National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and Rehabilitation Research Projects and Centers Program-Rehabilitation Research and Training Centers (RRTCs)-Improved Outcomes for Individuals With Serious Mental Illness and Co-Occurring Conditions, 21282-21285 [2010-9511]
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21282
Federal Register / Vol. 75, No. 78 / Friday, April 23, 2010 / Notices
Office of Postsecondary Education,
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Delegation of Authority: The Secretary
of Education has delegated authority to
Daniel T. Madzelan, Director,
Forecasting and Policy Analysis for the
Office of Postsecondary Education, to
perform the functions and duties of the
Assistant Secretary for Postsecondary
Education.
Authority: 5 U.S.C. Appendix 2.
Dated: April 20, 2010.
Daniel T. Madzelan,
Director, Forecasting and Policy Analysis.
[FR Doc. 2010–9516 Filed 4–22–10; 8:45 am]
BILLING CODE 4000–01–P
DEPARTMENT OF EDUCATION
National Institute on Disability and
Rehabilitation Research (NIDRR)—
Disability and Rehabilitation Research
Projects and Centers Program—
Rehabilitation Research and Training
Centers (RRTCs)—Improved Outcomes
for Individuals With Serious Mental
Illness and Co-Occurring Conditions
Catalog of Federal Domestic
Assistance (CFDA) Number: 84.133B–5.
AGENCY: Office of Special Education and
Rehabilitative Services, Department of
Education.
ACTION: Notice of proposed priority.
SUMMARY: The Assistant Secretary for
Special Education and Rehabilitative
Services proposes a funding priority for
the Disability and Rehabilitation
Research Projects and Centers Program
administered by NIDRR. Specifically,
this notice proposes a priority for an
RRTC on Improved Outcomes for
Individuals with Serious Mental Illness
and Co-Occurring Conditions. The
Assistant Secretary may use this priority
for competitions in fiscal year (FY) 2010
and later years. We take this action to
focus research attention on areas of
national need. We intend this priority to
improve rehabilitation services and
outcomes for individuals with
disabilities.
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DATES: We must receive your comments
on or before May 24, 2010.
ADDRESSES: Address all comments about
this notice to Donna Nangle, U.S.
Department of Education, 400 Maryland
Avenue, SW., room 5142, Potomac
Center Plaza (PCP), Washington, DC
20202–2700.
If you prefer to send your comments
by e-mail, use the following address:
donna.nangle@ed.gov. You must
include the term ‘‘Proposed Priority for
an RRTC on Improved Outcomes for
Individuals with Serious Mental Illness
and Co-Occurring Conditions’’ in the
subject line of your electronic message.
FOR FURTHER INFORMATION CONTACT:
Donna Nangle. Telephone: (202) 245–
7462 or by e-mail:
donna.nangle@ed.gov.
If you use a telecommunications
device for the deaf (TDD), call the
Federal Relay Service (FRS), toll free, at
1–800–877–8339.
SUPPLEMENTARY INFORMATION:
This notice of proposed priority is in
concert with NIDRR’s Final Long-Range
Plan for FY 2005–2009 (Plan). The Plan,
which was published in the Federal
Register on February 15, 2006 (71 FR
8165), can be accessed on the Internet
at the following site: https://www.ed.gov/
about/offices/list/osers/nidrr/
policy.html.
Through the implementation of the
Plan, NIDRR seeks to: (1) Improve the
quality and utility of disability and
rehabilitation research; (2) foster an
exchange of expertise, information, and
training to facilitate the advancement of
knowledge and understanding of the
unique needs of traditionally
underserved populations; (3) determine
best strategies and programs to improve
rehabilitation outcomes for underserved
populations; (4) identify research gaps;
(5) identify mechanisms of integrating
research and practice; and (6)
disseminate findings.
This notice proposes a priority that
NIDRR intends to use for RRTC
competitions in FY 2010 and possibly
later years. However, nothing precludes
NIDRR from publishing additional
priorities, if needed. Furthermore,
NIDRR is under no obligation to make
an award for this priority. The decision
to make an award will be based on the
quality of applications received and
available funding.
Invitation to Comment: We invite you
to submit comments regarding this
notice. To ensure that your comments
have maximum effect in developing the
notice of final priority, we urge you to
identify clearly the specific topic that
each comment addresses.
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Federal Register / Vol. 75, No. 78 / Friday, April 23, 2010 / Notices
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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
this proposed priority. Please let us
know of any further ways we could
reduce potential costs or increase
potential benefits while preserving the
effective and efficient administration of
the program.
During and after the comment period,
you may inspect all public comments
about this notice in room 5142, 550 12th
Street, SW., PCP, Washington, DC,
between the hours of 8:30 a.m. and 4:00
p.m., Washington, DC time, Monday
through Friday of each week except
Federal holidays.
Assistance to Individuals with
Disabilities in Reviewing the
Rulemaking Record: On request we will
provide an appropriate accommodation
or auxiliary aid to an individual with a
disability who needs assistance to
review the comments or other
documents in the public rulemaking
record for this notice. If you want to
schedule an appointment for this type of
accommodation or auxiliary aid, please
contact the person listed under FOR
FURTHER INFORMATION CONTACT.
