1995 National Health Interview
Survey Disability Supplements. American Journal on Mental Retardation,
106(3), 231-252.
Larson, S.A., Ryan, A., Salmi, P., Smith, D., and Wuorio, A.
(2012). Residential service for persons with developmental
disabilities: Status and trends through 2010. Minneapolis: University
of Minnesota, Research and Training Center on Community Living.
McVilly, K.R., Stancliffe, R.J., Parmenter, T.R., and Burton-Smith,
R.M. (2006). ``I get by with a little help from my friends'': Adults
with intellectual disability discuss loneliness. Journal of Applied
Research in Intellectual Disabilities, 19(2), 191-203.
Schalock, R.L., Borthwick-Duffy, S.A., Bradley, V.J., Buntinx,
W.H.E., Coulter, D.L., Craig, E.M., Gomez, S.C., Lachapelle, Y.,
Luckasson, R., Reeve, A., Shogren, K.A., Snell, M.E., Spreat, S.,
Tasse, M.J., Thompson, J.R., Verdugo-Alonso, M.A., Wehmeyer, M.L., and
Yeager, M.H. (2010). Intellectual disability: Definition,
classification, and systems of supports (11th ed.). Washington, DC:
American Association on Intellectual and Developmental Disabilities.
Stancliffe, R.J., and Lakin, C.K. (2005). Costs and outcomes of
community services for people with intellectual disabilities.
Baltimore, MD: Paul H. Brookes Publishing.
[[Page 9875]]
Stancliffe, R.J., Lakin, C.K., Doljanac, R., Byun, S.Y., Taub, S.,
Chiri, G., and Ferguson, P. (2007). Loneliness and living arrangements.
Intellectual and Developmental Disabilities, 45(6), 380-390.
Proposed Priority:
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for an RRTC on Community Living and
Participation for Individuals with Intellectual and Developmental
Disabilities.
The RRTC must contribute to improving the community living and
participation outcomes of individuals with intellectual and
developmental disabilities by:
(a) Conducting research activities in one or more of the following
priority areas, focusing on individuals with intellectual and
developmental disabilities as a group or on individuals in specific
disability or demographic subpopulations of individuals with
intellectual and developmental disabilities:
(i) Technology to improve community living and participation
outcomes for individuals with intellectual and developmental
disabilities.
(ii) Individual and environmental factors associated with improved
community living and participation outcomes for individuals with
intellectual and developmental disabilities.
(iii) Interventions that contribute to improved community living
and participation outcomes for individuals with intellectual and
developmental disabilities. Interventions include any strategy,
practice, program, policy, or tool that, when implemented as intended,
contributes to improvements in outcomes for individuals with
disabilities.
(iv) Effects of government practices, policies and programs on
community living and participation outcomes for individuals with
intellectual and developmental disabilities.
(v) Practices and policies that contribute to improved community
living and participation outcomes for transition-aged youth with
intellectual and developmental disabilities.
(b) Focusing its research on one or more specific stages of
research. If the RRTC is to conduct research that can be categorized
under more than one of the research stages, or research that progresses
from one stage to another, those stages must be clearly specified.
These stages and their definitions are provided at the beginning of the
Proposed Priorities section in this notice.
(c) Serving as a national resource center related to community
living and participation for individuals with intellectual and
developmental disabilities, their families, and other stakeholders by
conducting knowledge translation activities that include, but are not
limited to:
(i) Providing information and technical assistance to service
providers, individuals with intellectual and developmental disabilities
and their representatives, and other key stakeholders.
(ii) Providing training, including graduate, pre-service, and in-
service training, to rehabilitation providers and other disability
service providers, to facilitate more effective delivery of services to
individuals with intellectual and developmental disabilities. This
training may be provided through conferences, workshops, public
education programs, in-service training programs, and similar
activities.
(iii) Disseminating research-based information and materials
related to community living and participation for individuals with
intellectual and developmental disabilities.
(iv) Involving key stakeholder groups in the activities conducted
under paragraph (a) in order to maximize the relevance and usability of
the new knowledge generated by the RRTC.
Types of Priorities:
When inviting applications for a competition using one or more
priorities, we designate the type of each priority as absolute,
competitive preference, or invitational through a notice in the Federal
Register. The effect of each type of priority follows:
Absolute priority: Under an absolute priority, we consider only
applications that meet the priority (34 CFR 75.105(c)(3)).
Competitive preference priority: Under a competitive preference
priority, we give competitive preference to an application by (1)
awarding additional points, depending on the extent to which the
application meets the priority (34 CFR 75.105(c)(2)(i)); or (2)
selecting an application that meets the priority over an application of
comparable merit that does not meet the priority (34 CFR
75.105(c)(2)(ii)).
Invitational priority: Under an invitational priority, we are
particularly interested in applications that meet the priority.
However, we do not give an application that meets the priority a
preference over other applications (34 CFR 75.105(c)(1)).
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.
Executive Orders 12866 and 13563
Regulatory Impact Analysis
Under Executive Order 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 Executive Order
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
Executive order.
This proposed regulatory action is not a significant regulatory
action subject to review by OMB under section 3(f) of Executive Order
12866.
We have also reviewed this regulatory action under Executive Order
13563, which supplements and explicitly reaffirms the principles,
structures, and definitions governing regulatory review established in
Executive Order 12866. To the extent permitted by law, Executive Order
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;
[[Page 9876]]
(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.
Executive Order 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 these proposed priorities only upon a reasoned
determination that their benefits would justify their 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 these proposed priorities are
consistent with the principles in Executive Order 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 the RRTCs have been completed successfully, and the proposed
priorities will generate new knowledge through research. The new RRTCs
will generate, disseminate, and promote the use of new information that
would improve outcomes for individuals with disabilities in the areas
of community living and participation, employment, and health and
function.
Intergovernmental Review: This program is not subject to Executive
Order 12372 and the regulations in 34 CFR part 79.
Accessible Format: Individuals with disabilities can obtain this
document in an accessible format (e.g., braille, large print,
audiotape, or compact disc) by contacting the Grants and Contracts
Services Team, U.S. Department of Education, 400 Maryland Avenue SW.,
room 5075, PCP, Washington, DC 20202-2550. Telephone: (202) 245-7363.
If you use a TDD or TTY, call the FRS, toll free, at 1-800-877-8339.
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: February 7, 2013.
Michael Yudin,
Acting Assistant Secretary for Special Education and Rehabilitative
Services.
[FR Doc. 2013-03203 Filed 2-11-13; 8:45 am]
BILLING CODE 4000-01-P