Proposed Priority-National Institute on Disability, Independent Living, and Rehabilitation Research-Rehabilitation Research and Training Centers, 13569-13573 [2015-05989]
Download as PDF
13569
Federal Register / Vol. 80, No. 50 / Monday, March 16, 2015 / Notices
competing Continuation Progress Report
(PHS 2590), exists for a small group of
grantees. This collection also includes
other PHS post-award reporting
requirements: PHS 416–7 NRSA
Termination Notice, PHS 2271
Statement of Appointment, 6031–1
NRSA Annual Payback Activities
Certification, HHS 568 Final Invention
Statement and Certification, Final
Progress Report instructions, iEdison,
and PHS 3734 Statement
Relinquishing Interests and Rights in a
PHS Research Grant. The PHS 416–7,
2271, and 6031–1 are used by NRSA
recipients to activate, terminate, and
provide for payback of a NRSA.
Closeout of an award requires a Final
Invention Statement (HHS 568) and
Final Progress Report. iEdison allows
grantees and Federal agencies to meet
statutory requirements for reporting
inventions and patents. The PHS 3734
serves as the official record of grantee
relinquishment of a PHS award when an
award is transferred from one grantee
institution to another. Pre-award
reporting requirements are
simultaneously consolidated under
0925–0001. Frequency of response:
Applicants may submit applications for
published receipt dates. For NRSA
awards, fellowships are activated and
trainees appointed. Affected Public:
Universities and other research
institutions; Business or other for-profit;
Not-for-profit institutions; Federal
Government; and State, Local or Tribal
Government. Type of Respondents:
University administrators and principal
professionals. The annual reporting
burden is as follows: Total Estimated
Number of Respondents: 112,986.
Estimated Number of Responses per
Respondent: 1. Average Burden Hours
per Response: 5.6. Estimated Total
Annual Burden Hours Requested:
640,677. The annualized cost to
respondents is estimated to be
$22,423,709. There are no Capital Costs
to report. There are no Operating or
Maintenance Costs to report.
OMB approval is requested for 3
years. There are no costs to respondents
other than their time. The total
estimated annualized burden hours are
640,677.
ESTIMATES OF HOUR BURDEN
Number of
respondents
Information collection No. or title
Frequency of
response
RPPR (or 2590 or 416–9) .............................................................................
PHS 416–7 ....................................................................................................
PHS 2271 ......................................................................................................
PHS 6031–1 ..................................................................................................
HHS 568 ........................................................................................................
Final Progress Report ....................................................................................
iEdison ...........................................................................................................
PHS 3734 ......................................................................................................
40,569
3,371
15,500
1,600
22,681
22,681
6,000
584
112,986
15
30/60
15/60
20/60
5/60
1
15/60
6/60
608,535
1,686
3,875
528
1,814
22,681
1,500
58
........................
Dated: March 9, 2015.
Lawrence A. Tabak,
Deputy Director, National Institutes of Health.
[FR Doc. 2015–05929 Filed 3–13–15; 8:45 am]
BILLING CODE 4140–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Community Living
Proposed Priority—National Institute
on Disability, Independent Living, and
Rehabilitation Research—
Rehabilitation Research and Training
Centers
Administration for Community
Living, Department of Health and
Human Services.
ACTION: Notice of Proposed Priority.
AGENCY:
CFDA Number: 84.133B–6.
Rmajette on DSK2VPTVN1PROD with NOTICES
Annual burden
hours
1
1
1
1
1
1
1
1
Totals ......................................................................................................
Average time
(hrs) per
response
The Administrator of the
Administration for Community Living
proposes a priority for the
Rehabilitation Research and Training
Center (RRTC) Program administered by
the National Institute on Disability,
Independent Living, and Rehabilitation
Research (NIDILRR). Specifically, this
SUMMARY:
VerDate Sep<11>2014
14:09 Mar 13, 2015
Jkt 235001
notice proposes a priority for an RRTC
on Outcomes Measurement for Home
and Community Based Services. We
take this action to focus research
attention on an area of national need.
We intend this priority to contribute to
improved home and community based
services for individuals with
disabilities.
We must receive your comments
on or before April 15, 2015.
ADDRESSES: Address all comments about
this notice to Carolyn Baron, U.S.
Department of Health and Human
Services, 550 12th Street SW., Room
5134, PCP, Washington, DC 20202–
2700.
If you prefer to send your comments
by email, use the following address:
carolyn.baron@ed.gov. You must
include the phrase ‘‘Proposed Priorities
for RRTCs’’ and the priority title in the
subject line of your electronic message.
We will not accept comments
submitted by fax or those submitted
after the comment period. To ensure
that we do not receive duplicate copies,
please submit your comments only
once.
• Postal Mail or Commercial Delivery:
If you mail or deliver your comments
DATES:
PO 00000
Frm 00056
Fmt 4703
Sfmt 4703
5.6
640,677
about these proposed regulations,
address them to Carolyn Baron, U.S.
Department of Health and Human
Services, 400 Maryland Avenue SW.,
Room 5134, Potomac Center Plaza
(PCP), Washington, DC 20202–2700.
Privacy Note: The Department’s
policy is to make all comments received
from members of the public available for
public viewing in their entirety.
Therefore, commenters should be
careful to include in their comments
only information that they wish to make
publicly available.
FOR FURTHER INFORMATION CONTACT:
Carolyn Baron. Telephone: (202) 245–
7244 or by email: carolyn.baron@ed.gov.
If you use a telecommunications
device for the deaf (TDD) or a text
telephone (TTY), call the Federal Relay
Service (FRS), toll free, at 1–800–877–
8339.
This
notice of proposed priority is in concert
with NIDILRR’s currently approved
Long-Range Plan (Plan). The Plan,
which was published in the Federal
Register on April 4, 2013 (78 FR 20299),
can be accessed on the Internet at the
following site: www.ed.gov/about/
offices/list/osers/nidrr/policy.html.
SUPPLEMENTARY INFORMATION:
E:\FR\FM\16MRN1.SGM
16MRN1
Rmajette on DSK2VPTVN1PROD with NOTICES
13570
Federal Register / Vol. 80, No. 50 / Monday, March 16, 2015 / Notices
The Plan identifies a need for research
and training that can be used to improve
outcomes of individuals with
disabilities. To address this need,
NIDILRR seeks to: (1) Improve the
quality and utility of disability and
rehabilitation research; (2) foster an
exchange of research findings, expertise,
and other information to advance
knowledge and understanding of the
needs of individuals with disabilities
and their family members, including
those from among traditionally
underserved populations; (3) determine
effective practices, programs, and
policies to improve community living
and participation, employment, and
health and function outcomes for
individuals with disabilities of all ages;
(4) identify research gaps and areas for
promising research investments; (5)
identify and promote effective
mechanisms for integrating research and
practice; and (6) disseminate research
findings to all major stakeholder groups,
including individuals with disabilities
and their family members in formats
that are appropriate and meaningful to
them.