Purpose of Program: The purpose of
the Disability and Rehabilitation
Research Projects and Centers Program
is to plan and conduct research,
demonstration projects, training, and
related activities, including
international activities, to develop
methods, procedures, and rehabilitation
technology, that maximize the full
inclusion and integration into society,
employment, independent living, family
support, and economic and social selfsufficiency of individuals with
disabilities, especially individuals with
the most severe disabilities, and to
improve the effectiveness of services
authorized under the Rehabilitation Act
of 1973, as amended.
RRTC Program
The purpose of the RRTC program is
to improve the effectiveness of services
authorized under the Rehabilitation Act
of 1973, as amended, through advanced
research, training, technical assistance,
and dissemination activities in general
problem areas, as specified by NIDRR.
Such activities are designed to benefit
rehabilitation service providers,
individuals with disabilities, and the
family members or other authorized
representatives of individuals with
disabilities. In addition, NIDRR intends
to require all RRTC applicants to meet
the requirements of the General
Rehabilitation Research and Training
Centers (RRTC) Requirements priority
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that it published in a notice of final
priorities in the Federal Register on
February 1, 2008 (73 FR 6132).
Additional information on the RRTC
program can be found at: https://
www.ed.gov/rschstat/research/pubs/resprogram.html#RRTC.
21283
with SMI and co-occurring conditions
work even fewer hours, have lower total
earnings, and are less likely to engage in
competitive employment than those
with SMI alone (Cook et al., 2005;
Goldberg et al., 2007).
Health promotion, illness selfmanagement, and using a holistic
Statutory and Regulatory Requirements
approach to rehabilitation are practices
of RRTCs
that have been rigorously studied and
RRTCs must—
effectively used to prevent, control, or
• Carry out coordinated advanced
treat a variety of medical conditions
programs of rehabilitation research;
such as diabetes, breast and cervical
• Provide training, including
cancer, heart disease, and stroke. Peergraduate, pre-service, and in-service
delivered health and wellness education
training, to help rehabilitation
curriculums also have been widely
personnel more effectively provide
implemented to reduce tobacco or
rehabilitation services to individuals
alcohol usage, improve nutrition, and
with disabilities;
modify risk behaviors among the general
• Provide technical assistance to
population or subpopulations, including
individuals with disabilities, their
women, workers, and members of racial
representatives, providers, and other
or ethnic minorities (CDC, 2009; Collins,
interested parties;
Marks, and Koplan, 2009). While some
• Disseminate informational materials of this research and practice addresses
to individuals with disabilities, their
health promotion for individuals with
representatives, providers, and other
SMI, the science for individuals with
interested parties; and
SMI is still emerging, and has not
• Serve as centers of national
sufficiently advanced to address the
excellence in rehabilitation research for needs and experiences of individuals
individuals with disabilities, their
with SMI and co-occurring conditions
representatives, providers, and other
(CMHS, 2005; Richardson et al., 2005;
interested parties.
Sederer et al., 2006).
Applicants for RRTC grants must also
Past research funded by NIDRR and
demonstrate in their applications how
others provides a potential base for
they will address, in whole or in part,
testing models that link management
the needs of individuals with
and self-management of SMI and codisabilities from minority backgrounds.
occurring physical conditions to mental
health recovery (Vandiver, 2007). For
Program Authority: 29 U.S.C. 762(g) and
764(b)(2).
example, consumer-to-consumer
education and consumer-directed
programs 1 for individuals with SMI can
Applicable Program Regulations: 34
be effective in promoting recovery from
CFR part 350.
mental illness and merit further study as
Proposed Priority
mechanisms for health promotion
This notice contains one proposed
(CMHS, 2005). At the systems level, lack
priority.
of integration and coordination of
mental health and primary care services
Improved Outcomes for Individuals
contribute to poor health outcomes for
With Serious Mental Illness and Cothose with SMI (CMHS, 2005). Further
Occurring Conditions
study on integration and coordination of
Background
mental health and primary care services
at the systems level, therefore, would be
As many as 6.5 percent of adults ages
18–64 experience serious mental illness highly beneficial for individuals with
SMI and co-occurring physical
(SMI) during any 12-month period
conditions.
(Kessler et al., 2008). Individuals with
Improved management of SMI and coSMI are at high risk for chronic diseases
occurring conditions could contribute to
such as cardiovascular disease, diabetes,
improved health and employment
asthma, and cancer (Colton &
outcomes for these individuals
Manderscheid, 2006; Sederer, et al.,
(Merikangas et al., 2007). Research is
2006). The comorbidity of SMI and
chronic disease is associated with
1
limitations on activities such as self-care are Consumer-directed models of service delivery
defined by the belief that individuals with
and employment (McKnight-Eily et al.,
disabilities should determine the types, amounts,
2007). Individuals with SMI experience and sources of the services they receive. In the
mental health services context, consumer-directed
disproportionately low rates of
care approaches include self-help and mutual-aid
employment compared to the general
support groups, mental illness self-management,
United States population and to other
and advance crisis planning by individuals with
SMI (Cook, 2005).
individuals with disabilities, and those
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Federal Register / Vol. 75, No. 78 / Friday, April 23, 2010 / Notices
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needed to develop interventions that
address the interactions between SMI
and health that are potential barriers to
competitive employment, economic
well-being, and maximum participation
in society.
