8130 Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices

DEPARTMENT OF EDUCATION

National Institute on Disability and

Rehabilitation Research

AGENCY: Department of Education.

ACTION: Notice of Final Funding

Priorities for Fiscal Years 1997–1998 for

a Research and Demonstration Project

and Rehabilitation Research and

Training Centers.

SUMMARY: The Secretary announces final

funding priorities for the Research and

Demonstration Project (R&D) Program

and the Rehabilitation Research and

Training Center (RRTC) Program under

the National Institute on Disability and

Rehabilitation Research (NIDRR) for

fiscal years 1997–1998. The Secretary

takes this action to focus research

attention on areas of national need

consistent with NIDRR’s long-range

planning process, to improve

rehabilitation services and outcomes for

individuals with disabilities, and to

assist in the solutions to problems

encountered by individuals with

disabilities in their daily activities.

EFFECTIVE DATE: These priorities take

effect on March 24, 1997.

FOR FURTHER INFORMATION CONTACT:

David Esquith. Telephone: (202) 205–

8801. Individuals who use a

telecommunications device for the deaf

(TDD) may call the TDD number at (202)

205–8133. Internet:

DavidlEsquith@ed.gov.

SUPPLEMENTARY INFORMATION: This

notice contains final priorities to

establish one R&D project for research

on improving employment practices

covered by Title I of the Americans with

Disabilities Act (ADA), and two RRTCs

for research related to personal

assistance services (PAS) and

employment for persons with long-term

mental illness (LTMI).

NIDRR is in the process of developing

a revised long-range plan. The final

priorities in this notice are consistent

with the long-range planning process.

These final priorities support the

National Education Goal that calls for

all Americans to possess the knowledge

and skills necessary to compete in a

global economy and exercise the rights

and responsibilities of citizenship.

Note: This notice of final priorities does

not solicit applications. A notice inviting

applications under these competitions is

published in a separate notice in this issue

of the Federal Register.

Analysis of Comments and Changes

On October 31, 1996, the Secretary

published a notice of proposed

priorities in the Federal Register (61 FR

56374–56379). The Department of

Education received 9 letters

commenting on the notice of proposed

priorities by the deadline date. Two

additional comments were received

after the deadline date and were not

considered in this response. Technical

and other minor changes—and

suggested changes the Secretary is not

legally authorized to make under

statutory authority—are not addressed.

Research and Demonstration Projects

Program

Priority: Improving Employment

Practices Covered by Title I of the

Americans With Disabilities Act

Comment: One commenter

recommended that the grantee should

research the practices and procedures

businesses have used to create a diverse

work force and the attitudinal factors

that affect hiring and employment

decisions regarding persons with

disabilities.

Discussion: The Secretary believes

that research on the practices and

procedures business have used to create

a diverse work is an important, but

overly broad, topic that addresses issues

unrelated to those involving persons

with disabilities. As indicated in the

background to the priority, the Secretary

believes that a sufficent body of

attitudinal research exists, including

attitudinal research on the factors that

affect hiring and employment decisions

regarding persons with disabilities. The

Secretary does not believe that any

further attitudinal research is necessary

at this time.

Changes: None.

Comment: One commenter

recommended that the research team

include people with an established

credibility with the corporate

community.

Discussion: The Secretary believes

that the grantee’s ability to gain the

confidence and cooperation of private

sector entities with responsibilities

under Title I of the ADA is essential to

the success of the project. The

composition of the research team and

the qualifications of key personnel are

evaluated in the peer review process

using the applicable selection criteria.

The Secretary does not believe any

further personnel requirements are

necessary.

Changes: None.

Comment: One commenter

recommended that NIDRR suggest

collaborations that would enhance the

effectiveness of the interventions that

the project will develop to address

challenging employment practices.

Discussion: The Secretary believes

that applicants should have complete

discretion to select the participants in

any collaborative effort that is proposed.

The Secretary does not believe that

NIDRR should influence this decision

by making suggestions.

Changes: None.

Rehabilitation Research and Training

Centers (RRTCs)

Priority 1: Personal Assistance Services

Comment: One commenter applauded

the reference to studying PAS in the

community (outside the home), but

noted that the definition of PAS used in

the priority referred to home-based

services.

Discussion: NIDRR used the definition

of PAS that is included in the

Rehabilitation Act. The definition

specifically refers to services provided

on the job. The commenter focused on

the initial descriptive phrase ‘‘forms of

home-based assistance,’’ which was

intended to imply only that the services

are provided outside of an institution.

The definition of PAS in the priority

encompasses community-based

services, and this descriptive phrase in

the background statement does not

affect the required scope of work.

Changes: None.

Comment: Two commenters noted

that the priority appeared to either be

stating a preference for the

‘‘independent living’’ model of PAS, or

to be suggesting a comparative

evaluation of that model and the

‘‘medical model.’’ The commenters

believed that there was too much

emphasis on the differences between the

two models.

Discussion: The discussion of the two

models of PAS was intended only to

illustrate some of the ways in which

PAS is organized and delivered in the

community. The Secretary realizes that

these are two points on a continuum,

and that in fact most programs contain

elements of each of the ‘‘pure’’ models.

The important issue is to determine

what components of a PAS delivery

system are most appropriate for

individuals with disabilities of varying

ages, types of disabilities, cultural

backgrounds, lifestyles, and life goals.

The Secretary points out that all of the

references to models of PAS are

included in the background section and

do not have direct relevance to the

activities to be performed by the Center.

Changes: None.

Comment: One commenter

recommended that the compilation of a

database on extant PAS programs

should be considered a service, rather

than a research activity, and should not

compete for the limited resources

available for this Center.
Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices 8131

Discussion: NIDRR has identified the

need for such a database for research

purposes, not as a referral service. The

types of data to be collected could be

regularly updated to track trends in

availability, funding sources, eligibility

requirements, demand and usage, and

costs and resources. Such a database is

seen as a key to determining who has

access to PAS, and whether the PAS

that can be accessed varies according to

characteristics of the individual

consumer.

