[Federal Register: April 26, 2002 (Volume 67, Number 81)]
[Notices]
[Page 20869-20873]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr26ap02-146]
[[Page 20869]]
-----------------------------------------------------------------------
Part I
[[Page 20870]]
I
Department of Education
-----------------------------------------------------------------------
Office of Special Education and Rehabilitative Services, National
Institute on Disability and Rehabilitation Research; Notice
-----------------------------------------------------------------------
DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research
AGENCY: Office of Special Education and Rehabilitative Services,
Department of Education.
ACTION: Notice of proposed priorities.
-----------------------------------------------------------------------
SUMMARY: The Assistant Secretary for Special Education and
Rehabilitative Services proposes funding a priority for a Persons Aging
with Hearing and Vision Loss project and a priority on the Evaluation
of the Changing Universe of Disability and Systems Change Activities
under the Disability and Rehabilitation Research Projects (DRRP)
Program for the National Institute on Disability and Rehabilitation
Research (NIDRR) for fiscal years (FY) 2002-2004. The Assistant
Secretary takes this action to focus research attention on an
identified national need. We intend these priorities to improve the
rehabilitation services and outcomes for individuals aging with hearing
and vision loss or individuals with disabilities.
DATES: We must receive your comments on or before May 28, 2002.
ADDRESSES: Address all comments about these proposed priorities to
Donna Nangle, U.S. Department of Education, 400 Maryland Avenue, SW.,
room 3412, Switzer Building, Washington, DC 20202-2645. If you prefer
to send your comments through the Internet, use the following address:
donna.nangle@ed.gov
You must include the term Persons Aging with Hearing and Vision
Loss or Evaluation of the Changing Universe of Disability and Systems
Change Activities in the subject line of your electronic message.
FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 205-
5880.
If you use a telecommunications device for the deaf (TDD), you may
call the TDD number at (202) 205-4475 or via the Internet:
donna.nangle@ed.gov
Individuals with disabilities may obtain this document in an
alternative format (e.g., Braille, large print, audiotape, or computer
diskette) on request to the contact person listed under FOR FURTHER
INFORMATION CONTACT.
SUPPLEMENTARY INFORMATION:
Invitation To Comment
We invite you to submit comments regarding these proposed
priorities.
We invite you to assist us in complying with the specific
requirements of Executive Order 12866 and its overall requirement of
reducing regulatory burden that might result from the proposed
priorities. Please let us know of any further opportunities we should
take to reduce potential costs or increase potential benefits while
preserving the effective and efficient administration of the program.
During and after the comment period, you may inspect all public
comments about these priorities in room 3412, Switzer Building, 330 C
Street SW., Washington, DC, between the hours of 8:30 a.m. and 4:00
p.m., Eastern time, Monday through Friday of each week except Federal
holidays.
Assistance to Individuals With Disabilities in Reviewing the
Rulemaking Record
On request, we will supply an appropriate aid, such as a reader or
print magnifier, to an individual with a disability who needs
assistance to review the comments or other documents in the public
rulemaking record for the proposed priorities. If you want to schedule
an appointment for this type of aid, please contact the person listed
under FOR FURTHER INFORMATION CONTACT.
We will announce the final priorities in a notice in the Federal
Register. We will determine the final priorities after considering
responses to this notice and other information available to the
Department. This notice does not preclude us from proposing or funding
additional priorities, subject to meeting applicable rulemaking
requirements.
Note: This notice does not solicit applications. In any year in
which we choose to use these proposed priorities, we invite
applications through a notice published in the Federal Register.
When inviting applications we designate each priority as absolute,
competitive preference, or invitational.
The New Freedom Initiative (NFI) emphasizes the importance of
assistive and universally designed technologies, other employment
initiatives, and promotion of full access to community-based living.
