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Wednesday,

February 23, 2000

Part VI

Department of
Education
National Institute on Disability and
Rehabilitation Research; Notice of
Proposed Funding Priorities for Fiscal
Years (FY) 2000–2001 for Rehabilitation
Research and Training Centers (RRTCs);
Notice

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9182 Federal Register / Vol. 65, No. 36 / Wednesday, February 23, 2000 / Notices

DEPARTMENT OF EDUCATION We invite you to assist us in Rehabilitation Research and Training


complying with the specific Centers
National Institute on Disability and requirements of Executive Order 12866 The authority for the RRTC program
Rehabilitation Research; Notice of and its overall requirement of reducing is contained in section 204(b)(2) of the
Proposed Funding Priorities for Fiscal regulatory burden that might result from Rehabilitation Act of 1973, as amended
Years (FY) 2000–2001 for these proposed priorities. Please let us (29 U.S.C. 764(b)(2)). Under this
Rehabilitation Research and Training know of any further opportunities that program the Secretary makes awards to
Centers (RRTCs) we should take to reduce potential costs public and private organizations,
or increase potential benefits while including institutions of higher
AGENCY: Office of Special Education and
preserving the effective and efficient education and Indian tribes or tribal
Rehabilitative Services, Department of
administration of the program. organizations for coordinated research
Education.
SUMMARY: The Assistant Secretary for During and after the comment period, and training activities. These entities
the Office of Special Education and you may inspect all public comments must be of sufficient size, scope, and
Rehabilitative Services proposes about this priority in room 3414, quality to effectively carry out the
funding priorities for three Switzer Building, 330 C Street, SW., activities of the Center in an efficient
Rehabilitation Research and Training Washington, DC, between the hours of manner consistent with appropriate
Centers (RRTCs) under the National 9 a.m. and 4:30 p.m., Eastern time, State and Federal laws. They must
Institute on Disability and Monday through Friday of each week demonstrate the ability to carry out the
Rehabilitation Research (NIDRR) for FY except Federal holidays. training activities either directly or
2000–2001. This notice contains through another entity that can provide
Assistance to Individuals With
proposed priorities for one RRTC related that training. The Assistant Secretary
Disabilities in Reviewing the
to rehabilitation for persons with long- may make awards for up to 60 months
Rulemaking Record
term mental illness and two RRTCs through grants or cooperative
related to independent living. The On request, we will supply an agreements. The purpose of the awards
Assistant Secretary takes this action to appropriate aid, such as a reader or is for planning and conducting research,
focus research attention on areas of print magnifier, to an individual with a training, demonstrations, and related
national need. These priorities are disability who needs assistance to activities leading to the development of
intended to improve rehabilitation review the comments or other methods, procedures, and devices that
services and outcomes for individuals documents in the public rulemaking will benefit individuals with
with disabilities. The proposed record for these proposed priorities. If disabilities, especially those with the
priorities refer to NIDRR’s Long Range you want to schedule an appointment most severe disabilities.
Plan (the Plan). The plan can be for this type of aid, you may call (202) Description of Rehabilitation Research
accessed on the World Wide Web at: 205–8113 or (202) 260–9895. If you use and Training Centers
http://www.ed.gov/legislation/ a TDD, you may call the Federal
FedRegister/other/1999–12/68576.htm Information Relay Service at 1–800– RRTCs are operated in collaboration
877–8339. with institutions of higher education or
DATES: Comments must be received on
providers of rehabilitation services or
or before March 24, 2000. These proposed priorities support the other appropriate services. RRTCs serve
ADDRESSES: All comments concerning National Education Goal that calls for as centers of national excellence and
these proposed priorities should be every adult American to possess the national or regional resources for
addressed to Donna Nangle, U.S. skills necessary to compete in a global providers and individuals with
Department of Education, 400 Maryland economy. disabilities and the parents, family
Avenue, S.W., room 3414, Switzer The authority for the Secretary to members, guardians, advocates or
Building, Washington, D.C. 20202–2645. establish research priorities by reserving authorized representatives of the
l
Comments may also be sent through the funds to support particular research individuals.
Internet: Donna Nangle@ed.gov activities is contained in sections 202(g) RRTCs conduct coordinated,
You must include the term ‘‘Disability and 204 of the Rehabilitation Act of integrated, and advanced programs of
and Rehabilitation Research Projects 1973, as amended (29 U.S.C. 762(g) and research in rehabilitation targeted
and Centers’’ in the subject line of your 764). Regulations governing this toward the production of new
electronic message. program are found in 34 CFR part 350. knowledge to improve rehabilitation
FOR FURTHER INFORMATION CONTACT: We will announce the final priorities methodology and service delivery
Donna Nangle. Telephone: (202) 205– in a notice in the Federal Register. We systems, to alleviate or stabilize
5880. Individuals who use a will determine the final priorities after disabling conditions, and to promote
telecommunications device for the deaf considering responses to this notice and maximum social and economic
(TDD) may call the TDD number at (202) other information available to the independence of individuals with

