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Ms. PARRINO. Yes.

Senator HARKIN. When will it be done?
Ms. PARRINO. Next spring.

Senator HARKIN. Oh, by next year, OK.
Ms. PARRINO. Yes.

QUESTIONS SUBMITTED BY THE SUBCOMMITTEE

Senator HARKIN. We look forward to that too. Well, listen, I have a lot of other questions on budget items and things like that. Actually, I had one on the increase for the communications, and you touched on that. If I have any budget issues we will just send them down to you in writing.

Ms. PARRINO. That is fine.

Senator HARKIN. If you would report back I would appreciate it. Well, thank you very much. I am glad we were able to work this in today.

Ms. PARRINO. Thank you, Senator Harkin.

Senator HARKIN. Thank you, Ms. Parrino.

[The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED BY THE SUBCOMMITTEE

ADA

Last year President Bush signed into law the Americans with Disabilities Act to extend civil rights protection to people with disabilities and ensure their integration into the social and economic mainstream.

What, if any, technical assistance in complying with ADA is the Council providing to businesses and other entities affected by the Act?

The National Council on Disability is providing a variety of technical assistance to businesses and other entities regarding the Americans with Disabilities Act (ADA). The National Council is responsible for developing overall strategies for the implementation of ADA, along with other federal agencies designated by Section 506 of the Act. As intended by Congress, an important focus of the National Council's work, along with other federal agencies, will be the development of strategies to ensure performance of technical assistance activities that coordinated, comprehensive, and effective.

the

are

The National Council is planning to conduct an "ADA Watch." The purpose of ADA Watch is to gather and disseminate information about the effectiveness and impact of ADA. ADA Watch will have general oversight over the overall implementation and impact of the Act, both on people with disabilities and with those entities who must comply with the law. ADA Watch will use its information to promote a dialogue between people with disabilities and the business community about creative solutions for compliance with the law.

Are businesses contacting you, or are you seeking them out?

The National Council receives approximately 8 telephone calls per day and 5 to 10 letters per week requesting technical assistance on ADA. National Council staff members answers questions about specific applications of ADA or make referrals to other appropriate federal agencies.

What's the nature of the assistance they're seeking?

Most callers and writers are inquiring about regulatory matters. According to our staff, most calls come from law firms, members of the press, large corporations, state government, small businesses and people with disabilities.

Since the signing of ADA into law, members of the National Council and staff have given enumerable speeches to small business seminars, chambers of commerce, and consumer groups of people with disabilities, either in whole or in part regarding ADA. The National Council continues to be vitally interested in the implementation of and providing technical assistance on ADA.

Reauthorization of the Rehabilitation Act

When will the Council be submitting to the Congress its proposals for reauthorization of the Rehabilitation Act of 1973?

As we mentioned in our testimony before the Senate, the National Council has held four days of hearings on the reauthorization of the Rehabilitation Act of 1973 as amended. During the most recent meeting of the National Council which took place in Los Angeles in mid-March, the National Council deliberated on recommendations which we received from these hearings. At the present time, the

draft report on the reauthorization of the Act is being revised to reflect the deliberations of the National Council. As soon as this report has been finalized, we will be pleased to share it with the Members of the subcommittee.

What can you tell us about the nature of the reforms you'll be recommending?

During the four days of hearings which were held by the National Council, every effort was made to take a comprehensive look at each Title of the Act and to see what changes need to be made. While the National Council's specific recommendations will be embodied in the final report, one overriding concern which was reiterated throughout the hearings is the need to provide persons with disabilities a greater voice in determining what services they need and how these services will be delivered. While this may appear to only effect Title I of the Act (which is the Basic State Grant Program) this in fact is becoming an underlying principle of all aspects of rehabilitation services, including research and training efforts. In addition, the subcommittee should be aware that the National Council plans to make specific recommendations for each section of the Act in our final report.

NIDRR 5-Year Plan

One of the Council's mandates is to work with the National Institute on Disability and Rehabilitation Research (NIDRR) on the development of their 5-year plan. I understand that after a good deal of delay, progress is being made toward formulation of a new plan--one long overdue. The Department of Education anticipates that it will have a plan in effect around June of 1992.

What, generally, are the Council's recommendations to the Department for reform of the plan?

The National Council on Disability is pleased with the three-stage planning process of data collection, of development of papers by experts, including consumers and then, writing a plan. The National Council has supported this process of strong consumer and expert input into the development of the plan as an ongoing process. The National Council and NIDRR worked together on the first public hearing in the NIDRR planning process, held in Washington, D.C. in November 1990. National Council members will participate in the six public hearings which will be held in June in various locations in the United States. The National Council is also represented on the 15-member Executive Committee NIDRR Planning Process which will guide the process of development of expert papers.

Does the National Council see research implications for NIDRR in passage of the ADA?

Yes, of course, there are many research implications for NIDRR as a result of the passage of the ADA. NIDRR is already planning a multifaceted program to support the implementation of the ADA. In addition to this effort, research should address the effectiveness of the ADA through longterm monitoring and other approaches in order to document the impact of the ADA in the lives of persons with disabilities. Passage of the ADA impacts heavily on various sectors in society and cost data should be collected in areas such as reasonable accommodations and readily achievable environmental modifications. The ADA mandates assistive technology and environmental modifications for which engineering and technical standards research are needed.