References
Center for Mental Health Services
(CMHS), Substance Abuse and Mental
Health Services Administration. (2005).
HHS Pub. No. 4040. Rockville, MD:
Building Bridges: Mental Health
Consumers and Primary Care
Representatives in Dialogue. U.S.
Department of Health and Human
Services. See https://
download.ncadi.samhsa.gov/ken/pdf/
SMA06-4040/
Policy_Makers_Booklet.pdf.
Centers for Disease Control and
Prevention (CDC). (2009). The Guide to
Community Preventive Services. U.S.
Department of Health and Human
Services. See https://
www.thecommunityguide.org/
index.html.
Collins, J., Marks, J., & Koplan, J.
(2009). Chronic disease prevention and
control: Coming of age at the Centers for
Disease Control and Prevention.
Preventing Chronic Disease [serial
online]. See https://www.cdc.gov/pcd/
issues/2009/jul/08_0171.htm.
Colton, C. & Manderscheid, R. (2006).
Congruencies in increased mortality
rates, years of potential life lost, and
causes of death among public mental
health clients in eight States. Preventing
Chronic Disease [serial online]. See
https://www.cdc.gov/pcd/issues/2006/
apr/05_0180.htm.
Cook, J. (2005). ‘‘Patient-Centered’’
and ‘‘Consumer-Directed’’ Mental Health
Services. Prepared for the Institute of
Medicine, Committee on Crossing the
Quality Chasm—Adaptation to Mental
Health & Addictive Disorders. See
https://www.cmhsrp.uic.edu/download/
IOMreport.pdf.
Cook, J., Burke-Miller, J., Blyler, C.,
Leff, H., Mueser, K., Gold, P., Goldberg,
R., Mueser, K., Toprac, M., McFarlane,
W., Shafer, M., Blankertz, L., Dudek, K.,
Razzano, L., Grey, D., & Burke-Miller, J.
(2005). Results of a Multisite
Randomized Trial of Supported
Employment Interventions for
Individuals With Severe Mental Illness.
Archives of General Psychiatry, (62),
505–512. See https://archpsyc.amaassn.org/cgi/content/full/62/5/505.
Goldberg, R., Shafer, M., Onken, S.,
McFarlane, W., Donegan, K., Carey, M.,
Kaufmann, C. & Grey, D. (2007). Effects
of co-occurring disorders on
employment outcomes in a multisite
randomized study of supported
employment for people with severe
VerDate Nov<24>2008
15:23 Apr 22, 2010
Jkt 220001
mental illness. Journal of Rehabilitation
Research and Development, 44(6), 837–
850.
Kessler, R., Heeringa, S., Lakoma, M.,
Petukhova, M., Rupp, A., Schoenbaum,
M., Wang, P., & Zaslavsky, A. (2008).
The Individual-Level and Societal-Level
Effects of Mental Disorders on Earnings
in the United States: Results From the
National Comorbidity Survey
Replication. American Journal of
Psychiatry, 165, 703–711.
McKnight-Eily, L., Elam-Evans, L.,
Strine, T., Zack, M., Perry, G., PresleyCantrell, L., Edwards, V., & Croft, J.B.
(2007). Activity limitation, chronic
disease, and comorbid serious
psychological distress in U.S. adults—
BRFSS 2007. International Journal of
Public Health, 54, S111–S119.
Merikangas, K., Ames, M., Cui, L.,
Stang, P., Ustun, T., Von Korff, M., &
Kessler, R. (2007). The Impact of
Comorbidity of Mental and Physical
Conditions on Role Disability in the US
Adult Household Population. Archives
of General Psychiatry, 64(10), 1180–
1188. See https://archpsyc.ama-assn.org/
cgi/content/full/64/10/1180.
Richardson, C., Faulkner, G.,
McDevitt, J., Skrinar, G., Hutchinson, D.,
& Piette, J. (2005). Integrating Physical
Activity Into Mental Health Services for
Persons With Serious Mental Illness.
Psychiatric Services, 56(3), 324–331.
See https://ps.psychiatryonline.org.
Sederer, L., Silver, L., McVeigh, K., &
Levy, J. (2006). Integrating care for
medical and mental illnesses.
Preventing Chronic Disease [serial
online]. See https://www.cdc.gov/pcd/
issues/2006/apr/05_0214.htm.
Vandiver, V. (2007). Health Promotion
as Brief Treatment: Strategies for
Women with Co-morbid Health and
Mental Health Conditions. Brief
Treatment and Crisis Intervention, 7(3),
161–175. See https://
btci.edina.clockss.org/cgi/content/
abstract/7/3/161.
Proposed Priority
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes a priority for a Rehabilitation
Research and Training Center (RRTC) on
Improved Outcomes for Individuals
with Serious Mental Illness and CoOccurring Conditions. The RRTC must
conduct research to adapt, modify, and
enhance health and mental health
models to improve health and
employment outcomes for individuals
with serious mental illness (SMI) and
co-occurring conditions. The RRTC
must conduct research, knowledge
translation, training, dissemination, and
technical assistance within a framework
of self-management and consumer-
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directed services. Under this priority,
the RRTC must contribute to the
following outcomes:
(a) Increased knowledge that can be
used to enhance the health and wellbeing of individuals with SMI and cooccurring conditions. The RRTC must
contribute to this outcome by:
(1) Conducting research to develop a
better understanding of the health, and
health care needs of individuals with
SMI and co-occurring conditions.