l
205–4475. Internet: Department. This notice does not disabilities.
Donna Nangle@ed.gov preclude us from proposing or funding RRTCs provide training, including
Individuals with disabilities may additional priorities, subject to meeting graduate, pre-service, and in-service
obtain this document in an alternate applicable rulemaking requirements. training, to assist individuals to more
format (e.g., Braille, large print, effectively provide rehabilitation
audiotape, or computer diskette) on Note: This notice does not solicit services. They also provide training
request to the contact person listed in applications. In any year in which the
including graduate, pre-service, and in-
Assistant Secretary chooses to use any of
the preceding paragraph. service training, for rehabilitation
these proposed priorities, we invite
SUPPLEMENTARY INFORMATION: applications through a notice published in research personnel and other
the Federal Register. When inviting rehabilitation personnel.
Invitation To Comment RRTCs serve as informational and
applications we designate each priority as
We invite you to submit comments absolute, competitive preference, or technical assistance resources to
regarding these proposed priorities. invitational. providers, individuals with disabilities,

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Federal Register / Vol. 65, No. 36 / Wednesday, February 23, 2000 / Notices 9183

and the parents, family members, social isolation, as well as the potential While most mental health professionals
guardians, advocates, or authorized for periodic exacerbation. support the concept of self-
representatives of these individuals Quality is an important factor in the determination, not all agree that
through conferences, workshops, public delivery of effective mental health individuals with psychiatric disabilities
education programs, in-service training services. Defining quality services is not should have control over or participate
programs and similar activities. an easy task, nor is there ready in planning and decisionmaking
RRTCs disseminate materials in consensus on all components of the activities (Kent & Read, 1998).
alternate formats to ensure that they are concept. The Institute of Medicine states Individuals with psychiatric
accessible to individuals with a range of that quality of services is ‘‘the degree to disabilities are not yet full participants
disabling conditions. which health services for individuals in the disability self-determination
NIDRR encourages all Centers to and populations increase the likelihood movement. It is widely alleged that
involve individuals with disabilities of desired health outcomes and are professionals in the psychiatric
and individuals from minority consistent with current professional disabilities community continue to use
backgrounds as recipients of research knowledge’’ (Marder, 1999). However, medical compliance as a control
training, as well as clinical training. measuring the quality of services mechanism and as a determining factor
The Department is particularly provided to individuals with significant for awarding patients certain privileges.
interested in ensuring that the mental illness, as well as measuring The right to choose among treatment
expenditure of public funds is justified outcomes, present numerous challenges options is often regarded as a privilege
by the execution of intended activities because of the periodic and chronic that is earned through medical
and the advancement of knowledge and, nature of the illness, and the ongoing compliance (Chamberlain & Powers,
thus, has built this accountability into need for intensive therapeutic services 1999).
the selection criteria. Not later than and long-term support. Practitioners, Obstacles to the development and
three years after the establishment of policy makers, and consumers continue implementation of self-determination
any RRTC, NIDRR will conduct one or to ask questions about how to efforts include controversy over whether
more reviews of the activities and adequately meet the multifaceted needs severe mental illness is a lifelong
achievements of the Center. In of individuals with significant mental process or whether recovery is possible.
accordance with the provisions of 34 illness. Some discussants of this issue suggest
CFR 75.253(a), continued funding Generally, family members and that the need for extensive, lifelong