The NFI can be accessed on the Internet at the following site: http://
www.whitehouse.gov/news/freedominitiative/freedominitiative.html
NIDRR's published Long-Range Plan (the Plan), focusing on both
individual and systemic factors that impact functional capability,
includes the following elements: employment outcomes, health and
function, technology for access, community integration and independent
living, and associated activities such as the development of outcome
measures and disability statistics. The Plan can be accessed on the
Internet at: http://www.ed.gov/offices/OSERS/NIDRR/Products
Disability and Rehabilitation Research Project (DRRP) Program
The purpose of the DRRP Program is to plan and conduct research,
demonstration projects, training, and related activities to:
(a) Develop methods, procedures, and rehabilitation technology that
maximize the full inclusion and integration into society, employment,
independent living, family support, and economic and social self-
sufficiency of individuals with disabilities; and
(b) Improve the effectiveness of services authorized under the
Rehabilitation Act of 1973 (the Act).
Priorities
Persons Aging With Hearing and Vision Loss
Background
The primary study populations are older Americans who have
experienced hearing or vision loss earlier in their lives and who, with
advanced age, are experiencing the loss of the alternate sense. There
is a need to identify individuals who are aging with hearing and vision
loss from a broad and balanced sample of subjects, as exemplified by
U.S. Census data.
One of the most important changes in the United States over the
last 50 years has been the rapid increase in the number of people
living into their 70s, 80s and beyond. Today, average life expectancy
is 78 years compared to 47 years in 1900 (Campbell, et al.,
(Surveillance for Sensory Impaired, Activity Limitations, and Health-
Related Quality of Life Among Older Adults, NHIS, National Center for
Environmental Health, 1999). The number of Americans age 55 and over is
projected to increase twice as fast as the population as a whole
(Schmeider & Halfman, Statistics on visual impairment on older persons,
disability in children, life expectancy, Journal of Visual Impairment
and Blindness, Vol. 91, pgs. 602-606, 1997).
Furthermore, a growing number of the people who are living longer
are those who sustained a disability at some point earlier in their
lives. Many of these individuals will remain in the workforce due to
extensions of the traditional retirement age. The increase in longevity
in this century brings with it an increase in the amount of time spent
in all major activities, including work and retirement (Weinstein B.E.,
Geriatric Audiology, Thieme Med. Publishers, Inc., NY, NY 2000).
[[Page 20871]]
However, as people age, one of the most significant problems that
they face is the presence of a disability. For example, loss of vision
and hearing become more prevalent with aging, affecting millions of
Americans. When either of these disabilities is already present, the
onset of a secondary disability is especially problematic, particularly
when the individual is faced with additional age-related disabilities.
One-third of persons over 65 years of age have a hearing loss
sufficient to interfere with speech perception, and the prevalence
rises with increasing age (A Report of the Task Force on the National
Strategic Research Plan, NIDCD, 1989). There is also a growing number
of under-served individuals with a combination of multiple sensory,
physical, and cognitive impairments (Malakpa S., Job placement of blind
and visually impaired people with additional disabilities, RE: View,
Vol. 26, pgs. 67-77, 1994).
Low vision or blindness frequently coexists with other disabilities
including hearing loss, cognitive impairments, and mobility
limitations. Individuals with multiple disabilities present
technological challenges and require complex adjustments to achieve
functionality in and across environments (Greenbaum, et al., Use of
motorized wheelchair in conjunction with a guide dog for legally blind
and disabled, Archives of Physical Medicine and Rehabilitation, Vol.
79(2), pgs. 216-217, 1998). Functional status is diminished for sensory
impaired subjects. Combined vision and hearing impairments have greater
effect on function than single sensory impairments and influence
functional status independent of mental status and co-morbid illness.
For example, blind people who acquire significant hearing problems have
the core of their already constrained communication system threatened.
Persons with significant hearing loss, who lose visual acuity, are
equally affected. Overall, this suggests that interventions to improve
sensory function may improve functional independence (Keller, et al.,
The effect of visual and hearing impairment on functional status,
Journal of Geriatric Sociology, 47(11), pgs. 1319-25, 1999).