(2) Conducting research to identify or
develop and then test interventions that
aim to improve health outcomes and
promote recovery among individuals
living with SMI and co-occurring
conditions. These interventions must
include individual-level health
promotion strategies, such as peer
supports and consumer control, as well
as system-level strategies for the
delivery of physical and mental health
services. These interventions must be
based on the findings of research
conducted under paragraph (a)(1) of this
proposed priority. In carrying out this
activity, the grantee must investigate the
applicability of strategies that have
proven successful with the general
population or other subpopulations to
determine if they are effective with
individuals with SMI and co-occurring
conditions.
(b) Improved employment outcomes
among individuals with SMI and cooccurring conditions. The RRTC must
contribute to this outcome by
conducting research that demonstrates
how improvements in health service
delivery mechanisms, self-management,
peer support, and consumer control
affect employment outcomes in
individuals with SMI and co-occurring
conditions. In carrying out this activity
the grantee must utilize one or more of
the interventions developed under
paragraph (a)(2) of this proposed
priority.
(c) Increased incorporation of research
findings related to SMI, co-occurring
conditions, health management, and
employment into practice or policy. The
RRTC must contribute to this outcome
by coordinating with appropriate
NIDRR-funded knowledge translation
grantees to advance their work in the
following areas:
(1) Developing, evaluating, or
implementing strategies to increase
utilization of research findings related
to SMI, co-occurring conditions, health
management, and employment.
(2) Conducting training, technical
assistance, and dissemination activities
to increase utilization of research
findings related to SMI, co-occurring
conditions, health management, and
employment.
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Federal Register / Vol. 75, No. 78 / Friday, April 23, 2010 / Notices
Types of Priorities
When inviting applications for a
competition using one or more
priorities, we designate the type of each
priority as absolute, competitive
preference, or invitational through a
notice the Federal Register. The effect
of each type of priority follows:
Absolute priority: Under an absolute
priority, we consider only applications
that meet the priority (34 CFR
75.105(c)(3)).
Competitive preference priority:
Under a competitive preference priority,
we give competitive preference to an
application by (1) awarding additional
points, depending on the extent to
which the application meets the priority
(34 CFR 75.105(c)(2)(i)); or (2) selecting
an application that meets the priority
over an application of comparable merit
that does not meet the priority (34 CFR
75.105(c)(2)(ii)).
Invitational priority: Under an
invitational priority, we are particularly
interested in applications that meet the
priority. However, we do not give an
application that meets the priority a
preference over other applications (34
CFR 75.105(c)(1)).
Final Priority: We will announce the
final priority in a notice in the Federal
Register. We will determine the final
priority after considering responses to
this notice and other information
available to the Department. This notice
does not preclude us from proposing
additional priorities, requirements,
definitions, or selection criteria, subject
to meeting applicable rulemaking
requirements.
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
Note: This notice does not solicit
applications. In any year in which we choose
to use this priority, we invite applications
through a notice in the Federal Register.
Executive Order 12866: This notice
has been reviewed in accordance with
Executive Order 12866. Under the terms
of the order, we have assessed the
potential costs and benefits of this
proposed regulatory action.
The potential costs associated with
this proposed regulatory action are
those resulting from statutory
requirements and those we have
determined as necessary for
administering this program effectively
and efficiently.
In assessing the potential costs and
benefits—both quantitative and
qualitative—of this proposed regulatory
action, we have determined that the
benefits of the proposed priority justify
the costs.
Discussion of Costs and Benefits
The benefits of the Disability and
Rehabilitation Research Projects and
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15:23 Apr 22, 2010
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Centers Programs have been well
established over the years in that similar
projects have been completed
successfully. This proposed priority will
generate new knowledge through
research and development.
Another benefit of this proposed
priority is that the establishment of a
new RRTC will improve the lives of
individuals with disabilities. The new
RRTC will disseminate and promote the
use of new information that will
improve the options for individuals
with disabilities to obtain, retain, and
advance in employment.
Intergovernmental Review: This
program is not subject to Executive
Order 12372 and the regulations in 34
CFR part 79.
Accessible Format: Individuals with
disabilities can obtain this document in
an accessible format (e.g., braille, large
print, audiotape, or computer diskette)
by contacting the Grants and Contracts
Services Team, U.S. Department of
Education, 400 Maryland Avenue, SW.,
room 5075, PCP, Washington, DC
20202–2550. Telephone: (202) 245–
7363. If you use a TDD, call the FRS, toll
free, at 1–800–877–8339.
Electronic Access to This Document:
You can view this document, as well as
all other documents of this Department
published in the Federal Register, in
text or Adobe Portable Document
Format (PDF) on the Internet at the
following site: https://www.ed.gov/news/
fedregister. To use PDF you must have
Adobe Acrobat Reader, which is
available free at this site.
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: https://www.gpoaccess.gov/nara/
index.html.
Dated: April 20, 2010.
Alexa Posny,
Assistant Secretary for Special Education and
Rehabilitative Services.