depends at all times on satisfactory consumers want community-based support and the severity of the illness
performance and accomplishment. support services and treatment preclude using a self-determination
programs that are accessible and approach. In addition, the impact of
Proposed Priority 1: Long-term Mental designed to meet long-term needs. The self-determination approaches on
Illness potential for individuals with serious quality of services are unknown.
Background mental illness to be maintained in the Methodologies, indicators, and
community rather than in institutions, standards for measuring quality of care
The Surgeon General estimates that work productively, live independently, within self-determination models would
approximately 20 percent of the U.S. and participate in rehabilitation facilitate understanding the impact of
population experience a mental disorder planning is increased when a this approach on rehabilitation
in any given year, that 9 percent of the comprehensive support system is outcomes. In particular, research that
adult population have a diagnosable available in community settings. addresses questions about the ability of
major mental illness, and that a Research on consumer participation and individuals with serious mental
subpopulation of 5.4 percent of the community-based programs has illnesses to make decisions about
population is considered to have a provided evidence that there is a treatment and medication management
significant mental illness (Kessler, et. al. positive relationship between the level is lacking. Traditionally, program
1994, 1996). The costs to society of of consumer participation and planning and treatment decisions in the
mental illness are substantial. The therapeutic outcomes (Kent & Read, mental health field have been made by
indirect costs of mental illness in 1990, 1998). clinicians, and often involve
stemming from lost productivity at Proponents of community-based maintaining patients on medication
work, school, or home, were estimated service programs and support systems without consumer input or choice.
at $78.6 billion (Rice and Miller, 1996). long have advocated that consumers be Policies and service systems tend to
As the population grows, the needs of empowered to participate in the be based on a paternalistic model that
a growing number of individuals with a decisionmaking process. However, one restricts consumer control and input.
significant mental illness are not being reason individuals with disabilities However, there is evidence that
met. Only one in four adults with a have limited opportunities to participate consumer and family involvement in
diagnosable mental disorder receives in decisions about their services are decisionmaking and program planning
treatment and one third of children and related to the lack of consensus on a have the potential to foster higher
adolescents needing mental health definition for self-determination. Self- quality services and responsiveness
services are treated (Manderscheid & determination is defined and from providers. The effectiveness
Henderson, 1998). The lives of implemented differently (Ward, 1999) service models incorporating self-
individuals with long-term mental depending on the program, philosophy, determination and their relationship to
illnesses are complicated by inadequate and purposes for implementing a self- rehabilitation outcomes has not been
community resources, lack of access to determination model. However, there evaluated. There has not been adequate
new medications and psychosocial are some common concepts in the study of the impact of elements of self-
treatments, unemployment, and lack of definitions for self-determination; determination models on the
options for long-term care. Many NIDRR includes factors such as rehabilitation process. Similarly, there
individuals also experience consumer control, choice, self-direction, have not been adequate studies of the
homelessness, family disruptions, empowerment, leadership, and self- impact of the various components of
chronic medical conditions, alcohol and advocacy (Ward & Roger, 1999) as self-determination models on the
substance abuse, incarceration, and potential elements of self-direction. rehabilitation process.

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9184 Federal Register / Vol. 65, No. 36 / Wednesday, February 23, 2000 / Notices