Data from the Survey of Income and Program Participation (SIPP),
1997, indicate that 3.9 million (12.1 percent) persons age 65 and older
had difficulty seeing the words and letters in newspapers even when
wearing glasses or contact lenses; of that group, 1.1 million (3.3
percent) were unable to see the words and letters at all, while 2.8
million (8.8 percent) had visual problems that were not severe. The
SIPP also measures hearing problems. Even when wearing a hearing aid,
4.3 million (13.4 percent) had difficulty hearing normal conversation.
Of that group, about 500,000 (1.5 percent) were unable to hear what was
said in normal conversation while about 3.8 million (11.9 percent) had
hearing problems that were not severe.
The number of individuals with both severe hearing and visual
impairments (deaf-blind) is small. But, just as the number of elders
will be growing in absolute numbers and as an increasing proportion of
the population, the number of elders experiencing severe sensory loss
is likely to increase as well (Crews John E., Aging and Disability: The
issues for 1990's, In Boone (ed.): Challenge to Independence, pgs. 47-
59, U. Arkansas Press, Little Rock, AR, 1998). The greatest challenges
faced by multiple sensory impaired people are an absence of functional
communication modes and access to information technology. Unlike
individuals who, blind from an early age, learned Braille as part of
their developmental language in special classes or in institutions for
the blind, people who lose their vision in adulthood rarely master
Braille for communication purposes. To date, technologies for such
people have focused primarily on tactile interpreting for face-to-face
communication (Engleman, et al., Deaf-blindness and communication:
Practical knowledge and strategies, Journal of Visual Impairment and
Blindness, Vol. 92(11) pgs. 783-798, 1999).
In a recent report on data from the National Health Interview
Survey (NHIS) study, Campbell, Mority, Zack and Blackman (1999)
determined that older adults who reported vision and hearing
impairments were two times more likely than their peers without
impairments to report difficulty walking (48.3 percent vs. 22.2
percent), three times more likely to report difficulty getting outside
(32.8 percent vs. 11.9 percent), and almost 2.5 times more likely to
report difficulty getting into or out of bed or a chair (25.0 percent
vs. 10.4 percent). In addition, older adults who experience both vision
and hearing impairments were three times more likely than their peers
without impairments to report difficulty preparing meals (20.7 percent
vs. 7.8 percent) and more likely to report difficulty managing
medication (13.4 percent vs. 5.0 percent).
Furthermore, older adults who reported both vision and hearing loss
were more likely than those without either vision or hearing
impairments to have: (a) fallen during the preceding year (37.4 percent
vs. 19.8 percent), (b) broken a hip (7.6 percent vs. 4.5 percent), (c)
reported a higher prevalence of hypertension (53.4 percent vs. 44.3
percent), (d) reported heart disease (32.2 percent vs. 20.6 percent),
or (e) are twice as likely to experience a stroke (17.4 percent vs. 7.3
percent) (Campbell, et al., (Surveillance for Sensory Impaired,
Activity Limitations, and Health-Related Quality of Life Among Older
Adults, NHIS, National Center for Environmental Health, 1999).
Untangling the relationships among sensory loss, co-morbidities and
secondary conditions, and activity limitations poses an important
challenge for public health, the development of public policy,
vocational rehabilitation service providers, community integration
efforts, and fulfillment of the NFI. For example, the relation between
sensory limitations and activity limitations is not clearly understood,
more information is needed about the relation between underlying
conditions, activity limitations, and secondary conditions (Campbell,
1999).
In order to further our understanding of co-morbidity, studies that
examine community planning efforts for housing and transportation, the
effect of policy and planning efforts on the integration of older
persons with vision and hearing problems into the community, and the
influence of sensory and activity limitations in aging populations on
rehabilitation outcomes are crucial. Finally, more information is
needed regarding strategies that many older adults, who have a vision
and hearing disability, employ to sustain participation in the
community.