[FR Doc. 2010–9511 Filed 4–22–10; 8:45 am]
BILLING CODE 4000–01–P
ELECTION ASSISTANCE COMMISSION
Request for Substantive Comments on
the EAC’s Proposed Requirements for
the Testing of Pilot Voting Systems To
Serve UOCAVA Voters; Correction
AGENCY: United States Election
Assistance Commission.
ACTION: Notice; correction.
SUMMARY: This is a correcting to provide
for a thirty day public comment period
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21285
as reflected by commission tally vote.
The original notice incorrectly provided
for a fifteen day public comment period.
The U.S. Election Assistance
Commission (EAC) is publishing for
public comment a set of proposed
requirements for the testing of pilot
voting systems to be used by
jurisdictions to serve Uniformed and
Overseas voters.
FOR FURTHER INFORMATION CONTACT:
Matthew Masterson, Phone (202) 566–
3100, e-mail
votingsystemguidelines@eac.gov.
Correction
In the Federal Register of March 31,
2010, on page 16090, in the first
column, correct the DATE caption to
read:
DATES: Comments must be received on
or before 4 p.m. EST on April 30, 2010.
Alice Miller,
Chief Operating Officer, U.S. Election
Assistance Commission.
[FR Doc. 2010–9384 Filed 4–22–10; 8:45 am]
BILLING CODE 6820–KF–P
DEPARTMENT OF ENERGY
Agency Information Collection
Extension
U.S. Department of Energy.
Notice and request for
Comments.
AGENCY:
ACTION:
SUMMARY: The Department of Energy
(DOE), pursuant to the Paperwork
Reduction Act of 1995, intends to
extend, for three years, an information
collection request with the Office of
Management and Budget (OMB).
Comments were invited on: (a) Whether
the extended collection of information
is necessary for the proper performance
of the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
or other forms of information
technology.
DATES: Comments regarding this
proposed information collection must
be received on or before June 22, 2010.
If you anticipate difficulty in submitting
comments within that period or if you
want access to the collection of
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Agencies
[Federal Register Volume 75, Number 78 (Friday, April 23, 2010)]
[Notices]
[Pages 21282-21285]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-9511]
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DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research
(NIDRR)--Disability and Rehabilitation Research Projects and Centers
Program--Rehabilitation Research and Training Centers (RRTCs)--Improved
Outcomes for Individuals With Serious Mental Illness and Co-Occurring
Conditions
Catalog of Federal Domestic Assistance (CFDA) Number: 84.133B-5.
AGENCY: Office of Special Education and Rehabilitative Services,
Department of Education.
ACTION: Notice of proposed priority.
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SUMMARY: The Assistant Secretary for Special Education and
Rehabilitative Services proposes a funding priority for the Disability
and Rehabilitation Research Projects and Centers Program administered
by NIDRR. Specifically, this notice proposes a priority for an RRTC on
Improved Outcomes for Individuals with Serious Mental Illness and Co-
Occurring Conditions. The Assistant Secretary may use this priority for
competitions in fiscal year (FY) 2010 and later years. We take this
action to focus research attention on areas of national need. We intend
this priority to improve rehabilitation services and outcomes for
individuals with disabilities.
DATES: We must receive your comments on or before May 24, 2010.
ADDRESSES: Address all comments about this notice to Donna Nangle, U.S.
Department of Education, 400 Maryland Avenue, SW., room 5142, Potomac
Center Plaza (PCP), Washington, DC 20202-2700.
If you prefer to send your comments by e-mail, use the following
address: donna.nangle@ed.gov. You must include the term ``Proposed
Priority for an RRTC on Improved Outcomes for Individuals with Serious
Mental Illness and Co-Occurring Conditions'' in the subject line of
your electronic message.
FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 245-
7462 or by e-mail: donna.nangle@ed.gov.
If you use a telecommunications device for the deaf (TDD), call the
Federal Relay Service (FRS), toll free, at 1-800-877-8339.
SUPPLEMENTARY INFORMATION:
This notice of proposed priority is in concert with NIDRR's Final
Long-Range Plan for FY 2005-2009 (Plan). The Plan, which was published
in the Federal Register on February 15, 2006 (71 FR 8165), can be
accessed on the Internet at the following site: https://www.ed.gov/about/offices/list/osers/nidrr/policy.html.
Through the implementation of the Plan, NIDRR seeks to: (1) Improve
the quality and utility of disability and rehabilitation research; (2)
foster an exchange of expertise, information, and training to
facilitate the advancement of knowledge and understanding of the unique
needs of traditionally underserved populations; (3) determine best
strategies and programs to improve rehabilitation outcomes for
underserved populations; (4) identify research gaps; (5) identify
mechanisms of integrating research and practice; and (6) disseminate
findings.
This notice proposes a priority that NIDRR intends to use for RRTC
competitions in FY 2010 and possibly later years. However, nothing
precludes NIDRR from publishing additional priorities, if needed.
Furthermore, NIDRR is under no obligation to make an award for this
priority. The decision to make an award will be based on the quality of
applications received and available funding.
Invitation to Comment: We invite you to submit comments regarding
this notice. To ensure that your comments have maximum effect in
developing the notice of final priority, we urge you to identify
clearly the specific topic that each comment addresses.