Individuals with disabilities continue to face problems in the cost and adequacy of health insurance and health-related services. Studies in this area would show the magnitude of the need and identify services and finance problems. Finally, the impact of the ADA on individuals with severe disabilities and individuals who are elderly may require special attention.

Disability Prevention Program

As you know, the Centers for Disease Control runs a primary and secondary disabilities prevention program. You have been critical to the development and growth of this important activity. How do you think the program is working?

The National Council has a very good relationship with the Centers for Disease Control (CDC). Our Council tends to focus on the prevention of secondary disabilities even through we are concerned about the prevention of primary disabiliteis. Most of the people we serve, are people who already have some type of disabilities. Very often people with disabilities will die from secondary conditions, not from the primary disabilities. The National Council feels very strongly that the prevention of secondary disabilities must be interwoven into the public health and health care systems in this country.

Annual Reports Update

What is the status of the National Council's annual reports for fiscal years 1989, 1990 and 1991 on the condition of research affecting persons with disabilities and the activities of RSA and NIDRR?

The National Council's annual reports for fiscal year 1989 and 1990 on the condition of research affecting persons with disabilities and the activities of RSA and NIDRR have been combined into one volume and is available.

Material and research for the National Council's annual report for fiscal year 1991 is being compiled. A preliminary draft report is expected this summer with the final report expected by year's end. What is the status of the National Council's annual reports for fiscal year 1989, 1990 and 1991 on the progress that has been made in implementing the recommendations contained in the National Council's January 30, 1986, report, Toward Independence?

The National Council produced a special report for fiscal year 1989, entitled, The Education of Students with Disabilities" Where Do We Stand?, which was in accordance with the statutory mandate of the National Council which authorizes special report to the President and Congress regarding the progress of implementing recommendations contained in the National Council's 1986 report, Toward Independence.

A special report for fiscal year 1990 on the Americans with Disabilities Act is now under way, and will be released within the next few months.

A special report for fiscal year 1991 is in the planning and conceptual stages and is expected to be released by January 30, 1992.

Health Insurance

What were the findings of your preliminary study, to have been conducted in fiscal year 1990, on health insurance for persons with disabilities?

The National Council on Disability conducted a preliminary study on health insurance and health-related services problems experienced by persons with disabilities. The study entitled, Potential Study on Health Insurance and Persons with Disabilities, was submitted to the National Council in January, 1990. The document was an assessment of the need for a national level study. At that time, a number of national-level government or private sector agencies and organizations were conducting health insurance studies which had some relevance for individuals with disabilities. Findings from the National Council's preliminary study indicated that the health insurance and health related services problems faced by individuals with disabilities were

nsufficiently covered in other studies, such as that of the Pepper Commission.

The National Council's needs assessment indicated that this agency could play a vital role in articulating and promoting a disability >erspective in the national dialogue on health insurance reform. Such role would, at least partially, mitigate the impact of the omission of health insurance and health-related services protection under the Americans with Disabilities Act. In addition, a study would address the lack of a support system for non-medical services for individuals with disabilities, such as personal care assistance, interpreters, assistive technology and readers. The National Council's preliminary report identified the following specific issues which a future study might address: a) pre-existing condition exclusions, b) lack of adequate health insurance as a work disincentive, c) adequacy of the breath of coverage, d) high cost of health insurance.

How was your study conducted?

The National Council on Disability used the following information gathering and data collection methodologies in conducting this preliminary study: a) literature review, b) discussions with staff conducting federal agency and private sector studies, c) attendance at forums on health insurance, d) meetings with members of the health insurance industry and other service providers, regulators and

consumers.

Were your findings published?

Since this effort was a preliminary study, findings were not

published. However, findings were shared widely in discussions with study participants and other interested persons. This study was used as an in-house document.

Personal Assistance

Did these

The National Council conducted hearings last summer on personal
assistance services for individuals with disabilities.
hearings lead to any policy recommendations?

On January 9th and 10th, the National Council began hearings on issues surrounding the provision of personal assistance services for persons with disabilities and their families. During these two days of hearings, we focused on financial barriers to the provision of personal assistance services and how these barriers can be overcome. Throughout these two days of hearings, a cross section of groups which require Personal Assistance Services testified about their unique needs in this area. For example, Council members heard from several groups who provide Personal Assistance Services to elderly persons. Many of the groups testified that individuals who are elderly often require these services either because they are no longer mentally capable or their family members are no longer able to care for them for a variety of reasons. We also heard from a panel of witnesses who have physical disabilities as well as those with cognitive disabilities. Two persons who testified on behalf of persons who have head injuries explained that this population has unique and ongoing needs due to the nature of their disabilities.

Perhaps the most interesting panel was the one which discussed at length the financing of Personal Assistance Services. During this panel, we heard from both state and local administrators as well as a the World Institute on Disability. All three of these witnesses explained that, even with the most flexible Personal Assistance program, there is currently not enough money to provide services to all of the individuals who request them. Additionally, there is a wide discrepancy between states with regard to who is eligible for services and what services are provided. This diversity among states compounds the already difficult problem of providing Personal Assistance Services to persons with disabilities. A transcript of these hearings is being prepared by Council staff. When this

transcript becomes available, we will be pleased to share it available with the Subcommittee.

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