Priority 1
The Assistant Secretary proposes to establish a Disability and
Rehabilitation Research Project on Persons Aging with Hearing and
Vision Loss. The purpose of this absolute priority is to explore ways
to improve outcomes for persons who are blind or who are deaf and who
are now experiencing a secondary onset of hearing loss or vision
impairment resulting from aging. The DRRP will conduct research,
development, training, and dissemination activities and evaluate model
approaches for improving employment and community integration options,
including more viable communication systems, for such individuals who
are 55 years of age, or older. In carrying out this purpose the DRRP
must:
(1) Investigate the prevalence of age-related onset of deafness
among older American blind individuals and age-
[[Page 20872]]
related onset of blindness among older American deaf individuals and
the impact on the employment and community integration options,
including more viable communication systems for each population;
(2) Identify and evaluate technology and service delivery options,
such as transportation, housing, and community integration activities
for individuals with early onset deafness or blindness and late onset
hearing or vision loss and their effectiveness with persons
experiencing secondary sensory loss resulting from aging;
(3) Identify and evaluate access to use of technologies, including
assistive devices and telecommunication or other existing communication
systems, such as tactile interpreter support, needed to assist persons
with early onset deafness or blindness and late onset hearing or vision
loss and their effectiveness with persons experiencing secondary
sensory loss resulting from aging; and
(4) Using available dissemination mechanisms, with appropriate
assistive technical modification, disseminate findings, and develop
strategies to educate both consumers and providers, especially
vocational rehabilitation workers, in use of these techniques.
In addition, the DRRP must:
Coordinate the efforts of this DRRP with other NIDRR,
Office of Special Education Programs (OSEP), and Rehabilitation
Services Administration (RSA) projects that address related activities
such as Blindness, Deafness, Deaf-Blind, Aging, Accessible Housing,
Accessible Transportation, Telecommunication, Independent Living, and
Interpreter Training programs;
Solicit direct input from stakeholders (e.g., persons who
are deaf, blind, and deaf-blind; service providers; and employers) as
part of the ongoing planning, development, and implementation of the
DRRP's research activities;
Demonstrate efforts to secure supplementary funding that
will permit the DRRP more latitude in exploring additional related
studies, in addition to the Federal monies available from this NIDRR
grant; and
Identify and investigate a study population that includes
a balanced sample of subjects representative of national demographics.
Evaluation of the Changing Universe of Disability and Systems
Change Activities
Background
Demographic, social and environmental trends affect the prevalence
and distribution of various types of disabilities as well as the
demands of those disabilities on social policy and service systems.
Past studies related to the changing universe of disability have
included, as one focus, those which can be identified on the basis of
changing etiologies for existing disabilities, or the appearance of new
disabilities.
The changing universe of disability also refers to broader changes
such as growth in segments of the population with higher prevalence
rates for certain disabilities and the consequences of changes in
public policy, health care services, and medical and assistive
technologies. At the present time, significant policy changes at the
Federal level and implementation of those policies promise a
substantial and progressive impact on the provision of various services
and supports to all people with disabilities. Recent major policy
developments include the Supreme Court's Olmstead decision, the New
Freedom Initiative (NFI), and the Workforce Investment Act (WIA).
These new policies may provide additional opportunities for people
with significant disabilities to remain in or enter the workplace, to
live within the community, and to have increased access to assistive
technologies. Development of plans to evaluate and monitor the course
of these policies over time is critical for understanding the impact of
systems change activities on the changing universe of disability. Such
assessment requires the identification or development of appropriate
sources of data and the analytic work required to identify the
implications of policy changes for financing of, access to, and use of
home- and community-based long-term care services, rehabilitation
systems including vocational rehabilitation, and assistive technologies
on a highly dynamic population.