Changes: None.

Comment: One commenter stated that

there should be more emphasis on

training and services or technical

assistance in the priority.

Discussion: The Secretary believes

that there are many research issues that

must be addressed in the area of PAS

and that there is a tendency to respond

to the demands for training and

technical assistance before the research

base is secure. For that reason, the

priority focuses on research. Applicants

are free to propose training and

technical assistance that they believe

complements the research scope, but the

Secretary will not impose additional

requirements.

Changes: None.

Comment: The priority currently calls

for one conference for consumers and

one conference for policymakers to

share findings and obtain input on

outstanding issues in the final year of

the project. One commenter stated that

the priority should include a

requirement for three conferences to

assist in the design of the Center,

evaluate progress at the mid-point, and

extend the availability of effective PAS.

Discussion: The Secretary requires

conferences targeted to these two

audiences as a dissemination

mechanism. The commenter’s

suggestions would amount to dictating

the process that the grantee would use

in designing and evaluating its

activities, and the Secretary declines to

limit grantees in proposing their own

approaches to planning and managing

the project.

Changes: None.

Comment: Two commenters noted

that there were many required activities

in the priority and suggested that

various of these specific activities could

be deleted, while one suggested adding

a requirement to examine the ways in

which technology can be used to replace

or supplement personal assistance,

particularly in the workplace.

Discussion: The Secretary points out

that the Center focuses on four

objectives: analyzing the availability of

PAS; analyzing State policies and

practices; evaluating the impact of

various types of PAS; and developing

strategies to increase the supply of

qualified PAS. In addressing these

objectives, the Center is required to

conduct six activities. The Secretary

believes that all the required activities

are important in addressing the

objectives of the Center, and declines to

eliminate any of the basic requirements

in the priority. The requirement to

investigate the use of PAS at the

workplace reflects the importance of

identifying effective approaches that

have the potential to expand

employment opportunities and enhance

employment outcomes for individuals

with significant disabilities. In fulfilling

this requirement, the applicant may

address the use of technology to

promote independent functioning at the

workplace. The Secretary emphasizes

that applicants are free to determine

their approach to each of the objectives

of the RRTC within the constraints of

available resources.

Changes: None.

Priority 2: Vocational Rehabilitation

Services for Persons With Long-Term

Mental Illness

Comment: Two commenters

recommended studying the impact of

behavioral managed care on the delivery

of vocational rehabilitation services for

persons with LTMI.

Discussion: Based on the first purpose

of the priority, the Secretary believes

that an application could propose to

study the impact of behavioral managed

care on the delivery of vocational

rehabilitation services for persons with

LTMI. However, the Secretary prefers to

provide applicants with the discretion

to propose specific topics for

investigation.

Changes: None.

Comment: One commenter

recommended studying the costeffectiveness of vocational rehabilitation

for persons with LTMI, and a second

commenter recommended studying the

costs and benefits of providing

vocational rehabilitation to persons with

LTMI.

Discussion: The Secretary believes

that an applicant could propose to

conduct either study if the study

furthered the purpose of the RRTC to

conduct research on the achievement of

high quality employment outcomes for

persons with LTMI. However, the

Secretary prefers to provide applicants

with the discretion to propose specific

topics for investigation.

Changes: None.

Comment: One commenter

recommended including individuals

with head injury in the definition of

individuals with LTMI.

Discussion: The Secretary believes

that individuals who have experienced

a head injury and exhibit behaviors of

individuals with a long-term mental

illness could be included within the

target population of this RRTC. The

Secretary points out that for Fiscal Year

1996, NIDRR is funding ten projects

related to brain injury, including two

RRTCs. The Secretary does not believe

that NIDRR should support any

additional research on head injury at

this time.

Changes: None.

Comment: One commenter

recommended addressing the needs of

persons with dual diagnosis, youth,

women, and persons from minority

backgrounds.

Discussion: The Secretary points out

that all applicants must meet the

statutory requirement to demonstrate

how the application will address the

needs of individuals with disabilities

from minority backgrounds. In regard to

persons with dual diagnosis, youth, and

women, the Secretary believes that an

applicant could propose to address the

needs of these individuals. However,

the Secretary prefers to provide

applicants with the discretion to

propose specific target populations for

investigation.

Changes: None.

Comment: The same commenter

recommended requiring training and

dissemination activities to provide

consumers and families members with

useful information to assist them in

personal and systems advocacy. In

addition, the commenter recommended

assuring that any research and training

activities be undertaken within an

evaluative context.

Discussion: The Secretary agrees that

the RRTC should provide consumers

and family members with useful

information, and expects the RRTC’s

evaluation plan to address all research

and training activities. Dissemination

activities and the evaluation plan are

evaluated in the peer review process

using the applicable selection criteria.

The Secretary does not believe any

further personnel requirements are

necessary.

Changes: None.

Comment: One commenter suggested

identifying high demand occupational

opportunities that may match the work

skills and workplace requirements of

persons with LTMI. The commenter also

suggested identifying individualized

strategies that lead to economic selfsufficiency.

Discussion: The Secretary believes

that within the activity to analyze the

relationships between employment

experiences and the characteristics of
8132 Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices

impairment, an applicant could propose

to identify occupational opportunities

that may match the work skills and

workplace requirements of workers with

LTMI, and identify individualized

strategies that lead to economic selfsufficiency. However, the Secretary

prefers to provide applicants with the

discretion to propose specific topics for

investigation.

Changes: None.