[[Page 21283]]
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 this proposed
priority. Please let us know of any further ways we could reduce
potential costs or increase potential benefits while preserving the
effective and efficient administration of the program.
During and after the comment period, you may inspect all public
comments about this notice in room 5142, 550 12th Street, SW., PCP,
Washington, DC, between the hours of 8:30 a.m. and 4:00 p.m.,
Washington, DC time, Monday through Friday of each week except Federal
holidays.
Assistance to Individuals with Disabilities in Reviewing the
Rulemaking Record: On request we will provide an appropriate
accommodation or auxiliary aid to an individual with a disability who
needs assistance to review the comments or other documents in the
public rulemaking record for this notice. If you want to schedule an
appointment for this type of accommodation or auxiliary aid, please
contact the person listed under FOR FURTHER INFORMATION CONTACT.
Purpose of Program: The purpose of the Disability and
Rehabilitation Research Projects and Centers Program is to plan and
conduct research, demonstration projects, training, and related
activities, including international activities, to develop methods,
procedures, and rehabilitation technology, that maximize the full
inclusion and integration into society, employment, independent living,
family support, and economic and social self-sufficiency of individuals
with disabilities, especially individuals with the most severe
disabilities, and to improve the effectiveness of services authorized
under the Rehabilitation Act of 1973, as amended.
RRTC Program
The purpose of the RRTC program is to improve the effectiveness of
services authorized under the Rehabilitation Act of 1973, as amended,
through advanced research, training, technical assistance, and
dissemination activities in general problem areas, as specified by
NIDRR. Such activities are designed to benefit rehabilitation service
providers, individuals with disabilities, and the family members or
other authorized representatives of individuals with disabilities. In
addition, NIDRR intends to require all RRTC applicants to meet the
requirements of the General Rehabilitation Research and Training
Centers (RRTC) Requirements priority that it published in a notice of
final priorities in the Federal Register on February 1, 2008 (73 FR
6132). Additional information on the RRTC program can be found at:
https://www.ed.gov/rschstat/research/pubs/res-program.html#RRTC.
Statutory and Regulatory Requirements of RRTCs
RRTCs must--
Carry out coordinated advanced programs of rehabilitation
research;
Provide training, including graduate, pre-service, and in-
service training, to help rehabilitation personnel more effectively
provide rehabilitation services to individuals with disabilities;
Provide technical assistance to individuals with
disabilities, their representatives, providers, and other interested
parties;
Disseminate informational materials to individuals with
disabilities, their representatives, providers, and other interested
parties; and
Serve as centers of national excellence in rehabilitation
research for individuals with disabilities, their representatives,
providers, and other interested parties.
Applicants for RRTC grants must also demonstrate in their
applications how they will address, in whole or in part, the needs of
individuals with disabilities from minority backgrounds.
Program Authority: 29 U.S.C. 762(g) and 764(b)(2).
Applicable Program Regulations: 34 CFR part 350.
Proposed Priority
This notice contains one proposed priority.
Improved Outcomes for Individuals With Serious Mental Illness and Co-
Occurring Conditions
Background
As many as 6.5 percent of adults ages 18-64 experience serious
mental illness (SMI) during any 12-month period (Kessler et al., 2008).
Individuals with SMI are at high risk for chronic diseases such as
cardiovascular disease, diabetes, asthma, and cancer (Colton &
Manderscheid, 2006; Sederer, et al., 2006). The comorbidity of SMI and
chronic disease is associated with limitations on activities such as
self-care and employment (McKnight-Eily et al., 2007). Individuals with
SMI experience disproportionately low rates of employment compared to
the general United States population and to other individuals with
disabilities, and those with SMI and co-occurring conditions work even
fewer hours, have lower total earnings, and are less likely to engage
in competitive employment than those with SMI alone (Cook et al., 2005;
Goldberg et al., 2007).
Health promotion, illness self-management, and using a holistic
approach to rehabilitation are practices that have been rigorously
studied and effectively used to prevent, control, or treat a variety of
medical conditions such as diabetes, breast and cervical cancer, heart
disease, and stroke. Peer-delivered health and wellness education
curriculums also have been widely implemented to reduce tobacco or
alcohol usage, improve nutrition, and modify risk behaviors among the
general population or subpopulations, including women, workers, and
members of racial or ethnic minorities (CDC, 2009; Collins, Marks, and
Koplan, 2009). While some of this research and practice addresses
health promotion for individuals with SMI, the science for individuals
with SMI is still emerging, and has not sufficiently advanced to
address the needs and experiences of individuals with SMI and co-
occurring conditions (CMHS, 2005; Richardson et al., 2005; Sederer et
al., 2006).
Past research funded by NIDRR and others provides a potential base
for testing models that link management and self-management of SMI and
co-occurring physical conditions to mental health recovery (Vandiver,
2007). For example, consumer-to-consumer education and consumer-
directed programs \1\ for individuals with SMI can be effective in
promoting recovery from mental illness and merit further study as
mechanisms for health promotion (CMHS, 2005). At the systems level,
lack of integration and coordination of mental health and primary care
services contribute to poor health outcomes for those with SMI (CMHS,
2005). Further study on integration and coordination of mental health
and primary care services at the systems level, therefore, would be
highly beneficial for individuals with SMI and co-occurring physical
conditions.