Better understanding of the (5) Assess policies of service or hinder individuals with disabilities
implications of self-determination for providers and payers in terms of their in attaining full participation in society.
rehabilitation outcomes potentially will implications for fostering or impeding Questions as basic as defining
answer questions related to competency, self-determination, and identify independent living in the context of
patient rights, recovery, outcomes, and strategies for policy improvements. diverse socioeconomic factors must be
policies. Research addressing these In addition to the activities proposed addressed. Current challenges to
issues, describing standards for quality, by the applicant to carry out these independent living derive from the
and establishing outcome measures for purposes, the RRTC must: changing characteristics of both the IL
consumer driven decisions is lacking in (1) Conduct in the third year of the service system and the disability
the research literature. Studies grant, a state-of the-science conference population.
evaluating self-determination will on self-determination for persons with Substantial administrative, advocacy,
potentially further the understanding of significant and persistent mental illness strategic and service-delivery issues
the rehabilitation process for and publish a comprehensive report in affect the daily activities of Centers for
individuals with significant mental the fourth year of the grant; and Independent Living (CILs). Critical
illness, and identify strengths, (2) Address in its research the specific issues include funding and resource
weaknesses, and needed improvements needs of minority populations with management, quality staffing, and
in the existing models. LTMI. relationships with other agencies key to
The Plan emphasizes the importance the success of CILs. The issue of
Two Proposed Priorities on financial management of CILs calls for
of independent living and community Independent Living
integration. Central to independent a balanced approach to identify existing
living is the recognition that each Background policies, regulations, models, and
individual has a right to independence programs that serve to hinder or help in
The mission of NIDRR emphasizes establishing sound fiscal operation.
that comes from exercising maximal developing knowledge that will
control over his or her life. These Financial management requires
‘‘improve substantially the options for expertise in fiscal analysis, budgeting,
activities include making decisions disabled individuals to perform regular
involved in managing one’s own life, understanding grant requirements and
activities in the community, and the program rules, accounting, auditing, and
sustaining the ability and opportunity to capacity of society to provide full
make choices in performing everyday fundraising.
opportunities and appropriate supports CILs, which spend substantial
activities, and minimizing physical and for its disabled the Plan, published on amounts of money on personnel, are
psychological dependence on others. December 7, 1999 (64 FR 68575)).’’ subject to staffing problems typical of
Independent living is a concept that also Much of NIDRR’s work reflects the human service organizations and small
emphasizes participation and equity in components of the Independent Living businesses, including recruitment
the right to share in the opportunities, (IL) philosophy: consumer control, self- problems, training and competency
risks, and rewards available to all help, advocacy, peer relationships and development, and retention problems.
citizens. peer role models, and equal access to Staffing problems may impede the
Proposed Priority 1: Improving Service society, programs, and activities. NIDRR ability of CILs to deliver individualized
and Supports for Individuals with has funded subject-specific RRTCs in IL information and support services. An
Long-Term Mental Illness since 1980 and supports other projects essential step in strengthening
that incorporate principles of IL. continuity in services is to recruit, train,
The Assistant Secretary, in Most recently, NIDRR has funded one and retain first line managers.
collaboration with the Substance Abuse RRTC on Centers for Independent CILs lack documentation of the
and Mental Health Services Living (CIL) management and services competencies required for IL
Administration and the Center for and a second on IL and disability management. Awareness of competency
Mental Health Services, proposes to policy. The last year of the five-year needs is key to developing successful
establish an RRTC for the purpose of project period for the awards was 1999. recruitment strategies and staff
improving services and supports for In light of the research agenda development programs. For example,
individuals with long-term mental established in the Plan, and input innovative recruitment strategies are
illness. In carrying out these purposes, obtained from the Rehabilitation needed to attract youth with disabilities
the Center must: Services Administration (RSA) and who are transitioning from school to
(1) Develop measures that can be other Federal agencies and constituents, independent living to work in CIL
applied to evaluate self-determination in various meetings that addressed service programs. Creative efforts to
activities in terms of rehabilitation related themes, NIDRR has identified attract young persons entering the job
outcomes, quality of services, and critical issues in independent living to market as employees could assist the
availability of community resources; be addressed at this time. There is a CILs in understanding the needs of
(2) Identify and assess self- continuing need to fund two Centers youth with disabilities as consumers as
determination direction theories, that study independent living and well. Career development, with
models, and activities, as well as the community integration. pathways to more responsible positions
barriers to participation in self- Living independently and achieving in CILs, can be a key to the retention of
determination activities for individuals community integration to the maximum competent staff.
with disabilities; extent possible are issues at the crux of CILs exist in a framework of public
(3) Develop and evaluate management NIDRR’s mission. NIDRR is committed agencies, nonprofit organizations, and
tools to enable service providers to to the creation of a theoretical the local business sectors. The ability to
support self-determination; framework with measurable outcomes form effective partnerships and
(4) Develop, conduct, and evaluate, that is based upon the experiences of cooperative working relationships with
training on self-determination and individuals with disabilities. The new appropriate entities is essential to
consumer choice to improve paradigm of disability embodied in the successful CIL operation. Historically,
understanding and support of self- Plan requires analysis of the extent to relationships with State Vocational
determination; and which socioenvironmental factors help Rehabilitation agencies, Statewide

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Federal Register / Vol. 65, No. 36 / Wednesday, February 23, 2000 / Notices 9185