Comment: The same commenter

suggested applying short-term outcome

measures, such as occupational growth,

improved workplace behavioral and

coping strategies, and effective use of

helping behavior in the workplace, to

determine whether high quality

employment outcomes are being

achieved. The commenter also

recommended considering economic

self-sufficiency as a long-term outcome.

Discussion: The Secretary believes

applicants should have the discretion to

propose the types of employment

outcomes and outcome measures that

will be used in the RRTC’s research

activities. The proposed outcomes and

outcome measures will be evaluated in

the peer review process using the

applicable selection criteria. The

Secretary does not believe any further

requirements are necessary.

Changes: None.

Comment: The same commenter

recommended identifying necessary

supports and successful methods to

secure and sustain family and

therapeutic supports for the attainment

of employment outcomes.

Discussion: The Secretary believes

that within the activity to identify

models of long-term vocational and

community support for persons who

have achieved an employment outcome

after the receipt of VR services, an

applicant could propose to identify

necessary supports and successful

methods to secure and sustain family

and therapeutic supports. However, the

Secretary prefers to provide applicants

with the discretion to propose specific

topics for investigation.

Changes: None.

General

Comment: One commenter

recommended that the Centers publish

their research findings in refereed

journals.

Discussion: The quality of an

applicant’s proposed dissemination

activities are evaluated in the peer

review process using applicable

selection criteria. The Secretary does

not believe any further dissemination

requirements are necessary.

Changes: None.

Comment: One commenter

recommended that the Secretary

establish an RRTC focusing on

individuals with a combination of

significant physical and speech

disabilities with an emphasis on those

who use alternative and augmentative

communication devices.

Discussion: The Secretary believes

that individuals with a combination of

physical and speech disabilities face

significant barriers. The Secretary points

out that NIDRR is currently supporting

a Rehabilitation Engineering Research

Center in Augmentative

Communication. In response to the

commenter’s suggestion, NIDRR will

consider conducting a planning meeting

to explore research needs in this area

and issuing an invitational priority in

the FY 1998 Field-Initiated Research

competition to address the needs of

individuals with a combination of

significant physical and speech

disabilities.

Changes: None.

Research and Demonstration Projects

Authority for the R&D program of

NIDRR is contained in section 204(a) of

the Rehabilitation Act of 1973, as

amended (29 U.S.C. 760–762). Under

this program the Secretary makes

awards to public agencies and private

agencies and organizations, including

institutions of higher education, Indian

tribes, and tribal organizations. This

program is designed to assist in the

development of solutions to the

problems encountered by individuals

with disabilities in their daily activities,

especially problems related to

employment (see 34 CFR 351.1). Under

the regulations for this program (see 34

CFR 351.32), the Secretary may

establish research priorities by reserving

funds to support the research activities

listed in 34 CFR 351.10.

Priority

Under 34 CFR 75.105(c)(3), the

Secretary gives an absolute preference to

applications that meet the following

priority. The Secretary will fund under

this program only applications that meet

this absolute priority:

Priority: Improving Employment

Practices Covered by Title I of the

Americans With Disabilities Act

Background

The intent of Title I of the Americans

with Disabilities Act (ADA) is to include

and empower people with disabilities in

the work force (P. Blanck, The

Americans with Disabilities Act: Putting

the Employment Provisions to Work,

Annenberg Washington Program, page

9, 1993). Title I provides that employers,

employment agencies, labor

organizations, or joint labormanagement committees may not

discriminate against a qualified

individual with a disability in regard to

job application procedures, the hiring,

advancement, or discharge of

employees, employee compensation, job

training and other terms, conditions,

and privileges of employment.

Discrimination under Title I includes

not making reasonable accommodations

to the known physical or mental

limitations of an otherwise qualified

individual with a disability who is an

applicant or employee, unless such

covered entity can demonstrate that the

accommodation would impose an

undue hardship on the operation of the

business.

The employment status of persons

with disabilities is a matter of critical

importance, both in terms of public

expenditures and in the right of persons

with disabilities to participate fully in

the labor market (J. McNeil, Americans

with Disabilities: 1991–1992, Household

Economic Studies, pp. 70–33,

December, 1993). One of the

assumptions underlying the ADA is that

discriminatory employment practices

are contributing significantly to the

depressed employment status of persons

with disabilities. For 1994, of the 29.41

million persons 21 to 64 years old who

had a disability, 14.03 million or 47.7

percent were unemployed. For the same

year, the mean monthly earnings of

workers with disabilities was $1,713

compared to $2,160 for workers without

disabilities (J. McNeil, U.S. Bureau of

the Census, Survey of Income and

Program Participation, 1994).

The Equal Employment Opportunity

Commission (EEOC), which has

enforcement responsibility for Title I of

the ADA, estimates that Title I covers

approximately 666,000 businesses

employing approximately 86 million

workers (EEOC Press Release, July 19,

1994). Title I became effective for

employers with 25 or more employees

on July 26, 1992, and on July 26, 1994

for employers with 15 or more

employees. Partially as a result of the

recency of these effective dates, little is

known about the actual impact of Title

I on the employment practices of

covered entities. The research that has

been conducted on the impact of Title

I on employment practices relies

primarily on attitudinal surveys of

employers toward the ADA, and the

anticipated impact that Title I might

have on their employment practices (see

Baseline Study to Determine Business’

Attitudes, Awareness, and Reaction to

the Americans with Disabilities Act,

Gallup Survey Report, 1992).
Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices 8133

While little is known about the actual

impact of Title I on employment

practices, data collected by the EEOC

provide information about alleged Title

I ADA violations involving employment

practices. Since July 26, 1992 the EEOC

has maintained a database regarding the

number of ADA violations that have

been cited in charges and the

impairments cited in those charges. For

the cumulative reporting period

between July 26, 1992 and June 30,

1996, the EEOC reports that a total of

68,203 ADA charges were filed. Of the

68,203 charges, 52,448 or 76.9 percent

have been resolved. The majority of

resolutions are either ‘‘Administrative

Closures’’ (40.2 percent) or ‘‘No

Reasonable Cause’’ (45.2 percent). While

it is impossible to determine what

percentage of the ‘‘Administrative

Closures’’ involve charges that are

meritorious, the remaining 14.6 percent

of the charges resulted in ‘‘Merit

Resolutions’’ (settlements—4.9 percent,

withdrawals with benefits—7.2 percent,

reasonable cause 2.5 percent) (EEOC

Office of Program Operations from

EEOC’s Charge Data National Data

Base).