This notice proposes one priority that
NIDILRR intends to use for one or more
competitions in fiscal year (FY) 2015
and possibly later years. NIDILRR is
under no obligation to make an award
under this priority. The decision to
make an award will be based on the
quality of applications received and
available funding. NIDILRR may publish
additional priorities, as needed.
Invitation to Comment: We invite you
to submit comments regarding this
proposed priority. To ensure that your
comments have maximum effect in
developing the final priority, we urge
you to identify clearly the specific topic
within the priority that each comment
addresses.
We invite you to assist us in
complying with the specific
requirements of E.O. 12866 and 13563
and their 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
sent to NIDILRR 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
VerDate Sep<11>2014
14:09 Mar 13, 2015
Jkt 235001
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 (Rehabilitation
Act).
Rehabilitation Research and Training
Centers
The purpose of the RRTCs, which are
funded through the Disability and
Rehabilitation Research Projects and
Centers Program, is to achieve the goals
of, and improve the effectiveness of,
services authorized under the
Rehabilitation Act through welldesigned research, training, technical
assistance, and dissemination activities
in important topical areas as specified
by NIDILRR. These activities are
designed to benefit rehabilitation
service providers, individuals with
disabilities, family members,
policymakers and other research
stakeholders. Additional information on
the RRTC program can be found at:
https://www2.ed.gov/programs/rrtc/
index.html#types.
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.
RRTC on Outcomes Measurement for
Home and Community Based Services
Background
Approximately $140 billion is spent
nationally on Medicaid long-term
services and supports (LTSS) (Eiken et
al., 2014). States continue to rebalance
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
their LTSS expenditures to decrease the
reliance on nursing homes and other
institutional services for individuals of
all ages with disabilities. Nearly half of
Medicaid’s LTSS expenditures go
toward home and community-based
services (HCBS) compared to only 18%
in 1995 (Eiken et al., 2014). The aging
of the population and growing
consumer demand to live in home-based
settings will continue to increase the
need for home and community-based
services (HCBS). As more people receive
LTSS in the community, there is a need
for validated measures of consumer
outcomes and experiences that can be
used as indicators of HCBS quality
(Commission on Long Term Care, 2013;
Disability Rights Education & Defense
Fund, 2013). Compared to measurement
efforts in clinical settings, non-medical
performance measures in HCBS are in
the early stages of development and
standardization (National Quality
Forum, 2012). Accordingly, NIDILRR is
sponsoring a Rehabilitation Research
and Training Center on Outcomes
Measurement for Home and Community
Based Services.
Efforts to measure the quality of a
wide variety of services, including
home- and community-based LTSS, may
include structural measures (whether a
particular mechanism is in place),
process measures (which track the
performance of a particular action) and
outcomes measures (the results of
actions and mechanisms) (Disability
Rights Education & Defense Fund, 2013;
Booth & Fralich, 2006). In the long-term
care context, structural indicators of
quality may include the ratio of service
providers to consumers, for example,
and process indicators of quality may
include the skill levels of providers and
the timeliness of the services they
deliver (Disability Rights Education &
Defense Fund, 2013). User outcomes are
also important indicators of service
quality. In the HCBS context, health
status and levels of community
integration, participation, and inclusion
among service recipients can be
important markers of HCBS quality
(Disability Rights Education & Defense
Fund, 2013).
For decades, efforts to measure and
improve long-term care quality have
focused on nursing homes. Historically,
the assessment of quality in nursing
homes and other institutional long-term
care settings emphasized the protection
and safety of residents. As the delivery
of LTSS is increasingly taking place in
home and community-based settings,
these institution-based quality
measurement efforts have not been
translated into measures that are
relevant and important to individuals
E:\FR\FM\16MRN1.SGM
16MRN1
Rmajette on DSK2VPTVN1PROD with NOTICES
Federal Register / Vol. 80, No. 50 / Monday, March 16, 2015 / Notices
who are receiving services at home
(Commission on Long-Term Care, 2013).
While protection and safety are
important to HCBS recipients, other
factors are important and relevant in
these settings, including levels of
community integration, participation,
and inclusion.
As states continue to rebalance their
LTSS expenditures to decrease reliance
on nursing homes and increase service
delivery in home and community-based
settings, they have begun the process of
developing person-centered HCBS
measures that assess outcomes from the
perspective of service users. The State of
Wisconsin, for example, has developed
and implemented a set of measures that
assess ‘‘person-centered quality of life’’
outcomes that are important to HCBS
users (Karon & Schlaak, 2012). By
seeking extensive input from service
users and other stakeholders, Wisconsin
has developed quality of life concepts
and measures that are used to assess the
extent to which (1) individuals have
choice over their living arrangements
and services, (2) individuals have
desired social relationships and
participate in meaningful ways in
society, and (3) individuals are healthy
and safe (Wisconsin Department of
Health Services, 2014). Within this
person-centered outcomes measurement
system, service users are able to choose
the specific outcomes that are the most
important to them and describe the
extent to which the long-term care
services they are receiving support their
achievement of those outcomes. With
this outcomes assessment system
Wisconsin has developed state-wide
quality of life outcomes reports that
aggregate findings for all of its HCBS
users, as well as reports that provide
comparisons of outcomes across
different HCBS programs and
subpopulations (Karon & Schlaak,
2012).
Recent efforts at the Federal level
have begun to address the need for
HCBS quality measures. For example,
the Administration for Community
Living (ACL) is contracting with the
National Quality Forum (NQF) to create
a conceptual framework for HCBS
quality measurement and to make
recommendations for HCBS measure
development efforts. Through this work,
ACL aims to create a conceptual
foundation for the development of
measures that can be used to assess and
ultimately support independence and
community living outcomes of HCBS
recipients (National Quality Forum,
2015). Much work remains to
conceptualize and measure HCBS
quality in terms of the outcomes that are
important to long-term care recipients.
VerDate Sep<11>2014
14:09 Mar 13, 2015
Jkt 235001
These outcomes include adequacy and
appropriateness of care, as well as the
consumers’ level of control, social
integration, social participation, and
general quality of life (Kaye, 2014).
