[Federal Register Volume 63, Number 60 (Monday, March 30, 1998)]
[Notices]
[Pages 15203-15208]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-8196]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. 93631-98-01]
Developmental Disabilities: Request for Public Comments on
Proposed Developmental Disabilities Funding Priorities for Projects of
National Significance for Fiscal Year 1998
AGENCY: Administration on Developmental Disabilities (ADD), ACF, DHHS.
ACTION: Notice of request for public comments on developmental
disabilities tentative funding priority for Projects of National
Significance for Fiscal Year 1998.
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SUMMARY: The Administration on Developmental Disabilities (ADD)
announced that public comments are
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being requested on tentative funding priorities for Fiscal Year 1998
Projects of National Significance prior to being announced in its final
form.
We welcome comments and suggestions on this proposed announcement
and funding priority which will assist in bringing about the increased
independence, productivity, integration, and inclusion into the
community of individuals with developmental disabilities.
DATES: The closing date for submission of comments is May 26, 1998.
ADDRESSES: Comments should be sent to: Reginald F. Wells, Ph.D., Acting
Commissioner, Administration on Developmental Disabilities,
Administration for Children and Families, Department of Health and
Human Services, 370 L'Enfant Promenade, S.W., Washington, D.C. 20447.
FOR FURTHER INFORMATION CONTACT: Administration for Children and
Families (ACF), Pat Laird, 370 L'Enfant Promenade, S.W., Washington,
D.C. 20447, 202/690-7447.
SUPPLEMENTARY INFORMATION: This announcement consists of two parts:
Part I
Background
A. Goals of the Administration on Developmental Disabilities
The Administration on Developmental Disabilities is located within
the Administration for Children and Families, Department of Health and
Human Services (DHHS). Although different from the other ACF program
administrations in the specific constituency it serves, ADD shares a
common set of goals that promote the economic and social well-being of
families, children, individuals and communities. Through national
leadership, we see:
Families and individuals empowered to increase their own
economic independence and productivity;
Strong, healthy, supportive communities having a positive
impact on the quality of life and the development of children;
Partnerships with individuals, front-line service
providers, communities, States and Congress that enable solutions which
transcend traditional agency boundaries;
Services planned and integrated to improve client access;
and
A strong commitment to working with Native Americans,
individuals with developmental disabilities, refugees and migrants to
address their needs, strengths and abilities.
Emphasis on these goals and progress toward them will help more
individuals, including those with developmental disabilities, to live
productive and independent lives integrated into their communities. The
Projects of National Significance Program is one means through which
ADD promotes the achievement of these goals.
Two issues are of particular concern with these projects. First,
there is a pressing need for networking and cooperation among
specialized and categorical programs, particularly at the service
delivery level, to ensure continuation of coordinated services to
people with developmental disabilities. Second, project findings and
successful innovative models of projects need to be made available
nationally to policy makers as well as to direct service providers.
B. Purpose of the Administration on Developmental Disabilities
The Administration on Developmental Disabilities is the lead agency
within ACF and DHHS responsible for planning and administering programs
which promote the self-sufficiency and protect the rights of
individuals with developmental disabilities.
The 1996 Amendments (Pub. L. 104-183) to the Developmental
Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6000 et seq.)
(the Act) supports and provides assistance to States and public and
private nonprofit agencies and organizations to assure that individuals
with developmental disabilities and their families participate in the
design of and have access to culturally competent services, supports,
and other assistance and opportunities that promote independence,
productivity and integration and inclusion into the community.
The Act points out that:
Disability is a natural part of the human experience that
does not diminish the right of individuals with developmental
disabilities to enjoy the opportunity for independence, productivity
and inclusion into the community;
Individuals whose disabilities occur during their
developmental period frequently have severe disabilities that are
likely to continue indefinitely;
Individuals with developmental disabilities often require
lifelong specialized services and assistance, provided in a coordinated
and culturally competent manner by many agencies, professionals,
advocates, community representatives, and others to eliminate barriers
and to meet the needs of such individuals and their families;
The Act further finds that:
Individuals with developmental disabilities, including
those with the most severe developmental disabilities, are capable of
achieving independence, productivity, and integration and inclusion
into the community, and often require the provision of services,
supports and other assistance to achieve such;
Individuals with developmental disabilities have
competencies, capabilities and personal goals that should be
recognized, supported, and encouraged, and any assistance to such
individuals should be provided in an individualized manner, consistent
with the unique strengths, resources, priorities, concerns, abilities,
and capabilities of the individual;
Individuals with developmental disabilities and their
families are the primary decision makers regarding the services and
supports such individuals and their families receive; and play decision
making roles in policies and programs that affect the lives of such
individuals and their families; and
It is in the nation's interest for individuals with
developmental disabilities to be employed, and to live conventional and
independent lives as a part of families and communities.