The complaints filed with the EEOC

that result in ‘‘Merit Resolutions’’ may

be indications of not only

discriminatory employment practices,

but also the difficulties that employers

are having understanding or

implementing Title I’s requirements. In

a 1992 survey of 618 employers in

Georgia, 84 percent of the companies

indicated that they would like to receive

more information concerning ADA

requirements, 65 percent wanted more

information about financial incentives,

and 62 percent wanted disability

awareness training for employees and

having access to trained, motivated

employees with disabilities (J. Newman

and R. Dinwoodie, Impact of the

Americans with Disabilities Act on

Private Sector Employers, Journal of

Rehabilitation Administration, Vol. 20,

No. 1, February, 1996).

Persons with disabilities may be

exposed to substantial emotional and

financial hardship as a result of

discrimination or an employer’s lack of

understanding of the employment

practice requirements of the ADA.

Attempting to resolve Title I disputes

through the complaint process or

litigation, can be costly and timeconsuming for persons with disabilities,

employers, and the EEOC. Preventing

employment discrimination and

disputes through the provision of

information and technical assistance

enables employers and persons with

disabilities to share in the benefits of

productive and financially rewarding

employment.

Priority

The Secretary will establish a research

and demonstration project on improving

employment practices covered by Title

I of the ADA that will:

(1) Investigate the impact of the ADA

on the employment practices of private

sector small, medium, and large

businesses;

(2) Identify the ADA employment

practice requirements (with a special

emphasis on hiring) that have been most

challenging for employers to implement

successfully;

(3) Identify interventions that can be

used by private sector employers and

persons with disabilities to address the

challenging employment practice

requirements identified in (2) above;

(4) Demonstrate the effectiveness of

the interventions involving small,

medium-sized, and large businesses;

and

(5) Widely disseminate information

on effective interventions to employers

and persons with disabilities.

In carrying out the purposes of the

priority, the R&D project shall:

• Consult with the EEOC in order to

determine how EEOC public-use data

demonstrate the findings of compliance

problems in covered areas, especially in

hiring, and how those and future data

may be available for the purposes of the

project;

• Complement the General

Accounting Office qualitative evaluation

of the employment provisions of the

ADA; and

• Use a variety of information

dissemination strategies to reach as

wide an audience as possible, including

using the ten regional Disability and

Business Technical Assistance Centers.

Rehabilitation Research and Training

Centers (RRTCs)

Authority for the RRTC program of

NIDRR is contained in section 204(b)(2)

of the Rehabilitation Act of 1973, as

amended (29 U.S.C. 760–762). Under

this program the Secretary makes

awards to public and private

organizations, including institutions of

higher education and Indian tribes or

tribal organizations for coordinated

research and training activities. These

entities must be of sufficient size, scope,

and quality to effectively carry out the

activities of the Center in an efficient

manner consistent with appropriate

State and Federal laws. They must

demonstrate the ability to carry out the

training activities either directly or

through another entity that can provide

such training.

The Secretary may make awards for

up to 60 months through grants or

cooperative agreements. The purpose of

the awards is for planning and

conducting research, training,

demonstrations, and related activities

leading to the development of methods,

procedures, and devices that will

benefit individuals with disabilities,

especially those with the most severe

disabilities.

Under the regulations for this program

(see 34 CFR 352.32) the Secretary may

establish research priorities by reserving

funds to support particular research

activities.

Description of the Rehabilitation

Research and Training Center Program

RRTCs are operated in collaboration

with institutions of higher education or

providers of rehabilitation services or

other appropriate services. RRTCs serve

as centers of national excellence and

national or regional resources for

providers and individuals with

disabilities and the parents, family

members, guardians, advocates or

authorized representatives of the

individuals.

RRTCs conduct coordinated and

advanced programs of research in

rehabilitation targeted toward the

production of new knowledge to

improve rehabilitation methodology and

service delivery systems, alleviate or

stabilize disabling conditions, and

promote maximum social and economic

independence of individuals with

disabilities.

RRTCs provide training, including

graduate, pre-service, and in-service

training, to assist individuals to more

effectively provide rehabilitation

services. They also provide training

including graduate, pre-service, and inservice training, for rehabilitation

research personnel and other

rehabilitation personnel.

RRTCs serve as informational and

technical assistance resources to

providers, individuals with disabilities,

and the parents, family members,

guardians, advocates, or authorized

representatives of these individuals

through conferences, workshops, public

education programs, in-service training

programs and similar activities.

NIDRR encourages all Centers to

involve individuals with disabilities

and minorities as recipients in research

training, as well as clinical training.

Applicants have considerable latitude

in proposing the specific research and

related projects they will undertake to

achieve the designated outcomes;

however, the regulatory selection

criteria for the program (34 CFR 352.31)

state that the Secretary reviews the
8134 Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices

extent to which applicants justify their

choice of research projects in terms of

the relevance to the priority and to the

needs of individuals with disabilities.

The Secretary also reviews the extent to

which applicants present a scientific

methodology that includes reasonable

hypotheses, methods of data collection

and analysis, and a means to evaluate

the extent to which project objectives

have been achieved.