Another foundation for the
development of person-centered HCBS
outcomes measures is the ongoing work
of rehabilitation researchers to create
valid and reliable measures of
community participation of people with
disabilities (Walker, Mellick, Brooks, &
Whiteneck, 2003; Hammel, Magasi,
Heinemann, Whiteneck, Bogner &
Rodriguez, 2012; Whiteneck & Dijkers,
2009; Heinemann, 2010). These research
and development efforts include the
application of advanced item-scaling
and person-centered measurement
techniques that can be implemented as
computerized adaptive tests (CAT)
(Haley et al., 2008), thus reducing data
collection burden on people with
disabilities. These efforts to develop
participation outcome measures for
people with disabilities are highly
relevant to the applied efforts to develop
person-centered HCBS outcome
measures.
These and other Federal and state
efforts provide a strong foundation for
further research on and development of
person-centered HCBS outcomes
measures and measurement systems that
assess and promote community living,
independent living and social
integration of HCBS users. Accordingly,
NIDILRR aims to support a
Rehabilitation Research and Training
Center on Outcomes Measurement for
Home and Community Based Services.
This RRTC will conduct research and
development activities in this critical
area and will serve as a national
resource center on HCBS outcomes
measurement for Federal and state-level
policymakers, people with disabilities
and other key stakeholders.
References
Booth, M., Fralich, J. (2006). Performance
Measurement: Managing and Using
Home and Community-Based Services
Data for Quality Improvement.
University of Southern Maine: Muskie
School of Public Service. https://
muskie.usm.maine.edu/Publications/
DA/Performance-MeasurementHCBS.pdf.
Commission on Long Term Care. (September
30, 2013). Report to the Congress. https://
ltccommission.lmp01.lucidus.net/wpcontent/uploads/2013/12/Commissionon-Long-Term-Care-Final-Report-9-2613.pdf.
Disability Rights Education & Defense Fund
(2013). Identifying and Selecting Long
Term Services and Supports Outcomes
Measures. https://dredf.org/2013documents/Guide-LTSS-OutcomeMeasures.pdf.
PO 00000
Frm 00058
Fmt 4703
Sfmt 4703
13571
Eiken, Steve, et al. (2014). Medicaid
Expenditures for Long-Term Services
and Supports for FFY 2012. https://
www.medicaid.gov/medicaid-chipprogram-information/by-topics/longterm-services-and-supports/downloads/
ltss-expenditures-2012.pdf.
Haley, S., Gandek, B., Siebens, H., BlackSchaffer, R., Sinclair, S., Tao, W., Coster,
W., Ni, P., & Jette, A. (2008).
Computerized Adaptive Testing for
Follow-Up After Discharge From
Inpatient Rehabilitation: Participation
Outcomes. Archives of Physical
Medicine and Rehabilitation. 89(2): 275–
283.
Hammel, J., Magasi, S., Heinemann, A.,
Whiteneck, G., Bogner, & Rodriguez, E.
(2008). What Does Participation Mean?
An Insider Perspective From People
With Disabilities. Disability and
Rehabilitation. 30(19): 1445–1460.
Heinemann, A. (2010). Measurement of
Participation in Rehabilitation Research.
Archives of Physical Medicine and
Rehabilitation. 91(9): S1–S4.
Karon, S., and Schlaak, M. (2012). PEONIES
Member Interviews, State Fiscal Year
2012, Final Report. Madison, WI: Center
for Health Systems Research and
Analysis. https://www.chsra.wisc.edu/
peonies/documents/PEONIES%20Final
%20Report%20SFY2012%20-%20
rev%2011-9-2012.pdf.
Kaye, H. Stephen. Toward a Model LongTerm Services and Supports System:
State Policy Elements. The Gerontologist.
(October 2014). https://gerontologist.
oxfordjournals.org/content/54/5/754.
full.pdf+html.
National Quality Forum (2015). Home and
Community Based Services Quality.
https://www.qualityforum.org/Project
Description.aspx?projectID=77692.
National Quality Forum, ‘‘Measuring
Healthcare Quality for the Dual Eligible
Beneficiary Population, Measure
Application Partnership, Final Report to
HHS,’’ June, 2012.
Walker, N., Mellick, D., Brooks, CA,
Whiteneck, G. (2003). Measuring
Participation Across Impairment Groups
Using the Craig Handicap Assessment
Reporting Technique. American Journal
of Physical Medicine and Rehabilitation.
82(12): 936–941.
Whiteneck, G., & Dijkers, M. (2009). Difficult
to Measure Constructs. Conceptual and
Methodological Issues Concerning
Participation and Environmental Factors.
Archives of Physical Medicine and
Rehabilitation. 90(11) S22–S35.
Wisconsin Department of Health Services
(2014). Measuring Person-Centered
Quality. November 11, 2014: https://
www.dhs.wisconsin.gov/familycare/
reports/peonies.htm.
Definitions
The research that is proposed under
this priority must be focused on one or
more stages of research. If the RRTC is
to conduct research that can be
categorized under more than one
research stage, or research that
E:\FR\FM\16MRN1.SGM
16MRN1
Rmajette on DSK2VPTVN1PROD with NOTICES
13572
Federal Register / Vol. 80, No. 50 / Monday, March 16, 2015 / Notices
progresses from one stage to another,
those research stages must be clearly
specified. For purposes of this priority,
the stages of research are from the notice
of final priorities and definitions
published in the Federal Register on
June 7, 2013 (78 FR 34261).
(a) Exploration and Discovery means
the stage of research that generates
hypotheses or theories by conducting
new and refined analyses of data,
producing observational findings, and
creating other sources of research-based
information. This research stage may
include identifying or describing the
barriers to and facilitators of improved
outcomes of individuals with
disabilities, as well as identifying or
describing existing practices, programs,
or policies that are associated with
important aspects of the lives of
individuals with disabilities. Results
achieved under this stage of research
may inform the development of
interventions or lead to evaluations of
interventions or policies. The results of
the exploration and discovery stage of
research may also be used to inform
decisions or priorities.
(b) Intervention Development means
the stage of research that focuses on
generating and testing interventions that
have the potential to improve outcomes
for individuals with disabilities.
Intervention development involves
determining the active components of
possible interventions, developing
measures that would be required to
illustrate outcomes, specifying target
populations, conducting field tests, and
assessing the feasibility of conducting a
well-designed interventions study.
Results from this stage of research may
be used to inform the design of a study
to test the efficacy of an intervention.
(c) Intervention Efficacy means the
stage of research during which a project
evaluates and tests whether an
intervention is feasible, practical, and
has the potential to yield positive
outcomes for individuals with
disabilities. Efficacy research may assess
the strength of the relationships
between an intervention and outcomes,
and may identify factors or individual
characteristics that affect the
relationship between the intervention
and outcomes. Efficacy research can
inform decisions about whether there is
sufficient evidence to support ‘‘scalingup’’ an intervention to other sites and
contexts. This stage of research can
include assessing the training needed
for wide-scale implementation of the
intervention, and approaches to
evaluation of the intervention in real
world applications.