Toward these ends, ADD seeks to enhance the capabilities of
families in assisting individuals with developmental disabilities to
achieve their maximum potential, to support the increasing ability of
individuals with developmental disabilities to exercise greater choice
and self-determination, to engage in leadership activities in their
communities, as well as to ensure the protection of their legal and
human rights.
Programs funded under the Act are:
Federal assistance to State developmental disabilities
councils;
State system for the protection and advocacy of individual
rights;
Grants to university affiliated programs for
interdisciplinary training, exemplary services, technical assistance,
and information dissemination; and
Grants for Projects of National Significance.
C. Description of Projects of National Significance
Under Part E of the Act, demonstration grants and contracts are
awarded for projects of national significance that support the
development of national and State
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policy to enhance the independence, productivity, and integration and
inclusion of individuals with developmental disabilities through:
Data collection and analysis;
Technical assistance to enhance the quality of State
developmental disabilities councils, protection and advocacy systems,
and university affiliated programs; and
Other projects of sufficient size and scope that hold
promise to expand or improve opportunities for individuals with
developmental disabilities, including:
--technical assistance for the development of information and referral
systems;
--educating policy makers;
--Federal interagency initiatives;
--the enhancement of participation of racial and ethnic minorities in
public and private sector initiatives in developmental disabilities;
--transition of youth with developmental disabilities from school to
adult life; and
Section 162(d) of the Act requires that ADD publish in the Federal
Register proposed priorities for grants and contracts to carry out
Projects of National Significance. The Act also requires a period of 60
days for public comment concerning such proposed priorities. After
analyzing and considering such comments, ADD must publish in the
Federal Register final priorities for such grants and contracts, and
solicit applications for funding based on the final priorities
selected.
The following section presents the proposed priority areas for
Fiscal Year 1998 Projects of National Significance. We welcome comments
and suggestions. We would also like to receive suggestions on topics
which are timely and relate to needs in the developmental disabilities
field.
Please be aware that the development of the final funding priority
is based on the public comment response to this notice, current agency
and Departmental priorities, needs in the field of developmental
disabilities and the developmental disabilities network, etc., as well
as the availability of funds for this fiscal year.
Part II
Fiscal Year 1998 Proposed Priority Areas for Projects of National
Significance
ADD is interested in all comments and recommendations which address
areas of existing or evolving national significance related to the
field of developmental disabilities.
ADD also solicits recommendations for project activities which will
advocate for public policy change and community acceptance of all
individuals with developmental disabilities and families so that such
individuals receive the culturally competent services, supports, and
other assistance and opportunities necessary to enable them to achieve
their maximum potential through increased independence, productivity,
and integration into the community.
ADD is also interested in activities which promote the inclusion of
all individuals with developmental disabilities, including individuals
with the most severe disabilities, in community life; which promote the
interdependent activity of all individuals with developmental
disabilities and individuals who are not disabled; and which recognize
the contributions of these individuals (whether they have a disability
or not), as such individuals share their talents at home, school, and
work, and in recreation and leisure time.
No proposals, concept papers or other forms of applications should
be submitted at this time. Any such submission will be discarded.
ADD will not respond to individual comment letters. However, all
comments will be considered in preparing the final funding solicitation
announcement and will be acknowledged and addressed in that
announcement.
Please be reminded that, because of possible funding limitations,
the proposed priority areas listed below may not be published in a
final funding solicitation for this fiscal year.
Comments should be addressed to: Reginald F. Wells, Ph.D, Acting
Commissioner, Administration on Developmental Disabilities,
Administration for Children and Families, Department of Health and
Human Services, 370 L'Enfant Promenade, S.W., Washington, D.C. 20447.