The Department is particularly

interested in ensuring that the

expenditure of public funds is justified

by the execution of intended activities

and the advancement of knowledge and,

thus, has built this accountability into

the selection criteria. Not later than

three years after the establishment of

any RRTC, NIDRR will conduct one or

more reviews of the activities and

achievements of the Center. In

accordance with the provisions of 34

CFR 75.253(a), continued funding

depends at all times on satisfactory

performance and accomplishment.

General

The following requirements apply to

these RRTCs pursuant to the priorities

unless noted otherwise:

Each RRTC must conduct an

integrated program of research to

develop solutions to problems

confronted by individuals with

disabilities.

Each RRTC must conduct a

coordinated and advanced program of

training in rehabilitation research,

including training in research

methodology and applied research

experience, that will contribute to the

number of qualified researchers working

in the area of rehabilitation research.

Each Center must disseminate and

encourage the use of new rehabilitation

knowledge. They must publish all

materials for dissemination or training

in alternate formats to make them

accessible to individuals with a range of

disabling conditions.

Each RRTC must involve individuals

with disabilities and, if appropriate,

their family members, as well as

rehabilitation service providers in

planning and implementing the research

and training programs, in interpreting

and disseminating the research findings,

and in evaluating the Center.

Priorities

Under 34 CFR 75.105(c)(3), the

Secretary gives an absolute preference to

applications that meet one of the

following priorities. The Secretary will

fund under these competitions only

applications that meet one of these

absolute priorities:

Priority 1: Personal Assistance Services

Background

Over the past 20 years, various forms

of home-based assistance have emerged

as alternatives to institutional or

congregate care for individuals who are

unable to perform activities of daily

living (ADLs, such as eating, speaking,

toileting), or instrumental activities of

daily living (IADLs, such as

housekeeping, shopping, or food

preparation). This assistance often

comes in the form of chore services or

home health aides provided for older

persons through community agencies or

corporations and financed through

public or private health insurance.

However, individuals with disabilities,

particularly through the independent

living movement, have developed and

promoted an alternative model of

personal assistance featuring consumer

direction. In this priority, personal

assistance services (PAS) is used to refer

to the full range of service delivery

models for providing home-based

support services, including chore

services, home health care, and

consumer-directed personal assistants

(PAs).

Programs to fund and provide

personal assistance services for

individuals with severe disabilities have

developed in response to the increased

numbers of persons with disabilities

living independently in their homes

(Kennedy, J., Policy and Program Issues

in Providing Personal Assistance

Services, Journal of Rehabilitation, July/

August/September, 1993). The term

‘‘personal assistance services’’ was

added to the Rehabilitation Act of 1973,

with the 1992 amendments, and defined

as ‘‘a range of services, provided by one

or more persons, designed to assist an

individual with a disability to perform

daily living activities on or off the job

that the individual would typically

perform if the individual did not have

a disability’’ (section 7(11)). The

provision of on-the-job or related PAS is

specifically authorized under the

Vocational Rehabilitation Services

Program while an individual is

receiving services under the program

(section 103(a)(15)). In addition, PAS is

considered to be an element in the

definition of ‘‘independent living

services’’ in section 7(30)(B)(vi) of the

Act.

PAS is also supported by health care

agencies, public welfare agencies,

educational institutions, private

insurance providers, nonprofit

organizations, client self-funding, and a

host of less common sources. Indeed,

researchers have identified more than

300 State level PAS programs, and

suggest that they may be categorized by:

(1) target population, such as persons

who are aged, persons with

developmental disabilities, persons with

mental illness; (2) type of service, such

as chore services and medical services;

and (3) method of funding, such as

public Medicaid assistance or private

individual or insurer purchase of care

from home health care providers

(Medlantic Research Foundation, The

Feasibility of Establishing a Regional

Personal Assistance Program in the

Metropolitan Washington D.C. Area,

1991).

Information from the 1990 Survey of

Income and Program Participation

(SIPP) and the 1990 Decennial Census

indicates that about 4.1 million

nonelderly adults, and 5.8 million

elderly persons living in community

settings have acute or chronic health

conditions that may make them

candidates for individual personal

assistance in their homes (Adler,

Population Estimates of Disability and

Long-Term Care, ASPE Research Notes,

l995). The population potentially in

need of PAS is very diverse in terms of

geographic location, disability or

medical condition, personal health care

needs, and psychosocial characteristics.

Two major contrasting models of

personal assistance may be identified as

the independent living (IL) model, and

the medical model. The range of

personal services programs may be

arrayed on a continuum between the

two pure archetypes, with many

variations falling at various points on

the continuum. The original, or medical

model, is characterized by

professionalism; agency control and

supervision of service providers; and

strictly specified tasks that generally

must be provided in the home. An

agency hires, trains (usually under a

medical, nursing, or health services

approach), pays, assigns, supervises,

and terminates the workers, commonly

referred to as health aides, and the user

has a limited role in planning, directing,

and assessing this delimited range of

services. In the IL model, individuals

with disabilities have a substantial role

in determining the terms and conditions

of PAS, and they hire, train, and

supervise their PAs (A Comparison of

Some of the Characteristics of Two

Models of Personal Assistance Services,

World Institute on Disability, 1995).

Although research has shown that PAS

are effective, cost efficient, and popular

with those assisted under the IL model,

the medical model predominates

throughout the United States (Kennedy,

1991; Kennedy and Litvak, S. Case

Studies of Six State Personal Assistance

Service Programs funded by the
Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices 8135

Medicaid Personal Care Option, 1991).

The reasons for the prevalence of the

medical model are not entirely clear, but

there are several possible explanations.

The medical model emerged earlier, in

response to the needs of elderly persons,

who were then being cared for in a

medical or quasi-medical environment.