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\1\ Consumer-directed models of service delivery are defined by
the belief that individuals with disabilities should determine the
types, amounts, and sources of the services they receive. In the
mental health services context, consumer-directed care approaches
include self-help and mutual-aid support groups, mental illness
self-management, and advance crisis planning by individuals with SMI
(Cook, 2005).
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Improved management of SMI and co-occurring conditions could
contribute to improved health and employment outcomes for these
individuals (Merikangas et al., 2007). Research is
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needed to develop interventions that address the interactions between
SMI and health that are potential barriers to competitive employment,
economic well-being, and maximum participation in society.
References
Center for Mental Health Services (CMHS), Substance Abuse and
Mental Health Services Administration. (2005). HHS Pub. No. 4040.
Rockville, MD: Building Bridges: Mental Health Consumers and Primary
Care Representatives in Dialogue. U.S. Department of Health and Human
Services. See https://download.ncadi.samhsa.gov/ken/pdf/SMA06-4040/Policy_Makers_Booklet.pdf.
Centers for Disease Control and Prevention (CDC). (2009). The Guide
to Community Preventive Services. U.S. Department of Health and Human
Services. See https://www.thecommunityguide.org/.
Collins, J., Marks, J., & Koplan, J. (2009). Chronic disease
prevention and control: Coming of age at the Centers for Disease
Control and Prevention. Preventing Chronic Disease [serial online]. See
https://www.cdc.gov/pcd/issues/2009/jul/08_0171.htm.
Colton, C. & Manderscheid, R. (2006). Congruencies in increased
mortality rates, years of potential life lost, and causes of death
among public mental health clients in eight States. Preventing Chronic
Disease [serial online]. See https://www.cdc.gov/pcd/issues/2006/apr/05_0180.htm.
Cook, J. (2005). ``Patient-Centered'' and ``Consumer-Directed''
Mental Health Services. Prepared for the Institute of Medicine,
Committee on Crossing the Quality Chasm--Adaptation to Mental Health &
Addictive Disorders. See https://www.cmhsrp.uic.edu/download/IOMreport.pdf.
Cook, J., Burke-Miller, J., Blyler, C., Leff, H., Mueser, K., Gold,
P., Goldberg, R., Mueser, K., Toprac, M., McFarlane, W., Shafer, M.,
Blankertz, L., Dudek, K., Razzano, L., Grey, D., & Burke-Miller, J.
(2005). Results of a Multisite Randomized Trial of Supported Employment
Interventions for Individuals With Severe Mental Illness. Archives of
General Psychiatry, (62), 505-512. See https://archpsyc.ama-assn.org/cgi/content/full/62/5/505.
Goldberg, R., Shafer, M., Onken, S., McFarlane, W., Donegan, K.,
Carey, M., Kaufmann, C. & Grey, D. (2007). Effects of co-occurring
disorders on employment outcomes in a multisite randomized study of
supported employment for people with severe mental illness. Journal of
Rehabilitation Research and Development, 44(6), 837-850.
Kessler, R., Heeringa, S., Lakoma, M., Petukhova, M., Rupp, A.,
Schoenbaum, M., Wang, P., & Zaslavsky, A. (2008). The Individual-Level
and Societal-Level Effects of Mental Disorders on Earnings in the
United States: Results From the National Comorbidity Survey
Replication. American Journal of Psychiatry, 165, 703-711.
McKnight-Eily, L., Elam-Evans, L., Strine, T., Zack, M., Perry, G.,
Presley-Cantrell, L., Edwards, V., & Croft, J.B. (2007). Activity
limitation, chronic disease, and comorbid serious psychological
distress in U.S. adults--BRFSS 2007. International Journal of Public
Health, 54, S111-S119.
Merikangas, K., Ames, M., Cui, L., Stang, P., Ustun, T., Von Korff,
M., & Kessler, R. (2007). The Impact of Comorbidity of Mental and
Physical Conditions on Role Disability in the US Adult Household
Population. Archives of General Psychiatry, 64(10), 1180-1188. See
https://archpsyc.ama-assn.org/cgi/content/full/64/10/1180.
Richardson, C., Faulkner, G., McDevitt, J., Skrinar, G.,
Hutchinson, D., & Piette, J. (2005). Integrating Physical Activity Into
Mental Health Services for Persons With Serious Mental Illness.
Psychiatric Services, 56(3), 324-331. See https://ps.psychiatryonline.org.
Sederer, L., Silver, L., McVeigh, K., & Levy, J. (2006).
Integrating care for medical and mental illnesses. Preventing Chronic
Disease [serial online]. See https://www.cdc.gov/pcd/issues/2006/apr/05_0214.htm.
Vandiver, V. (2007). Health Promotion as Brief Treatment:
Strategies for Women with Co-morbid Health and Mental Health
Conditions. Brief Treatment and Crisis Intervention, 7(3), 161-175. See
https://btci.edina.clockss.org/cgi/content/abstract/7/3/161.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for a Rehabilitation Research and Training
Center (RRTC) on Improved Outcomes for Individuals with Serious Mental
Illness and Co-Occurring Conditions. The RRTC must conduct research to
adapt, modify, and enhance health and mental health models to improve
health and employment outcomes for individuals with serious mental
illness (SMI) and co-occurring conditions. The RRTC must conduct
research, knowledge translation, training, dissemination, and technical
assistance within a framework of self-management and consumer-directed
services. Under this priority, the RRTC must contribute to the
following outcomes:
(a) Increased knowledge that can be used to enhance the health and
well-being of individuals with SMI and co-occurring conditions. The
RRTC must contribute to this outcome by:
(1) Conducting research to develop a better understanding of the
health, and health care needs of individuals with SMI and co-occurring
conditions.