Proposed Fiscal Year 1998 Priority Area 1: Unequal Protection Under the
Law, Invisible Victims of Crime--Individuals with Developmental
Disabilities
With the passage of the Americans with Disabilities Act (ADA) many
people in the disability community thought it would bring equality
under the law: a final fulfillment of their constitutional rights.
However, individuals with a developmental disability who are victims of
a crime often find the criminal justice system to be less than fair;
and to make matters worse the community services meant to assist
victims of crime are ill-prepared to meet their needs.
Persons with developmental disabilities have a significantly higher
risk of becoming crime victims than non-disabled persons. Differences
in victimization rates are most pronounced for the crimes of sexual
assault and robbery. There is also a high probability of repeat
victimization, because over time those who victimize individuals with
disabilities come to regard them as easy prey--where crimes can be
committed against them with little chance of detection or punishment.
A recent analysis combining these victimization probabilities with
data from the U.S. National Crime Victimization Survey estimates that
roughly 5 million serious crimes are committed against persons with
developmental disabilities in the U.S. each year.
Research shows that offenders seek victims with disabilities
specifically because they are considered to be vulnerable and unable to
seek help or report the crime. More than half of the crimes committed
against victims with developmental disabilities are never reported to
justice authorities, and when they are reported, they are often handled
administratively rather than through criminal prosecution.
Administrative actions such as licensing sanctions against a group home
or the firing of the suspect are common. Such administrative sanctions
represent a separate and unequal ``justice'' system.
When crimes are reported, there are lower rates of police follow-
up, prosecution and convictions. When convictions occur, studies show
that sentences for crimes committed against individuals with
disabilities are lighter, particularly for sexual assault. Possible
explanations offered for this are the difficulty of investigating these
cases, lack of special police training, no provision of reasonable
accommodations, and the negative stereotype held toward people with
developmental disabilities.
The Americans with Disabilities Act is a significant tool that can
address these extreme disparities in the treatment of people with
developmental disabilities in the criminal justice system. Congress
clearly intended the ADA to remove barriers to effective participation
in all aspects of American society including the justice system. Title
II, Part A of the ADA states that ``no otherwise qualified individual
with a disability shall, by reason of such a disability, be excluded
from participation in or denied the benefits of the services, programs
or activities of a public entity, or subjected to discrimination by any
such entity.'' ``Public entity'' encompasses all police,
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probation and law enforcement agencies, correctional facilities, and
state and local court systems. Agents of the criminal justice system
have a responsibility and obligation to ensure that they do not treat
persons with disabilities in a discriminatory manner. However, many of
these agents or ``public entities'' are unsure of the application of
ADA to them and/or how to make accommodations for people with physical
and mental disabilities. Law enforcement agencies and other entities in
the criminal justice system are not alone in their ignorance of their
responsibilities under ADA. Many of the victim assistance services
programs do not realize their obligations under ADA, thus placing
persons with developmental disabilities at a greater risk of harm.
Clearly, more extensive collaboration between the disability
community and the criminal justice system is needed to facilitate equal
justice for all citizens. ADD would be interested in collaborative
projects involving training and education. These two components are
critical to the elimination of physical and attitudinal barriers
experienced by people with developmental disabilities when they
encounter the criminal justice system as victims of crime. Existing
curricula need to be tested and further developed; inclusionary methods
must be shared. New networks need to be created at the local, state,
and national levels allowing for the dissemination of information.
The enormity of this issue will go unknown until there is national
data collected on the victimization of people with developmental
disabilities. The National Victims Survey collects no data on this
population. Research must be conducted identifying the barriers to
services. Key to this research would be explanations for why this
injustice has continued; what constitutes violence/abuse/neglect in the
context of disability; and are the situations for people with
disabilities different from the situations in the general population.
ADD would consider projects addressing these areas of concern with
the outcome of a criminal justice system that treats its citizens with
developmental and other disabilities with equality.
Proposed Fiscal Year 1998 Priority Area 2: Domestic Violence and Women
with Developmental Disabilities--The Hidden Violence
In a special report, ``Violence Against Women: Estimates from the
Redesigned Survey'', which presented 1995 data from the National Crime
Victimization Survey, it was reported that women were attacked about
six times more often by offenders with whom they had an intimate
relationship than were male violence victims during 1992 and 1993.