(d) Scale-Up Evaluation means the
stage of research during which a project
VerDate Sep<11>2014
14:09 Mar 13, 2015
Jkt 235001
analyzes whether an intervention is
effective in producing improved
outcomes for individuals with
disabilities when implemented in a realworld setting. During this stage of
research, a project tests the outcomes of
an evidence-based intervention in
different settings. It examines the
challenges to successful replication of
the intervention, and the circumstances
and activities that contribute to
successful adoption of the intervention
in real-world settings. This stage of
research may also include well-designed
studies of an intervention that has been
widely adopted in practice, but that
lacks a sufficient evidence-base to
demonstrate its effectiveness.
Proposed Priority
The Administrator of the
Administration for Community Living
proposes a priority for the
Rehabilitation Research and Training
Center (RRTC) program administered by
the National Institute on Disability,
Independent Living, and Rehabilitation
Research (NIDILRR). Specifically, this
notice proposes a priority for an RRTC
on Outcomes Measurement for Home
and Community Based Services. The
RRTC will engage in research,
development, and testing of measures to
assess the quality of HCBS in terms of
the person-centered outcomes achieved
by people with disabilities who use the
services in home and community
settings. The RRTC will also engage in
knowledge translation, development of
informational products, and
dissemination to enhance the field’s
capacity to measure the extent to which
HCBS leads to improved outcomes in
community living and independent
living areas that are important to people
with disabilities and other stakeholders.
Ultimately, the RRTC’s development of
non-medical, person-centered outcome
measures is intended to inform the
design, implementation, and continuous
improvement of Federal and state
policies and programs related to the
delivery of HCBS to people with
disabilities. The RRTC must contribute
to these outcomes by:
(a) Identifying or developing
measures, and then testing the proposed
measures to assess the person-centered
outcomes of individuals with
disabilities who are receiving home and
community-based services. HCBS
measures developed under this priority
must be non-medical and must focus on
the end-users’ experience of community
living, independent living, social
integration, community participation,
and other similar outcomes. The
measures developed under this priority
must also be designed to minimize data
PO 00000
Frm 00059
Fmt 4703
Sfmt 4703
collection burden on HCBS recipients.
Possible methods for minimizing this
burden include, but are not limited to,
use of relevant administrative data,
modifying administrative data to
include person-centered goals as well as
fields to assess progress toward those
goals, and use of advanced item-scaling
and person-centered measurement
techniques that can be implemented as
computerized adaptive tests (CAT).
(b) Increasing incorporation of the
RRTC’s HCBS outcome measures into
practice and policy. The RRTC must
contribute to this outcome by—
(1) Working closely with NIDILRR
and the Administration for Community
Living (ACL) at each stage of the
measure development and testing
processes to ensure that its activities are
informing and informed by other HCBS
quality initiatives taking place within
ACL and other relevant Federal and
state agencies. This specifically includes
the work taking place under the
National Quality Forum’s work with the
Department of Health and Human
Services (https://www.qualityforum.org/
ProjectDescription.aspx
?projectID=77692).
(2) Developing procedures and
mechanisms for applying HCBS
outcome measures in policy and service
delivery settings to maximize quality
and appropriateness of HCBS from the
end-user perspective.
(3) Collaborating with stakeholder
groups to develop, evaluate, or
implement strategies to increase
utilization of new HCBS outcome
measures. Stakeholder groups include
but, are not limited to, people with
disabilities, Federal- and state-level
policymakers; home and community
based service providers; advocacy
organizations; and Centers for
Independent Living.
(4) Collaborating with relevant
NIDILRR-sponsored knowledge
translation grantees to help promote the
uptake of RRTC products by relevant
stakeholders and embed the outcome
measures into the overall health care
measurement system.
(c) Serving as a national resource
center related to person-centered
measurement of HCBS outcomes:
(1) Disseminating information and
providing technical assistance related to
HCBS outcome and quality
measurement to policymakers, service
providers, people with disabilities and
their representatives, and other key
stakeholders; and
(2) Providing relevant and appropriate
training, including graduate, preservice, and in-service training, to HCBS
providers, researchers and qualitymeasurement personnel, and other
E:\FR\FM\16MRN1.SGM
16MRN1
Federal Register / Vol. 80, No. 50 / Monday, March 16, 2015 / Notices
disability service providers, to facilitate
more effective delivery of HCBS to
people with disabilities. This training
may be provided through conferences,
workshops, public education programs,
in-service training programs, and
similar activities.
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 or
in a Funding Opportunity Announcement
posted at www.grants.gov.
Executive Orders 12866 and 13563
Rmajette on DSK2VPTVN1PROD with NOTICES
Regulatory Impact Analysis
Under E.O. 12866, the Secretary must
determine whether this regulatory
action is ‘‘significant’’ and, therefore,
subject to the requirements of the
Executive Order and subject to review
by the Office of Management and
Budget (OMB). Section 3(f) of E.O.
12866 defines a ‘‘significant regulatory
action’’ as an action likely to result in
a rule that may—
(1) Have an annual effect on the
economy of $100 million or more, or
adversely affect a sector of the economy,
productivity, competition, jobs, the
environment, public health or safety, or
State, local, or tribal governments or
communities in a material way (also
referred to as an ‘‘economically
significant’’ rule);
(2) Create serious inconsistency or
otherwise interfere with an action taken
or planned by another agency;
(3) Materially alter the budgetary
impacts of entitlement grants, user fees,
or loan programs or the rights and
obligations of recipients thereof; or
(4) Raise novel legal or policy issues
arising out of legal mandates, the
President’s priorities, or the principles
stated in the E.O.
This proposed regulatory action is not
a significant regulatory action subject to
review by OMB under section 3(f) of
E.O. 12866.
We have also reviewed this regulatory
action under E.O. 13563, which
supplements and explicitly reaffirms the
principles, structures, and definitions
governing regulatory review established
in E.O. 12866. To the extent permitted
VerDate Sep<11>2014
14:09 Mar 13, 2015
Jkt 235001
by law, E.O. 13563 requires that an
agency—
(1) Propose or adopt regulations only
upon a reasoned determination that
their benefits justify their costs
(recognizing that some benefits and
costs are difficult to quantify);
(2) Tailor its regulations to impose the
least burden on society, consistent with
obtaining regulatory objectives and
taking into account—among other things
and to the extent practicable—the costs
of cumulative regulations;
(3) In choosing among alternative
regulatory approaches, select those
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety,
and other advantages; distributive
impacts; and equity);
(4) To the extent feasible, specify
performance objectives, rather than the
behavior or manner of compliance a
regulated entity must adopt; and
(5) Identify and assess available
alternatives to direct regulation,
including economic incentives—such as
user fees or marketable permits—to
encourage the desired behavior, or
provide information that enables the
public to make choices.