(2) Conducting research to identify or develop and then test
interventions that aim to improve health outcomes and promote recovery
among individuals living with SMI and co-occurring conditions. These
interventions must include individual-level health promotion
strategies, such as peer supports and consumer control, as well as
system-level strategies for the delivery of physical and mental health
services. These interventions must be based on the findings of research
conducted under paragraph (a)(1) of this proposed priority. In carrying
out this activity, the grantee must investigate the applicability of
strategies that have proven successful with the general population or
other subpopulations to determine if they are effective with
individuals with SMI and co-occurring conditions.
(b) Improved employment outcomes among individuals with SMI and co-
occurring conditions. The RRTC must contribute to this outcome by
conducting research that demonstrates how improvements in health
service delivery mechanisms, self-management, peer support, and
consumer control affect employment outcomes in individuals with SMI and
co-occurring conditions. In carrying out this activity the grantee must
utilize one or more of the interventions developed under paragraph
(a)(2) of this proposed priority.
(c) Increased incorporation of research findings related to SMI,
co-occurring conditions, health management, and employment into
practice or policy. The RRTC must contribute to this outcome by
coordinating with appropriate NIDRR-funded knowledge translation
grantees to advance their work in the following areas:
(1) Developing, evaluating, or implementing strategies to increase
utilization of research findings related to SMI, co-occurring
conditions, health management, and employment.
(2) Conducting training, technical assistance, and dissemination
activities to increase utilization of research findings related to SMI,
co-occurring conditions, health management, and employment.
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Types of Priorities
When inviting applications for a competition using one or more
priorities, we designate the type of each priority as absolute,
competitive preference, or invitational through a notice the Federal
Register. The effect of each type of priority follows:
Absolute priority: Under an absolute priority, we consider only
applications that meet the priority (34 CFR 75.105(c)(3)).
Competitive preference priority: Under a competitive preference
priority, we give competitive preference to an application by (1)
awarding additional points, depending on the extent to which the
application meets the priority (34 CFR 75.105(c)(2)(i)); or (2)
selecting an application that meets the priority over an application of
comparable merit that does not meet the priority (34 CFR
75.105(c)(2)(ii)).
Invitational priority: Under an invitational priority, we are
particularly interested in applications that meet the priority.
However, we do not give an application that meets the priority a
preference over other applications (34 CFR 75.105(c)(1)).
Final Priority: We will announce the final priority in a notice in
the Federal Register. We will determine the final priority after
considering responses to this notice and other information available to
the Department. This notice does not preclude us from proposing
additional priorities, requirements, definitions, or selection
criteria, subject to meeting applicable rulemaking requirements.
Note: This notice does not solicit applications. In any year in
which we choose to use this priority, we invite applications through
a notice in the Federal Register.
Executive Order 12866: This notice has been reviewed in accordance
with Executive Order 12866. Under the terms of the order, we have
assessed the potential costs and benefits of this proposed regulatory
action.
The potential costs associated with this proposed regulatory action
are those resulting from statutory requirements and those we have
determined as necessary for administering this program effectively and
efficiently.
In assessing the potential costs and benefits--both quantitative
and qualitative--of this proposed regulatory action, we have determined
that the benefits of the proposed priority justify the costs.
Discussion of Costs and Benefits
The benefits of the Disability and Rehabilitation Research Projects
and Centers Programs have been well established over the years in that
similar projects have been completed successfully. This proposed
priority will generate new knowledge through research and development.
Another benefit of this proposed priority is that the establishment
of a new RRTC will improve the lives of individuals with disabilities.
The new RRTC will disseminate and promote the use of new information
that will improve the options for individuals with disabilities to
obtain, retain, and advance in employment.
Intergovernmental Review: This program is not subject to Executive
Order 12372 and the regulations in 34 CFR part 79.
Accessible Format: Individuals with disabilities can obtain this
document in an accessible format (e.g., braille, large print,
audiotape, or computer diskette) by contacting the Grants and Contracts
Services Team, U.S. Department of Education, 400 Maryland Avenue, SW.,
room 5075, PCP, Washington, DC 20202-2550. Telephone: (202) 245-7363.
If you use a TDD, call the FRS, toll free, at 1-800-877-8339.
Electronic Access to This Document: You can view this document, as
well as all other documents of this Department published in the Federal
Register, in text or Adobe Portable Document Format (PDF) on the
Internet at the following site: https://www.ed.gov/news/fedregister. To
use PDF you must have Adobe Acrobat Reader, which is available free at
this site.
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: https://www.gpoaccess.gov/nara/.
Dated: April 20, 2010.
Alexa Posny,
Assistant Secretary for Special Education and Rehabilitative Services.
[FR Doc. 2010-9511 Filed 4-22-10; 8:45 am]
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