During each year women were the victims of more than 4.5 million
violent crimes, including approximately 500,000 rapes or other sexual
assaults. Women from 19-29 years of age were more likely than women of
other ages to be victimized by an intimate party. Women of all races
were about equally vulnerable to attacks. However, women in families
with incomes below $10,000 per year were more likely than other women
to be violently attacked.
Persons with developmental disabilities have a 4 to 10 times higher
risk of becoming crime victims than non-disabled persons. Differences
in victimization rates are pronounced for the crime of sexual assault.
The rates of sexual assault on this population is very alarming.
One study found that 83% of women and 32% of men with developmental
disabilities in their sample had been sexually assaulted. Other studies
have found from 86%-91% of women in their samples had been sexually
assaulted. Another study found that of those who were sexually
assaulted, 50% had been assaulted 10 or more times.
One of the few studies conducted specifically on the prevalence of
abuse among women with disabilities, found little difference in the
occurrence of abuse in comparison with non-disabled women. However, it
found that women with disabilities may be at greater risk of abuse from
health care providers or caregivers. Another difference identified was
that the duration of the abuse experienced was longer than for women
without disabilities. The reason suggested for this duration finding
was that interventions available to non-disabled women may not be
available or accessible to women with physical disabilities. Other
reasons included a feeling of powerlessness to escape, lack of
opportunity to report the abuse, or dependency on their caregiver.
Another recent study confirmed these barriers to services plus
additional ones and offered recommendations for their elimination.
For the first time in our nation's history we are finally dealing
with the issue of domestic violence at a national level. The 1994 Crime
Act contains the landmark Violence Against Women Act. Implementation of
its provisions are under the control of the Violence Against Women
Office at the U.S. Department of Justice. Not only does this office
provide funding for various programs under the Act but it houses the
Advisory Council on Violence Against Women and operates the Domestic
Violence Hotline (1-800-799-SAFE, TDD 1-800-787-3224).
Although women with disabilities are at higher risk for all types
of violence, there are no dedicated resources being devoted on a
Federal level to decrease or eliminate the violence experienced by
these women. The U.S. Department of Justice has just begun to consider
people with disabilities in general as targets of violence in regard to
hate crimes and victim's assistance.
Projects are needed that would partner programs within the criminal
justice system with domestic violence service programs to develop
strategies and training for assisting women with developmental and
other significant disabilities. Public awareness programs must be
developed sensitizing communities about the violence experienced by
these women. Data collection programs should include data specifically
on the prevalence of violence against women with disabilities and the
types of services and supports they require to overcome their
victimization. The active involvement of women with disabilities in
policy making and service provision at the local, state and Federal
levels must be a significant effort of such projects. The results of
these types of activities should be the full inclusion of women with
disabilities in funding streams and criminal justice strategies as
administered by local, state and Federal governments.
Proposed Fiscal Year 1998 Priority Area 3: Healthy Lifestyles and
Recreation--Factors Contributing Towards A Quality of Life for Persons
With Developmental Disabilities
As more and more people with disabilities in general are having
increased life spans due to advancements in medical technologies and
innovative scientific research attention must be given toward healthy
lifestyles and methods to reduce the effects of aging with a
disability. Americans with disabilities strive for equal access to
opportunities and programs and services that enable them to experience
a quality lifestyle comparable to other Americans and to maintain their
independence and function. As some individuals with certain
disabilities have experienced physical weaknesses, loss of function,
and pain, it has raised questions about what constitutes optimal levels
of physical activity or exercise, dietary requirements, and therapies
that are helpful in sustaining their standard of life.