E.O. 13563 also requires an agency ‘‘to
use the best available techniques to
quantify anticipated present and future
benefits and costs as accurately as
possible.’’ The Office of Information and
Regulatory Affairs of OMB has
emphasized that these techniques may
include ‘‘identifying changing future
compliance costs that might result from
technological innovation or anticipated
behavioral changes.’’
We are issuing this proposed priority
only upon a reasoned determination
that its benefits would justify its costs.
In choosing among alternative
regulatory approaches, we selected
those approaches that would maximize
net benefits. Based on the analysis that
follows, the Department believes that
this proposed priority is consistent with
the principles in E.O. 13563.
We also have determined that this
regulatory action would not unduly
interfere with State, local, and tribal
governments in the exercise of their
governmental functions.
In accordance with both Executive
Orders, the Department has assessed the
potential costs and benefits, both
quantitative and qualitative, of this
regulatory action. The potential costs
are those resulting from statutory
requirements and those we have
determined as necessary for
administering the Department’s
programs and activities.
The benefits of the Disability and
Rehabilitation Research Projects and
PO 00000
Frm 00060
Fmt 4703
Sfmt 4703
13573
Centers Program have been well
established over the years. Projects
similar to one envisioned by the
proposed priority have been completed
successfully, and the proposed priority
would generate new knowledge through
research. The new RRTC would
generate, disseminate, and promote the
use of new information that would
improve outcomes for individuals with
disabilities in the area of home and
community based services.
Intergovernmental Review: This
program is not subject to E.O. 12372.
Electronic Access to This Document:
The official version of this document is
the document published in the Federal
Register. Free Internet access to the
official edition of the Federal Register
and the Code of Federal Regulations is
available via the Federal Digital System
at: www.gpo.gov/fdsys. At this site you
can view this document, as well as all
other documents of this Department
published in the Federal Register, in
text or Adobe Portable Document
Format (PDF). To use PDF you must
have Adobe Acrobat Reader, which is
available free at the site.
You may also access documents of the
Department published in the Federal
Register by using the article search
feature at: www.federalregister.gov.
Specifically, through the advanced
search feature at this site, you can limit
your search to documents published by
the Department.
Dated: March 11, 2015.
Kathy Greenlee,
Administrator.
[FR Doc. 2015–05989 Filed 3–13–15; 8:45 am]
BILLING CODE 4154–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Office of the Secretary
[Document Identifier: HHS–OS–0990–New–
60D]
Agency Information Collection
Activities; Proposed Collection; Public
Comment Request
Office of the Secretary, HHS.
Notice.
AGENCY:
ACTION:
In compliance with section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the
Secretary (OS), Department of Health
and Human Services, announces plans
to submit a new Information Collection
Request (ICR), described below, to the
Office of Management and Budget
(OMB). Prior to submitting that ICR to
OMB, OS seeks comments from the
SUMMARY:
E:\FR\FM\16MRN1.SGM
16MRN1
Agencies
[Federal Register Volume 80, Number 50 (Monday, March 16, 2015)]
[Notices]
[Pages 13569-13573]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-05989]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Community Living
Proposed Priority--National Institute on Disability, Independent
Living, and Rehabilitation Research--Rehabilitation Research and
Training Centers
AGENCY: Administration for Community Living, Department of Health and
Human Services.
ACTION: Notice of Proposed Priority.
-----------------------------------------------------------------------
CFDA Number: 84.133B-6.
SUMMARY: The Administrator of the Administration for Community Living
proposes a priority for the Rehabilitation Research and Training Center
(RRTC) Program administered by the National Institute on Disability,
Independent Living, and Rehabilitation Research (NIDILRR).
Specifically, this notice proposes a priority for an RRTC on Outcomes
Measurement for Home and Community Based Services. We take this action
to focus research attention on an area of national need. We intend this
priority to contribute to improved home and community based services
for individuals with disabilities.
DATES: We must receive your comments on or before April 15, 2015.
ADDRESSES: Address all comments about this notice to Carolyn Baron,
U.S. Department of Health and Human Services, 550 12th Street SW., Room
5134, PCP, Washington, DC 20202-2700.
If you prefer to send your comments by email, use the following
address: carolyn.baron@ed.gov. You must include the phrase ``Proposed
Priorities for RRTCs'' and the priority title in the subject line of
your electronic message.
We will not accept comments submitted by fax or those submitted
after the comment period. To ensure that we do not receive duplicate
copies, please submit your comments only once.
Postal Mail or Commercial Delivery: If you mail or deliver
your comments about these proposed regulations, address them to Carolyn
Baron, U.S. Department of Health and Human Services, 400 Maryland
Avenue SW., Room 5134, Potomac Center Plaza (PCP), Washington, DC
20202-2700.
Privacy Note: The Department's policy is to make all comments
received from members of the public available for public viewing in
their entirety. Therefore, commenters should be careful to include in
their comments only information that they wish to make publicly
available.
FOR FURTHER INFORMATION CONTACT: Carolyn Baron. Telephone: (202) 245-
7244 or by email: carolyn.baron@ed.gov.
If you use a telecommunications device for the deaf (TDD) or a text
telephone (TTY), call the Federal Relay Service (FRS), toll free, at 1-
800-877-8339.
SUPPLEMENTARY INFORMATION: This notice of proposed priority is in
concert with NIDILRR's currently approved Long-Range Plan (Plan). The
Plan, which was published in the Federal Register on April 4, 2013 (78
FR 20299), can be accessed on the Internet at the following site:
www.ed.gov/about/offices/list/osers/nidrr/policy.html.
[[Page 13570]]
The Plan identifies a need for research and training that can be
used to improve outcomes of individuals with disabilities. To address
this need, NIDILRR seeks to: (1) Improve the quality and utility of
disability and rehabilitation research; (2) foster an exchange of
research findings, expertise, and other information to advance
knowledge and understanding of the needs of individuals with
disabilities and their family members, including those from among
traditionally underserved populations; (3) determine effective
practices, programs, and policies to improve community living and
participation, employment, and health and function outcomes for
individuals with disabilities of all ages; (4) identify research gaps
and areas for promising research investments; (5) identify and promote
effective mechanisms for integrating research and practice; and (6)
disseminate research findings to all major stakeholder groups,
including individuals with disabilities and their family members in
formats that are appropriate and meaningful to them.
This notice proposes one priority that NIDILRR intends to use for
one or more competitions in fiscal year (FY) 2015 and possibly later
years. NIDILRR is under no obligation to make an award under this
priority. The decision to make an award will be based on the quality of
applications received and available funding. NIDILRR may publish
additional priorities, as needed.