Independent Living Councils, and State disability, such as HIV/AIDS, multiple Proposed Priority 2: Improved
Consumer Advocacy Organizations have chemical sensitivity and environmental Management of CIL Programs and
been at the heart of CIL operations and illness, challenge IL concepts, services, Services
responsibilities. Recent developments in and research. CILs and other The Assistant Secretary proposes to
the area of employment services and organizations can serve as a resource to establish an RRTC on IL management,
entitlement benefits for individuals with teach youth, aging persons, and services and strategies that will conduct
disabilities pose additional challenges underserved populations about research and training activities and
for CILs by introducing new actors, new independent living. There may be an develop and evaluate model approaches
clients, and new rules. Passage of the opportunity for CILs to develop strong to enhance the capacity of CILs to
Workforce Investment Act of 1998 and alliances with parent information operate and manage effective advocacy
the Work Incentives Improvement Act training centers and schools (from pre- and service programs and maintain
of 1999 might provide new school through postsecondary programs) effective external partnerships. In
opportunities for CILs to play a role in and with the aging and underserved carrying out this purpose, the Center
the process of vocational rehabilitation. populations through appropriate must:
A challenge to facilitating (1) Develop a database of existing CIL
partnerships.
independent living and community funding and economic resources, and
integration is the changing universe of As an example of the role of
identify innovative and best practices in
disability. Demographic, social and demographic factors, disability has a
creating secure economic foundations
environmental trends affect the disproportionate impact upon African for CILs;
prevalence and distribution of various Americans, Hispanic Americans, and (2) Working in collaboration with
types of disability as well as the American Indians. An array of appropriate entities, design and test
demands of those disabilities on social culturally-sensitive service-delivery several options for generating funding
policy and service systems. Within the models, community organizations, and from alternative sources, including
universe of disabilities are: (1) changing other resources is necessary to provide business development strategies and
etiologies for existing disabilities; (2) services to individuals from minority analyze policy-related and
growth in segments of the population backgrounds. Organizations with programmatic consequences of various
with higher prevalence rates for certain grassroots orientations, including CILs, funding options, especially those
disabilities; (3) the consequences of are in a unique position to help identify independent of public financing;
changes in public policy and in health the specific needs of individuals from (3) Identify best practices and develop
care services and technologies; and (4) those affected populations. Model and test programs for CILs in expanding
the appearance of new disabilities. strategies in other countries might be services to youth with disabilities and
The CILs and consumer organizations adapted to reach unserved and their families, including those from
can prepare to address changing needs underserved populations in the United diverse cultural backgrounds, and in
of diverse populations with attention to States. interfacing with education and
the infrastructure of resource transition programs to prepare children
availability and management strategy. Physical environment, including the
and youth for independent living;
At the same time, there is a need to built environment, can pose numerous (4) Develop and test strategies to
frame the history and role of the obstacles that confound living enable CILs to benefit from management
independent living movement within independently. Individuals with models of other successful community-
the context of theories of society and disabilities living in rural communities based organization or organizations.
social movements and organizational may be isolated from CILs and Develop and test innovative models of
and group structure. Such a framework vocational rehabilitation services. cost-effective training to improve core
could identify ways to: (1) reach out to Isolation resulting from distance, lack of competency skills in geographically
underserved populations, (2) collaborate available transportation, lack of dispersed and culturally and
with key organizations that might not be monetary resources to support social linguistically diverse CIL staff,
perceived as traditional disability services, limited job opportunities, lack including but not limited to those from
advocates, and (3) recognize the role of of a health care delivery system, and Indian tribes and tribal organizations,
environmental factors on successfully unavailability of accessible and and evaluate strategies for improved
living independently and achieving affordable housing can be problems for recruitment and retention of CIL staff
community integration. A sound rural Americans. Similar problems may from diverse backgrounds;
theoretical base can be drawn upon to confront persons from minority (5) Review CIL and vocational
develop policy and service-delivery backgrounds in inner cities and remote rehabilitation agency policies related to
models that can help maximize social areas, persons who are homeless, and collaborations, and design strategies for
participation for individuals with migrants. For all populations, and for all innovative partnerships to promote
disabilities. salient issues that affect independent employment outcomes for individuals
Researchers have identified an living and community integration, the with disabilities;
association between disabilities and social and economic costs and benefits (6) Coordinate activities with and
poverty, especially among youth provide instruments, curricula,
of various strategies must be evaluated.
(Fujiura G et al., ‘‘Disability Among methodologies, and resource guides, as
Ethnic and Racial Minorities in the The Plan discusses research on well as research findings, including but
United States,’’ Journal of Disability physical inclusion, including the not necessarily limited to distance
Policy Studies, Vol. 9, No. 2, pgs. 112– identification and evaluation of models learning and web-based technologies, to
130, 1998). The growing number of that facilitate housing that are consistent the RSA training and technical
individuals aging with long-standing with consumer choice. In addition to assistance provider under Part C of Title
disabilities, as well as the increase in physical and economic accessibility, VII of the Rehabilitation Act; and
the population of older persons who model housing approaches must (7) Provide training and information
acquire disabilities as they age, is maximize community integration and for CILs, policy makers, administrators,
another aspect of a changing disability ability to participate in a range of and advocates on research findings and
population. Newer etiologies of normative activities. identified strategies.