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A recent ADD report, ``Aging and Cerebral Palsy: The Critical
Needs'', based on a roundtable meeting, articles, research papers, and
other publications summarized the major issues of concern of people
with cerebral palsy. Some of the issues expressed were related to (1)
exercise--inability to determine what type of exercise(s) is best
suited to maintain cardio-pulmonary conditioning, physical strength,
bone density, coordination, joint mobility and weight control; (2)
women's issues--inability to find accurate information and competent
medical care (including counseling) when they were younger such as
reproductive health care and as they are aging on menopause; (3)
quality of medical care--few medical professionals, especially
dentists, are familiar with cerebral palsy making it difficult to
obtain treatment; (4) emotional and psychological issues--the aging
process begins early as overstressed muscles and joints wear out
relatively quickly, and people in their 30s and 40s are often ill-
equipped to deal with problems that their peers will often not
encounter for two more decades; and (5) managed care--these
organizations have a mixed history of providing appropriate and timely
services to individuals with disabilities, have many financial
incentives that may not be congruent with the needs of individuals with
disabilities or the philosophy of the disability rights movement, and
long-term supports and services may be at particular risk in a managed
care environment. Some of these issues are transferable to other types
of disabilities. For instance, in one study on breast and cervical
cancer screening it was reported that women with disabilities tend to
be less likely than women without disabilities to receive pelvic exams
on a regular basis, and women with more severe functional limitations
are significantly less likely to do so. Women with physical
disabilities are at a higher risk for delayed diagnosis of breast and
cervical cancer, primarily for reasons of environmental, attitudinal,
and information barriers. There are few studies on women with mental
retardation or other cognitive disabilities.
At this time there is little research that can provide answers to
these questions. Yet the concerns cannot be ignored. There are an
estimated 54 million people with a disability within the United States,
almost half of whom are considered to have a severe disability. An
estimated 4% age 5 and over need personal assistance with one or more
activities; over 5.8 million people need assistance in instrumental
activities of daily living (IADL), while 3.4 million need assistance in
``activities of daily living'' (ADL). As one ages, activity limitations
increase along with the need for assistance. Reviewing this data from a
purely economic standpoint it makes sense to dedicate some resources to
the prevention or alleviation of regressive symptoms that prevent
individuals with developmental and other disabilities from functioning
at their maximum level.
ADD would support projects that facilitate working partnerships
between people representing the issue of consumers, research
foundations, physical education/recreation fields, sports/athletic
associations, health care organizations, and others such as aging to
develop and test guidelines for exercise regimens, examine alternative
forms of medicine, foster training programs for health professionals,
coordinate and disseminate consumer education materials, promote model
programs plus other activities that would lead to factors or indicators
of a quality life.
Serious consideration should be given to how the promotion of
``wellness'' or ``staying healthy'' for people with developmental and
other significant disabilities supports choice of lifestyle that
coincides with the philosophy of self-determination. Specialized sports
equipment has been designed for use by serious athletes with
disabilities, but little information and equipment exists for those
people with disabilities who are non-athletes and want to exercise or
play. And how can this information be incorporated into generic fitness
centers.
Proposed Fiscal Year 1998 Priority Area 4: Promoting Future
Partnerships By Minority Institutions and Consumer Organizations With
ADD Through Participation in the Projects of National Significance
``People with disabilities have always been excluded from the
bounty of our nation's resources. Minorities with disabilities, in
particular, have been the most disenfranchised of the disenfranchised.
It is time we bring them into the fold as full, first-class
participants in our society.'' (Hon. Rev. Jesse L. Jackson, National
Rainbow Coalition).
A 1993 report from the National Council on Disability (NCD),
``Meeting the Unique Needs of Minorities with Disabilities'',
reinforces this statement. After convening a national conference and a
public hearing, NCD found that ``Persons with disabilities who are also
members of minorities face double discrimination and a double
disadvantage in our society. They are more likely to be poor and
undereducated and to have fewer opportunities than other members of the
population.''
The 1990 Census confirmed America's rapidly changing racial
profile. According to the census data there are 30 million African
Americans (an increase of 13.2% since 1980); 22.4 million Hispanic
Americans (an increase of 53%); 7.3 million Asian Americans (an
increase of 107.8%); and 2.0 million Native Americans (an increase of
37.9%). In comparison, the European American population grew only 6.0%
since 1980. By the year 2000, the nation will have 260 million people,
one of every three of whom will be either African-American, Latino, or
Asian-American.
As a result of factors such as poverty, unemployment, and poor
health status, persons of minority backgrounds are at high risk of
disability. Based largely on population projections and substantial
anecdotal evidence, it is clear that the number of persons from these
minority populations who have disabilities is increasing. Moreover,
based on similar projections, the proportion of minority populations
with disabling conditions will probably increase at even faster rates
than that of the general population.