Invitation to Comment: We invite you to submit comments regarding
this proposed priority. To ensure that your comments have maximum
effect in developing the final priority, we urge you to identify
clearly the specific topic within the priority that each comment
addresses.
We invite you to assist us in complying with the specific
requirements of E.O. 12866 and 13563 and their 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 sent to NIDILRR 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 (Rehabilitation Act).
Rehabilitation Research and Training Centers
The purpose of the RRTCs, which are funded through the Disability
and Rehabilitation Research Projects and Centers Program, is to achieve
the goals of, and improve the effectiveness of, services authorized
under the Rehabilitation Act through well-designed research, training,
technical assistance, and dissemination activities in important topical
areas as specified by NIDILRR. These activities are designed to benefit
rehabilitation service providers, individuals with disabilities, family
members, policymakers and other research stakeholders. Additional
information on the RRTC program can be found at: https://www2.ed.gov/programs/rrtc/#types.
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.
RRTC on Outcomes Measurement for Home and Community Based Services
Background
Approximately $140 billion is spent nationally on Medicaid long-
term services and supports (LTSS) (Eiken et al., 2014). States continue
to rebalance their LTSS expenditures to decrease the reliance on
nursing homes and other institutional services for individuals of all
ages with disabilities. Nearly half of Medicaid's LTSS expenditures go
toward home and community-based services (HCBS) compared to only 18% in
1995 (Eiken et al., 2014). The aging of the population and growing
consumer demand to live in home-based settings will continue to
increase the need for home and community-based services (HCBS). As more
people receive LTSS in the community, there is a need for validated
measures of consumer outcomes and experiences that can be used as
indicators of HCBS quality (Commission on Long Term Care, 2013;
Disability Rights Education & Defense Fund, 2013). Compared to
measurement efforts in clinical settings, non-medical performance
measures in HCBS are in the early stages of development and
standardization (National Quality Forum, 2012). Accordingly, NIDILRR is
sponsoring a Rehabilitation Research and Training Center on Outcomes
Measurement for Home and Community Based Services.
Efforts to measure the quality of a wide variety of services,
including home- and community-based LTSS, may include structural
measures (whether a particular mechanism is in place), process measures
(which track the performance of a particular action) and outcomes
measures (the results of actions and mechanisms) (Disability Rights
Education & Defense Fund, 2013; Booth & Fralich, 2006). In the long-
term care context, structural indicators of quality may include the
ratio of service providers to consumers, for example, and process
indicators of quality may include the skill levels of providers and the
timeliness of the services they deliver (Disability Rights Education &
Defense Fund, 2013). User outcomes are also important indicators of
service quality. In the HCBS context, health status and levels of
community integration, participation, and inclusion among service
recipients can be important markers of HCBS quality (Disability Rights
Education & Defense Fund, 2013).
For decades, efforts to measure and improve long-term care quality
have focused on nursing homes. Historically, the assessment of quality
in nursing homes and other institutional long-term care settings
emphasized the protection and safety of residents. As the delivery of
LTSS is increasingly taking place in home and community-based settings,
these institution-based quality measurement efforts have not been
translated into measures that are relevant and important to individuals
[[Page 13571]]
who are receiving services at home (Commission on Long-Term Care,
2013). While protection and safety are important to HCBS recipients,
other factors are important and relevant in these settings, including
levels of community integration, participation, and inclusion.
As states continue to rebalance their LTSS expenditures to decrease
reliance on nursing homes and increase service delivery in home and
community-based settings, they have begun the process of developing
person-centered HCBS measures that assess outcomes from the perspective
of service users. The State of Wisconsin, for example, has developed
and implemented a set of measures that assess ``person-centered quality
of life'' outcomes that are important to HCBS users (Karon & Schlaak,
2012). By seeking extensive input from service users and other
stakeholders, Wisconsin has developed quality of life concepts and
measures that are used to assess the extent to which (1) individuals
have choice over their living arrangements and services, (2)
individuals have desired social relationships and participate in
meaningful ways in society, and (3) individuals are healthy and safe
(Wisconsin Department of Health Services, 2014). Within this person-
centered outcomes measurement system, service users are able to choose
the specific outcomes that are the most important to them and describe
the extent to which the long-term care services they are receiving
support their achievement of those outcomes. With this outcomes
assessment system Wisconsin has developed state-wide quality of life
outcomes reports that aggregate findings for all of its HCBS users, as
well as reports that provide comparisons of outcomes across different
HCBS programs and subpopulations (Karon & Schlaak, 2012).
Recent efforts at the Federal level have begun to address the need
for HCBS quality measures. For example, the Administration for
Community Living (ACL) is contracting with the National Quality Forum
(NQF) to create a conceptual framework for HCBS quality measurement and
to make recommendations for HCBS measure development efforts. Through
this work, ACL aims to create a conceptual foundation for the
development of measures that can be used to assess and ultimately
support independence and community living outcomes of HCBS recipients
(National Quality Forum, 2015). Much work remains to conceptualize and
measure HCBS quality in terms of the outcomes that are important to
long-term care recipients. These outcomes include adequacy and
appropriateness of care, as well as the consumers' level of control,
social integration, social participation, and general quality of life
(Kaye, 2014).
Another foundation for the development of person-centered HCBS
outcomes measures is the ongoing work of rehabilitation researchers to
create valid and reliable measures of community participation of people
with disabilities (Walker, Mellick, Brooks, & Whiteneck, 2003; Hammel,
Magasi, Heinemann, Whiteneck, Bogner & Rodriguez, 2012; Whiteneck &
Dijkers, 2009; Heinemann, 2010). These research and development efforts
include the application of advanced item-scaling and person-centered
measurement techniques that can be implemented as computerized adaptive
tests (CAT) (Haley et al., 2008), thus reducing data collection burden
on people with disabilities. These efforts to develop participation
outcome measures for people with disabilities are highly relevant to
the applied efforts to develop person-centered HCBS outcome measures.
These and other Federal and state efforts provide a strong
foundation for further research on and development of person-centered
HCBS outcomes measures and measurement systems that assess and promote
community living, independent living and social integration of HCBS
users. Accordingly, NIDILRR aims to support a Rehabilitation Research
and Training Center on Outcomes Measurement for Home and Community
Based Services. This RRTC will conduct research and development
activities in this critical area and will serve as a national resource
center on HCBS outcomes measurement for Federal and state-level
policymakers, people with disabilities and other key stakeholders.
References
Booth, M., Fralich, J. (2006). Performance Measurement: Managing and
Using Home and Community-Based Services Data for Quality
Improvement. University of Southern Maine: Muskie School of Public
Service. https://muskie.usm.maine.edu/Publications/DA/Performance-Measurement-HCBS.pdf.