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9186 Federal Register / Vol. 65, No. 36 / Wednesday, February 23, 2000 / Notices

In carrying out these purposes, the changing universe of disability as Applicable Program Regulations: 34
Center must coordinate with other articulated in the Plan, and is grounded CFR Part 350.
NIDRR and OSERS grantees and in social science theory and methods; Program Authority: 29 U.S.C. 760–
community-based organizations that (2) Identify and evaluate strategies to 762.
focus upon independent living and with promote accessible cost-effective
the National Center for the advocacy and generic community Electronic Access to This Document.
Dissemination of Disability Research. services for individuals with significant You may view this document, as well
The RRTC on improved management of disabilities, and address specifically at as all other Department of Education
CIL programs and services will be least one changing universe population; documents published in the Federal
funded jointly by NIDRR and RSA and (3) Evaluate the use of peer networks Register, in text or Adobe Portable
will be required to work closely with and communication channels to assist Document Format (PDF) on the Internet
the RSA grantee providing training, individuals with disabilities to maintain at either of the following sites:
technical assistance, and transition wellness, access community services,
http://ocfo.ed.gov/fedreg.htm
assistance to CILs and Statewide and participate in community life;
http://www.ed.gov/news.html
Independent Living Councils under Part (4) Assess the concept and application
C of Title VII of the Rehabilitation Act. of independent living for diverse To use the PDF you must have the
populations of cultural and linguistic Adobe Acrobat Reader Program with
Proposed Priority 3: IL and the New minorities, including but not limited to Search, which is available free at either
Paradigm of Disability those from Indian tribes and tribal of the preceding sites. If you have
organizations, and identify and evaluate questions about using the PDF, call the
The Assistant Secretary proposes to
culturally appropriate independent U.S. Government Printing Office (GPO),
establish an RRTC on IL and the New
living approaches and strategies to assist toll free, at 1–888–293–6498; or in the
Paradigm of Disability that will facilitate individuals within these groups to
the development of innovative Washington, DC, area at (202) 512–1530.
attain self-determined independent
independent living strategies to meet living goals; and Note: The official version of this document
the challenges of the 21st century. This (5) Provide training and information is the document published in the Federal
Center will promote an understanding for CILs, policy makers, administrators, Register. Free Internet access to the official
of independent living concepts and edition of the Federal Register and the Code
and advocates on research findings and
practices in the context of the physical of Federal Regulations is available on GPO
identified strategies. Access at: http://www.access.gpo.gov/nara/
and social environments noted in the In carrying out these purposes, the
new paradigm of disability, including index.html
project must coordinate with other
assessment of the application of NIDRR and OSERS grantees and (Catalog of Federal Domestic Assistance
independent living to the changing community-based organizations that Number 84.133B, Rehabilitation Research
universe of disability. In carrying out and Training Centers)
focus on independent living, the Center
these purposes, the Center must: on Emergent Disability, the National Dated: February 17, 2000.
(1) Develop an analytical framework Center for the Dissemination of Curtis L. Richards,
for research on living independently Disability Research, and the RSA Acting Assistant Secretary for Special
that incorporates the definition of IL, training and technical assistance Education and Rehabilitative Services.
the contextual framework of disability provider under Part C of Title VII of the [FR Doc. 00–4259 Filed 2–22–00; 8:45 am]
and an accessible community, and the Rehabilitation Act. BILLING CODE 4000–01–U

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