ADD is determined to build the knowledge and capacity of the
organizations and institutions having majority representation of people
from diverse ethnic/cultural backgrounds and/or disabilities. In the
future, ADD should receive applications that reflect the experiences
and perceptions and needs of those diverse populations. To achieve this
goal ADD would consider projects that provide training and technical
assistance on the grants development process, including developing the
financial and managerial capacity to administer a grant; identify and
facilitate a network of such organizations or institutions; prepare and
disseminate necessary materials; and utilize existing resources. ADD
also would support projects that form coalitions of consumer and
minority organizations to jointly address this effort.
Proposed Fiscal Year 1998 Priority Area 5: Girl Power! Moving From
Despair to Empowerment of Girls with Developmental Disabilities
Unwanted and unplanned teenage pregnancies present a myriad of
problems to society, to young parents, and their children. For young
mothers who live below the poverty level, as most teenage mothers do,
economic
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problems are exacerbated by unplanned births. For teenage girls with
disabilities, unplanned births compound problems of disability,
poverty, and isolation.
Unplanned and unwanted pregnancies continue to be one of the most
prevalent problems of our society, involving social, economic, health,
and education issues. When unmarried teenagers become parents, they are
unlikely to graduate from high school, their career options are usually
decreased, and they often require more community services.
Both teenage mothers and their babies are likely to have greater
health problems than non-teenage mothers and their children. Babies
born to teenagers are often low birth weight. Low birth weight babies
can increase the likelihood of certain disabilities. Teenage girls who
have unplanned pregnancies often do not have strong academic
backgrounds, sophisticated coping skills, or confidence to believe that
they can influence their futures.
The U.S. Department of Health and Human Services/Office of the
Assistant Secretary for Planning and Evaluation reports that there are
approximately 200,000 births a year to girls age 17 and younger.
According to the ``National Campaign to Prevent Teen-age Pregnancy'',
approximately four out of ten girls in the United States becomes
pregnant at least once before the age of 20. Teenage pregnancy is not a
new problem nor considered a problem in some cultures.
However, today in the U.S. most careers depend on knowledge of
technology as well as basic skills, and most young women discontinue
their educations when they have unplanned or unwanted pregnancies.
Teachers, parents, and community leaders are aware of the
importance of a wide range of developmental experiences for young
people. However, young women and young people with disabilities
continue to experience isolation, fewer opportunities, and lower
expectations from their families and communities. Young women with
disabilities are especially likely to be denied, in subtle but
significant ways, the experiences that provide them with the tools for
self-determination. This very point is raised in the ``Report from the
National Longitudinal Transition Study of Special Education Students.
It was found that female 12th-graders with disabilities were much less
likely than males to have competitive employment as their postschool
goal, a pattern that reflects in their postschool reality. Despite
higher academic performance while in school, young women with
disabilities were just as likely as young men to drop out of school,
and almost 25% did so because of pregnancy or childrearing
responsibilities. Within 3 to 5 years after high school, 30% of young
women with disabilities were married and 41% were mothers, a rate that
was significantly higher than the reported parenting rate for young men
with disabilities (16%) or for young women of the same age in the
general population (26%). This raises significant questions about the
frequency with which these young women were mothers in their early
years after leaving school and why other options such as further
schooling or employment were not pursued. School programs chosen by or
provided to many young women with disabilities support a postschool
path involving home and child care more likely than postsecondary
education or employment.
Some studies have shown that people with disabilities and
particularly women with disabilities are more likely to be targets of
crime and/or abuse. In addition, women with low self-esteem are more
vulnerable to relationships that lead to unplanned and unwanted
pregnancies.
The Administration on Developmental Disabilities is proposing
demonstration projects to address the multiplicity of issues involved
with pregnancies among teenagers with developmental and other
disabilities. These projects should be collaborative efforts by
disability groups, and family planning organizations, and any other
public and private community agencies that are addressing this issue.
Mentoring models using women with disabilities need to be developed.
(Federal Catalog of Domestic Assistance Number 93.631--Developmental
Disabilities--Projects of National Significance)
Dated: March 17, 1998.
Reginald F. Wells,
Acting Commissioner, Administration on Developmental Disabilities.
[FR Doc. 98-8196 Filed 3-27-98; 8:45 am]
BILLING CODE 4184-01-P