Commission on Long Term Care. (September 30, 2013). Report to the
Congress. https://ltccommission.lmp01.lucidus.net/wp-content/uploads/2013/12/Commission-on-Long-Term-Care-Final-Report-9-26-13.pdf.
Disability Rights Education & Defense Fund (2013). Identifying and
Selecting Long Term Services and Supports Outcomes Measures. https://dredf.org/2013-documents/Guide-LTSS-Outcome-Measures.pdf.
Eiken, Steve, et al. (2014). Medicaid Expenditures for Long-Term
Services and Supports for FFY 2012. https://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/downloads/ltss-expenditures-2012.pdf.
Haley, S., Gandek, B., Siebens, H., Black-Schaffer, R., Sinclair,
S., Tao, W., Coster, W., Ni, P., & Jette, A. (2008). Computerized
Adaptive Testing for Follow-Up After Discharge From Inpatient
Rehabilitation: Participation Outcomes. Archives of Physical
Medicine and Rehabilitation. 89(2): 275-283.
Hammel, J., Magasi, S., Heinemann, A., Whiteneck, G., Bogner, &
Rodriguez, E. (2008). What Does Participation Mean? An Insider
Perspective From People With Disabilities. Disability and
Rehabilitation. 30(19): 1445-1460.
Heinemann, A. (2010). Measurement of Participation in Rehabilitation
Research. Archives of Physical Medicine and Rehabilitation. 91(9):
S1-S4.
Karon, S., and Schlaak, M. (2012). PEONIES Member Interviews, State
Fiscal Year 2012, Final Report. Madison, WI: Center for Health
Systems Research and Analysis. https://www.chsra.wisc.edu/peonies/documents/PEONIES%20Final%20Report%20SFY2012%20-%20rev%2011-9-2012.pdf.
Kaye, H. Stephen. Toward a Model Long-Term Services and Supports
System: State Policy Elements. The Gerontologist. (October 2014).
https://gerontologist.oxfordjournals.org/content/54/5/754.full.pdf+html.
National Quality Forum (2015). Home and Community Based Services
Quality. https://www.qualityforum.org/ProjectDescription.aspx?projectID=77692.
National Quality Forum, ``Measuring Healthcare Quality for the Dual
Eligible Beneficiary Population, Measure Application Partnership,
Final Report to HHS,'' June, 2012.
Walker, N., Mellick, D., Brooks, CA, Whiteneck, G. (2003). Measuring
Participation Across Impairment Groups Using the Craig Handicap
Assessment Reporting Technique. American Journal of Physical
Medicine and Rehabilitation. 82(12): 936-941.
Whiteneck, G., & Dijkers, M. (2009). Difficult to Measure
Constructs. Conceptual and Methodological Issues Concerning
Participation and Environmental Factors. Archives of Physical
Medicine and Rehabilitation. 90(11) S22-S35.
Wisconsin Department of Health Services (2014). Measuring Person-
Centered Quality. November 11, 2014: https://www.dhs.wisconsin.gov/familycare/reports/peonies.htm.
Definitions
The research that is proposed under this priority must be focused
on one or more stages of research. If the RRTC is to conduct research
that can be categorized under more than one research stage, or research
that
[[Page 13572]]
progresses from one stage to another, those research stages must be
clearly specified. For purposes of this priority, the stages of
research are from the notice of final priorities and definitions
published in the Federal Register on June 7, 2013 (78 FR 34261).
(a) Exploration and Discovery means the stage of research that
generates hypotheses or theories by conducting new and refined analyses
of data, producing observational findings, and creating other sources
of research-based information. This research stage may include
identifying or describing the barriers to and facilitators of improved
outcomes of individuals with disabilities, as well as identifying or
describing existing practices, programs, or policies that are
associated with important aspects of the lives of individuals with
disabilities. Results achieved under this stage of research may inform
the development of interventions or lead to evaluations of
interventions or policies. The results of the exploration and discovery
stage of research may also be used to inform decisions or priorities.
(b) Intervention Development means the stage of research that
focuses on generating and testing interventions that have the potential
to improve outcomes for individuals with disabilities. Intervention
development involves determining the active components of possible
interventions, developing measures that would be required to illustrate
outcomes, specifying target populations, conducting field tests, and
assessing the feasibility of conducting a well-designed interventions
study. Results from this stage of research may be used to inform the
design of a study to test the efficacy of an intervention.
(c) Intervention Efficacy means the stage of research during which
a project evaluates and tests whether an intervention is feasible,
practical, and has the potential to yield positive outcomes for
individuals with disabilities. Efficacy research may assess the
strength of the relationships between an intervention and outcomes, and
may identify factors or individual characteristics that affect the
relationship between the intervention and outcomes. Efficacy research
can inform decisions about whether there is sufficient evidence to
support ``scaling-up'' an intervention to other sites and contexts.
This stage of research can include assessing the training needed for
wide-scale implementation of the intervention, and approaches to
evaluation of the intervention in real world applications.
(d) Scale-Up Evaluation means the stage of research during which a
project analyzes whether an intervention is effective in producing
improved outcomes for individuals with disabilities when implemented in
a real-world setting. During this stage of research, a project tests
the outcomes of an evidence-based intervention in different settings.
It examines the challenges to successful replication of the
intervention, and the circumstances and activities that contribute to
successful adoption of the intervention in real-world settings. This
stage of research may also include well-designed studies of an
intervention that has been widely adopted in practice, but that lacks a
sufficient evidence-base to demonstrate its effectiveness.
Proposed Priority
The Administrator of the Administration for Community Living
proposes a priority for the Rehabilitation Research and Training Center
(RRTC) program administered by the National Institute on Disability,
Independent Living, and Rehabilitation Research (NIDILRR).
Specifically, this notice proposes a priority for an RRTC on Outcomes
Measurement for Home and Community Based Services. The RRTC will engage
in research, development, and testing of measures to assess the quality
of HCBS in terms of the person-centered outcomes achieved by people
with disabilities who use the services in home and community settings.
The RRTC will also engage in knowledge translation, development of
informational products, and dissemination to enhance the field's
capacity to measure the extent to which HCBS leads to improved outcomes
in community living and independent living areas that are important to
people with disabilities and other stakeholders. Ultimately, the RRTC's
development of non-medical, person-centered outcome measures is
intended to inform the design, implementation, and continuous
improvement of Federal and state policies and programs related to the
delivery of HCBS to people with disabilities. The RRTC must contribute
to these outcomes by:
(a) Identifying or developing measures, and then testing the
proposed measures to assess the person-centered outcomes of individuals
with disabilities who are receiving home and community-based services.