It was a logical extension to duplicate

the medical model in home-based

services, including elements of medical

prescriptiveness, health services

training and qualifications, and focus on

such things as security and

accountability. It is also possible that

older clients are less comfortable with

learning new roles in determining their

own needs and supervising their care,

and that some may lack the physical or

cognitive capacities to assume these

roles. On the other hand, it may be that

younger disabled individuals place

much higher value on autonomy, social

integration, self-determination and

independence than do many of the frail

elderly.

Although researchers have described

these two models of PAS, there is

insufficient information on the

characteristics of the PAS that is

available to various subgroups of

individuals with disabilities, including

not only information on the service

delivery models, but also factors such as

eligibility criteria, quantity and nature

of services provided, sources of

financing, and costs (per client, per unit

of services, and total). Researchers,

service providers, policymakers, and

advocates would benefit from greater

knowledge about the kinds of PAS

services available to disabled

individuals with various characteristics,

including age, type of disability,

geographic location, work history, and

residential and family status. A

comprehensive database of available

PAS, on a State-by-State basis, is

fundamental to conducting the analyses

that will accomplish the purposes of

this priority.

Beyond improving understanding of

what exists, it is important to both

assess the contributions of these

services to individuals with disabilities

and to society, and to anticipate new

developments in service provision and

planning. The objectives of the IL model

of PAS are somewhat different from

those of the medical model. To some

extent, these are the individual goals

and objectives of the disabled persons

who use PAS. However, there are some

overall objectives or expectations that

society has in their establishment and

funding of these programs. It is

important to define both sets of

objectives and develop standards and

measures that will permit an assessment

of the effectiveness of PAS in achieving

societal objectives as well as in

satisfying the expectations of the users

of PAS. The objectives of these two

groups are expected to be similar,

although not necessarily identical and

not prioritized in the same order.

Societal objectives may include the

avoidance of costly future interventions

through health maintenance, prevention

of further disablement, safety, and

return to work, and these may be

reasonably objective and quantifiable

outcomes. Consumer objectives may

focus on more subjective measures such

as autonomy, social integration, and

quality of life. Consumers and

policymakers will be best served by a

comprehensive assessment of PAS

outcomes. This priority focuses on the

access to, use and outcomes of, and

satisfaction with, various configurations

of PAS by individuals of working age.

Increasingly, individuals using PAS,

and often the PAs as well, are entering

the worksite as a result of innovations

in telecommuting, flexiplace, home

businesses, and individual

accommodations for workers in

traditional work sites. There is need for

studies that will examine alternative

approaches to providing PAS to

individuals with disabilities in

employment settings, including on-site

versus off-site assistance, configurations

of services necessary to support

employment, and that examine relations

between PAs and job coaches,

rehabilitation counselors, interpreters,

and other service personnel. The

relationship between the types of

services available through PAS and the

likelihood of maintaining employment

is an area for investigation.

The introduction of managed care

approaches to health care delivery and

financing and the influence of Federal

court decisions are likely to result in

extensive changes to State-administered

Medicaid programs providing PAS. In

addition, the Robert Wood Johnson

Foundation is providing $3 million in

grants to stimulate States, nonprofit

organizations, and communities to

demonstrate the effectiveness of the

choice concept in PAS. There is also an

anticipated decentralization of

responsibility for service delivery and

devolution of regulatory control over

funds and services to the States or local

government levels. It is unclear what

effect these new patterns will have on

availability, eligibility, and service

configurations. There is a need to

analyze the impact of these anticipated

new public program and policy

directions on the administration of PAS,

and to improve public information,

increase interagency collaboration on

effective program features, and develop

strategies to address shortages of trained

personnel for providing PAS.

Priority 1: The Secretary will establish

an RRTC that will contribute to the

understanding of personal assistance

services that informs policymaking and

practice throughout the nation by:

(1) Analyzing the patterns of access to

PAS in terms of the characteristics of

the consumers with disabilities, the

components of the PAS programs, and

the administrative requirements;

(2) Assessing the impact of

devolution/decentralization on PAS

through the analysis of trends in the

availability of PAS and the correlation

of these trends with new developments

in State policies;

(3) Evaluating the impact of various

types and amounts of PAS on desired

consumer outcomes, including health

maintenance and secondary prevention,

appropriate versus inappropriate health

care utilization, productivity and

employment, community participation,

emotional well-being, and life

satisfaction; and

(4) Developing strategies to increase

the availability of effective PAS and

qualified PAs.

In addition to activities proposed by

the applicant to carry out these

objectives, the RRTC must conduct the

following activities:

• Develop and maintain a

comprehensive database on types of

PAS available on a State-by-State basis,

including relevant descriptors of the

PAS and the clients served;

• Investigate existing practices of

integrating PAS into the workplace, and

disseminate models of effective

practices;

• Assess the availability of qualified

PAs and develop strategies to increase

the pool, skill levels, work performance,

job satisfaction, and sustained

involvement of qualified PAs in the

field;

• Identify new models at the State

level, including service configurations,

financing methods, or delivery practices

that have the potential to make more

effective PAS available to individuals

with disabilities who need PAS;

• Conduct at least one conference for

consumers and one conference for

policy makers in the final year of

operations to share findings with these

target audiences and to obtain feedback

on outstanding issues; and

• Coordinate with ongoing research

activities in the Robert Wood Johnson

Independence initiative and the

Department of Health and Human

Services Cash and Counseling

demonstration, as well as with other
8136 Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices

relevant NIDRR research centers and

projects.

Priority 2: Vocational Rehabilitation

Services for Persons With Long-term

Mental Illness

Background

The National Institute of Mental

Health estimates that there are over 3

million adults ages 18–69 who have a

serious mental illness (Manderscheid,

R.W. & Sonnenschein, M.A. (Eds.),

Mental Health, United States 1992 U.S.

Department of Health and Human

Services, Rockville, MD; DHHS

Publication No.(SMA) 92–1942).