NIDRR-funded research on the changing universe of disabilities has
assisted with better understanding of factors such as new etiologies,
as mentioned earlier. In their early writing on the topic, Seelman and
Sweeney had postulated that ``poverty is the primary screening
indicator of the many variables that increase the risk of disability
(Seelman K., and Sweeney S., The Changing Universe of Disability,
American Rehabilitation, Autumn-Winter 1995).'' Subsequent analyses of
relationships between poverty and disability have identified factors,
such as access to health care, where one lives, and exposure to
environmental risks, that influence prevalence and distribution
(Fujiura G., Quality of Life and the Poverty Agenda; Emergent
Disability in America, In press, 2000; Fujiura G., Yamaki K.,
Czechowicz S., Disability Among Ethnic and Racial Minorities in the
United States, Journal of Disability Policy Studies, Issue 9, 1998). In
identifying an array of factors associated with the ``changing causes
and patterns of disabilities,'' one must also address ``the disability
related consequences, including functional loss, employment, and social
behavior (Seelman and Sweeney, 1995).'' Ultimately, the researcher must
carefully focus on evaluation of the impact of policy or systems change
while controlling for the range of other variables that affect
disabilities, including those factors that are unique to underserved
and unserved populations. With a carefully constructed analytic
framework, research can address the paucity of information about the
degree to which rehabilitation services are provided to unserved or
underserved populations, within the context of the changing universe of
disability. In addition, studies can illuminate how policies and
systems change influence access, usage, and rehabilitation service
outcomes for these populations.
Priority 2
The Assistant Secretary proposes to establish a Disability and
Rehabilitation Research Project on the Evaluation of the Changing
Universe of Disability and Systems Change Activities. The purpose of
the proposed absolute priority is to evaluate the implications over
time of systems change activities for populations within the changing
universe of disability. The DRRP must:
(1) Identify and evaluate existing or proposed data systems that
can be used to monitor systems change activities at the State or
Federal level or both, including policy changes related to the NFI, the
WIA, and the Olmstead decision;
(2) Identify, evaluate, and project the impact of systems change
activities and new policies for people with newly emergent disabilities
or changing manifestations of disability or both, including those who
are unserved and underserved;
(3) Develop proposals for new systems or data variables, or
changes, as necessary, to existing data systems that will facilitate
use of such data to eliminate gaps in the availability of mechanisms to
monitor the impact of systems change activities on people with newly
emergent disabilities or changing manifestations of disability or both,
including those who are unserved and underserved;
[[Page 20873]]
(4) Disseminate findings and recommendations to modify monitoring
data systems or to institute new monitoring approaches; and
(5) Conduct research to identify and evaluate the implications of
policy changes or other systems change activities on public and private
rehabilitation programs and services for persons with newly emergent
disabilities or changing manifestations of disability or both,
including those who are unserved and underserved.
In carrying out these purposes the applicant must:
Involve consumers or their families, as appropriate, in
all stages of the research and demonstration endeavor;
Demonstrate culturally appropriate and sensitive methods
of data collection, measurements, and dissemination addressing needs of
individuals with disabilities from diverse backgrounds;
By the end of the fourth year, convene a national
conference to disseminate and discuss information about the affect of
systems change activities on persons with newly emergent disabilities
or changing manifestations of disability or both including those who
are unserved and underserved and proposals to address gaps in such
activities; and
Serve as a resource to researchers, consumers and consumer
groups, planners, and policymakers for conceptual and statistical
information that addresses the changing universe of disability,
including systems change issues. Applicable Program Regulations: 34 CFR
part 350.
Electronic Access to This Document
You may review this document, as well as all other Department of
Education documents published in the Federal Register, in text or Adobe
Portable Document Format (PDF) on the Internet at the following site:
www.ed.gov/legislation/FedRegister
To use PDF you must have Adobe Acrobat Reader, which is available
free at this site. If you have questions about using PDF, call the U.S.
Government Printing Office (GPO), toll free, at 1-888-293-6498; or in
the Washington, DC, area at (202) 512-1530.
Note: The official version of this document is the document
published in the Federal Register. Free Internet access to the
official edition of the Federal Register and the Code of Federal
Regulations is available on GPO access at: http://
www.access.gpo.gov/nara/index.html
(Catalog of Federal Domestic Assistance Number 84.133A, Disability
Rehabilitation Research Project.)
Program Authority: 29 U.S.C. 762(g) and 764(b).
Dated: April 23, 2002.
Loretta L. Petty,
Acting Assistant Secretary for Special Education and Rehabilitative
Services.
[FR Doc. 02-10356 Filed 4-25-02; 8:45 am]
BILLING CODE 4000-01-P