HCBS measures developed under this priority must be non-medical and
must focus on the end-users' experience of community living,
independent living, social integration, community participation, and
other similar outcomes. The measures developed under this priority must
also be designed to minimize data collection burden on HCBS recipients.
Possible methods for minimizing this burden include, but are not
limited to, use of relevant administrative data, modifying
administrative data to include person-centered goals as well as fields
to assess progress toward those goals, and use of advanced item-scaling
and person-centered measurement techniques that can be implemented as
computerized adaptive tests (CAT).
(b) Increasing incorporation of the RRTC's HCBS outcome measures
into practice and policy. The RRTC must contribute to this outcome by--
(1) Working closely with NIDILRR and the Administration for
Community Living (ACL) at each stage of the measure development and
testing processes to ensure that its activities are informing and
informed by other HCBS quality initiatives taking place within ACL and
other relevant Federal and state agencies. This specifically includes
the work taking place under the National Quality Forum's work with the
Department of Health and Human Services (https://www.qualityforum.org/ProjectDescription.aspx?projectID=77692).
(2) Developing procedures and mechanisms for applying HCBS outcome
measures in policy and service delivery settings to maximize quality
and appropriateness of HCBS from the end-user perspective.
(3) Collaborating with stakeholder groups to develop, evaluate, or
implement strategies to increase utilization of new HCBS outcome
measures. Stakeholder groups include but, are not limited to, people
with disabilities, Federal- and state-level policymakers; home and
community based service providers; advocacy organizations; and Centers
for Independent Living.
(4) Collaborating with relevant NIDILRR-sponsored knowledge
translation grantees to help promote the uptake of RRTC products by
relevant stakeholders and embed the outcome measures into the overall
health care measurement system.
(c) Serving as a national resource center related to person-
centered measurement of HCBS outcomes:
(1) Disseminating information and providing technical assistance
related to HCBS outcome and quality measurement to policymakers,
service providers, people with disabilities and their representatives,
and other key stakeholders; and
(2) Providing relevant and appropriate training, including
graduate, pre-service, and in-service training, to HCBS providers,
researchers and quality-measurement personnel, and other
[[Page 13573]]
disability service providers, to facilitate more effective delivery of
HCBS to people with disabilities. This training may be provided through
conferences, workshops, public education programs, in-service training
programs, and similar activities.
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 or in a Funding Opportunity
Announcement posted at www.grants.gov.
Executive Orders 12866 and 13563
Regulatory Impact Analysis
Under E.O. 12866, the Secretary must determine whether this
regulatory action is ``significant'' and, therefore, subject to the
requirements of the Executive Order and subject to review by the Office
of Management and Budget (OMB). Section 3(f) of E.O. 12866 defines a
``significant regulatory action'' as an action likely to result in a
rule that may--
(1) Have an annual effect on the economy of $100 million or more,
or adversely affect a sector of the economy, productivity, competition,
jobs, the environment, public health or safety, or State, local, or
tribal governments or communities in a material way (also referred to
as an ``economically significant'' rule);
(2) Create serious inconsistency or otherwise interfere with an
action taken or planned by another agency;
(3) Materially alter the budgetary impacts of entitlement grants,
user fees, or loan programs or the rights and obligations of recipients
thereof; or
(4) Raise novel legal or policy issues arising out of legal
mandates, the President's priorities, or the principles stated in the
E.O.
This proposed regulatory action is not a significant regulatory
action subject to review by OMB under section 3(f) of E.O. 12866.
We have also reviewed this regulatory action under E.O. 13563,
which supplements and explicitly reaffirms the principles, structures,
and definitions governing regulatory review established in E.O. 12866.
To the extent permitted by law, E.O. 13563 requires that an agency--
(1) Propose or adopt regulations only upon a reasoned determination
that their benefits justify their costs (recognizing that some benefits
and costs are difficult to quantify);
(2) Tailor its regulations to impose the least burden on society,
consistent with obtaining regulatory objectives and taking into
account--among other things and to the extent practicable--the costs of
cumulative regulations;
(3) In choosing among alternative regulatory approaches, select
those approaches that maximize net benefits (including potential
economic, environmental, public health and safety, and other
advantages; distributive impacts; and equity);
(4) To the extent feasible, specify performance objectives, rather
than the behavior or manner of compliance a regulated entity must
adopt; and
(5) Identify and assess available alternatives to direct
regulation, including economic incentives--such as user fees or
marketable permits--to encourage the desired behavior, or provide
information that enables the public to make choices.
E.O. 13563 also requires an agency ``to use the best available
techniques to quantify anticipated present and future benefits and
costs as accurately as possible.'' The Office of Information and
Regulatory Affairs of OMB has emphasized that these techniques may
include ``identifying changing future compliance costs that might
result from technological innovation or anticipated behavioral
changes.''
We are issuing this proposed priority only upon a reasoned
determination that its benefits would justify its costs. In choosing
among alternative regulatory approaches, we selected those approaches
that would maximize net benefits. Based on the analysis that follows,
the Department believes that this proposed priority is consistent with
the principles in E.O. 13563.
We also have determined that this regulatory action would not
unduly interfere with State, local, and tribal governments in the
exercise of their governmental functions.
In accordance with both Executive Orders, the Department has
assessed the potential costs and benefits, both quantitative and
qualitative, of this regulatory action. The potential costs are those
resulting from statutory requirements and those we have determined as
necessary for administering the Department's programs and activities.
The benefits of the Disability and Rehabilitation Research Projects
and Centers Program have been well established over the years. Projects
similar to one envisioned by the proposed priority have been completed
successfully, and the proposed priority would generate new knowledge
through research. The new RRTC would generate, disseminate, and promote
the use of new information that would improve outcomes for individuals
with disabilities in the area of home and community based services.
Intergovernmental Review: This program is not subject to E.O.
12372.
Electronic Access to This Document: The official version of this
document is the document published in the Federal Register. Free
Internet access to the official edition of the Federal Register and the
Code of Federal Regulations is available via the Federal Digital System
at: www.gpo.gov/fdsys. At this site you can view this document, as well
as all other documents of this Department published in the Federal
Register, in text or Adobe Portable Document Format (PDF). To use PDF
you must have Adobe Acrobat Reader, which is available free at the
site.
You may also access documents of the Department published in the
Federal Register by using the article search feature at:
www.federalregister.gov. Specifically, through the advanced search
feature at this site, you can limit your search to documents published
by the Department.
Dated: March 11, 2015.
Kathy Greenlee,
Administrator.
[FR Doc. 2015-05989 Filed 3-13-15; 8:45 am]
BILLING CODE 4154-01-P