Estimates of unemployment among this

group remains in the 80–90 percent

range (Baron, R., NIDRR Public Hearing

on Disability Research, November 28,

1995).

The Social Security Administration

(SSA) operates the nation’s two largest

Federal programs providing cash

benefits to people with disabilities—the

Supplemental Security Income (SSI)

and the Social Security Disability

Insurance (SSDI) programs. The number

of SSI/SSDI beneficiaries with severe

mental illness, and the nation’s

expenditures for them, have continued

to grow over the last ten years and SSA

expects the number will continue to

grow (SSA, Developing a World-Class

Employment Strategy for People with

Disabilities, September, 1994). A recent

study by the U.S. General Accounting

Office (GAO) found that by 1994, mental

impairments, which are associated with

the longest entitlement periods,

accounted for 57 percent of the SSI

beneficiary population aged 18 to 64

and 31 percent of the SSDI beneficiary

population (GAO Report, SSA

DISABILITY, Program Redesign

Necessary to Encourage Return to Work,

April, 1996).

There are significant complexities in

designing effective return-to-work

strategies to assist individuals in the

SSA caseload. Assisting those

individuals who can return to work will

require varying approaches and levels of

support. Individuals who have

completed the process of establishing

themselves as disabled for SSA

purposes may find it difficult to later

view themselves as having remaining

work potential. The transfer payments

and other benefits contingent on SSI/

SSDI eligibility (especially medical

insurance benefits) may increase the

opportunity costs involved in return to

work beyond the level acceptable to the

individual. The benefit structure may

provide a particular barrier for low-wage

workers, those who are unskilled, or

had marginal attachments to the labor

market in the past. Beneficiaries face the

loss of Medicare or Medicaid benefits if

they return to work and marginal jobs

may not offer adequate, or any, medical

coverage, especially for pre-existing

conditions. Relinquishing these benefits

is particularly risky for individuals with

LTMI, since recurring episodes of their

illness may result in repeated job loss

and the need for quick access to

benefits.

SSA has implemented several work

incentive programs to help people with

disabilities enter or re-enter the

workforce by protecting their cash and

medical benefits until they can support

themselves (Red Book on Work

Incentives—A Summary Guide to Social

Security and Supplemental Security

Income Work Incentives for People with

Disabilities, SSA Pub. No. 64–030, U.S.

Government Printing Office, June,

1992). For individuals with a LTMI, the

Social Security Work Incentives (SSWI)

have the potential to be a valuable

component of the overall rehabilitation

process. However, there has been

neither a comprehensive assessment of

the effectiveness of the SSWI programs

nor an identification of the possible

improvements to the program. There is

some evidence, especially anecdotal

evidence, that rather than using SSA

work incentives, individuals may

decide to work for earnings at a level

that does not threaten continued

eligibility for benefits (Rehabilitation

Services Administration (RSA), Program

Administrative Review—The Provision

of Vocational Rehabilitation Services to

Individuals Who Have Severe Mental

Illness, 1995).

The State Vocational Rehabilitation

(VR) Program provides services to

nearly 1,000,000 individuals with

disabilities each year. In fiscal year

1992, individuals with the primary

disabling condition of a mental illness

made up about 19 percent of those who

received services from the State VR

Program, the second largest disability

group. However, RSA has reported that

the success rate for this population

generally falls below the average success

rate for the VR program. In 1993, RSA

conducted a Program Administrative

Review (PAR) in order to improve the

provision of vocational rehabilitation

services to individuals who have severe

mental illness. Specifically the study

examined the use of identified best

practices including their use and

relationship to successful outcomes and

made recommendations for actions to be

taken by VR State agencies to improve

employment outcomes. In their review

of a sample of case records of

individuals with severe mental illness,

documentation of the use of SSWIs was

found in a relatively small percentage of

the records of those individuals eligible

for such incentives. RSA also found that

individuals who achieved employment

outcomes were more likely to have used

work incentives.

There are numerous other barriers

facing individuals with severe mental

illness seeking vocational rehabilitation

including the often chronic and

episodic nature of the illness, the

iatrogenic effects of pharmacological

and psychological treatment

interventions, difficulties in assessing

clients’ work readiness, and stigma

toward persons with mental illness.

There is still much to be learned about

the interaction of diagnosis, symptoms,

skills and job environment. Because the

severity of symptoms does not

necessarily correspond with an

individual’s functional limitations, it is

important to develop a better

understanding of how psychiatric

symptoms and diagnosis affect

vocational outcomes (Cook, J.A. &

Picket, S.A., Recent Trends in

Vocational Rehabilitation for Persons

with Psychiatric Disabilities, American

Rehabilitation, 20(4), pages 2–12, 1995).

There have been a variety of types or

models of vocational rehabilitation

programs and techniques that have been

developed to increase the employment

of individuals with mental illness,

including models which have

demonstrated effectiveness in returning

persons with LTMI to competitive

employment. What we do not know is

which types of vocational rehabilitation

model are most beneficial for which

types of consumers and at which stages

of their recovery process (McGurrin,

M.C., An Overview of the Effectiveness

of Traditional Vocational Rehabilitation

Services in the Treatment of Long Term

Mental Illness, Psychosocial

Rehabilitation Journal, 17(3), pp. 37–54,

1994).

In addition, there is a need for more

information on duration and quality of

employment, including issues of

disclosure and consumer choice.

Individuals with mental illness bring to

the work place a range of unique needs.

Because the episodic nature of the

disability may cause intermittent

instability, ongoing support is often

needed for both the employee with

mental illness and the employer in

order to maintain employment. One

study of outcomes among this

population found that the occurrence of

uninterrupted vocational support was a

major predictor of employment status,

even controlling for prior work history,

client demographics, and level of

functioning (Cook, J.A. et al.,

Cultivation and Maintenance of
Federal Register / Vol. 62, No. 35 / Friday, February 21, 1997 / Notices 8137

Relationships with Employers of People

with Psychiatric Disabilities,

Psychosocial Rehabilitation Journal,

17(3), pp. 103–115, 1994).

RSA in its examination of the use of

best practices in VR State agencies

found that the use of ongoing vocational

support services and community-based

support services were not frequently

planned for at the time individuals’

service plans were being developed nor

routinely planned for at the time

individuals were leaving the VR

program. However, individuals who

achieved employment outcomes were

more likely to have had postemployment needs assessed during the

development of their individualized

rehabilitation program

There is a need for studies that

examine long-term employment issues

including the experiences of employers

and employees with LTMI in long term

employment relationships and that

assess the vocational and community

supports needed to maintain

employment.

Priority 2: The Secretary will establish

an RRTC for the purpose of conducting

a comprehensive program of research on

the achievement of high quality

employment outcomes for persons with

LTMI. The RRTC shall:

(1) Examine how public policies and

benefit programs affect the employment

of individuals with LTMI;

(2) Identify the characteristics of

consumers (including their stage in the

recovery process) that benefit from

various types of vocational

rehabilitation models;

(3) Examine factors that promote long

term job retention such as workplace

strategies that assist in the maintenance

of employee—employer relationships

and the availability of long-term

supports; and

(4) Develop and deliver training and

technical assistance to rehabilitation

service providers and consumers of

mental health services on new and

effective rehabilitation techniques and

accommodations and evaluate the

efficacy of the training.

In addition to the activities proposed

by the applicant to fulfill these

objectives, the RRTC shall:

• Identify effective strategies to

broaden the understanding and use of

the SSA’s Work Incentives Program for

individuals with LTMI;

• Conduct studies on long-term

relationships between employers and

persons with LTMI including in-depth

assessment of disclosure issues, career

patterns, accommodations and conflict

resolution in the workplace;

• Analyze the relationships between

employment experiences and the

characteristics of impairment (e.g.,

diagnosis, periodicity, medication,

symptoms), and between employment

experiences and the characteristics of

the work environment; and

• Identify successful models of longterm vocational and community support

for persons who have attained

employment after the receipt of VR

services.

In carrying out the purposes of the

priority, the RRTC shall:

• Involve individuals with

psychiatric disabilities in all phases of

the planning, implementation,

evaluation and dissemination of project

activities; and

• Coordinate with the Social Security

Administration and with other relevant

research and demonstration activities

sponsored by the Center for Mental

Health Services, Rehabilitation Services

Administration and the NIDRR.

Applicable Program Regulations: 34

CFR Parts 350, 351, and 352.

Program Authority: 29 U.S.C. 760–762.

(Catalog of Federal Domestic Assistance

Numbers: 84.133A, Research and

Demonstration Projects, 84.133B,

Rehabilitation Research and Training Center

Program)

Dated: February 18, 1997.

Judith E. Heumann,

Assistant Secretary for Special Education and

Rehabilitative Services.

[FR Doc. 97–4317 Filed 2–20–97; 8:45 am]

BILLING CODE 4000–01–P

DEPARTMENT OF EDUCATION

[CFDA Nos.: 84.133A and 84.133B]

Office of Special Education and

Rehabilitative Services; National

Institute on Disability and

Rehabilitation Research; Notice

Inviting Applications for New Awards

Under Certain Programs for Fiscal

Year 1997

Note to Applicants: This notice is a

complete application package. Together with

the statute authorizing the programs and

applicable regulations governing the

programs, including the Education

Department General Administrative

Regulations (EDGAR), this notice contains

information, application forms, and

instructions needed to apply for a grant

under these competitions.

These programs support the National

Education Goal that calls for all

Americans to possess the knowledge

and skills necessary to compete in a

global economy and exercise the rights

and responsibilities of citizenship.

The estimated funding levels in this

notice do not bind the Department of

Education to make awards in any of

these categories, or to any specific

number of awards or funding levels,

unless otherwise specified in statute.

Applicable Regulations: The

Education Department General

Administrative Regulations (EDGAR),

34 CFR Parts 74, 75, 77, 80, 81, 82, 85,

and 86; and the following program

regulations:

(a) Research and Demonstration

Projects (R&D)—34 CFR Parts 350 and

351;

(b) Rehabilitation Research and

Training Centers (RRTCs)—34 CFR Parts

350 and 352; and

(c) The Notice of Final Funding

Priorities published elsewhere in this

issue of the Federal Register.

Program Title: Research and

Demonstration Projects.

CFDA Number: 84.133A.

Purpose of Program: The Research

and Demonstration Projects program is

designed to support discrete research,

demonstration, training, and related

projects to develop methods,

procedures, and technology that

maximize the full inclusion and

integration into society, independent

living, employment, family support, and

economic and social self-sufficiency of

individuals with disabilities, especially

those with the most severe disabilities.

In addition, the R&D program supports

discrete research, demonstration, and

training projects that specifically

address the implementation of Titles I,

III, VI, VII, and VIII of the Rehabilitation

Act, with emphasis on projects to

improve the effectiveness of these

programs and to meet the needs

described in State Plans submitted to

the Rehabilitation Services

Administration by State vocational

rehabilitation agencies.

Selection Criteria: The Secretary uses

the following selection criteria to

evaluate applications under this

program.

(a) Potential Impact of Outcomes:

Importance of Program (Weight 3.0).

The Secretary reviews each application

to determine to what degree—

(1) The proposed activity relates to

the announced priority;

(2) The research is likely to produce

new and useful information (research

activities only);

(3) The need and target population are

adequately defined;

(4) The outcomes are likely to benefit

the defined target population;

(5) The training needs are clearly

defined (training activities only);

(6) The training methods and

developed subject matter are likely to

meet the defined need (training

activities only); and

(7) The need for information exists

(utilization activities only).