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10 ORGANIZATION AND ADMINISTRATION OF FEDERAL RESEARCH PROGRAMS
Pages 244-292

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From page 244...
... SCOPE OF FEDERAL RESEARCH EFFORTS Federal expenditures in programs whose missions emphasize rehabilitation-related research are presented in Figure 10-1, showing that the National Institute on Disability and Rehabilitation Research (NIDRR) has the largest single program accounting for 48 percent ($70 million)
From page 245...
... ter for Medical Rehabilitation Research (NCMRR) supports 8 percent ($12 million)
From page 246...
... Other programs have separate committees; for example, the VA Rehabilitation Research and Development Service is under the jurisdiction of the Veterans' Affairs Committee, and the Social Security Administration's efforts are under the jurisdiction of the Labor, Health and Human Services and Education Subcommittee.
From page 247...
... . Disability and rehabilitation research is a part of many ICDs, but it is the central focus of only one, NCMRR, which is part of the National Institute of Child Health and Human Development (NICHD)
From page 248...
... Figure 10-2 shows that 12 percent (based on expenditures) of the abstracts were not related to rehabilitation science and engineering, 37 percent included a focus on rehabilitation science, another 39 percent focused on a single state of the enabling-disabling process (illustrated in Chapter 3)
From page 249...
... Rehabilitation science: Projects that address movement among states in the enabling-disabling process. Rehabilitation engineering: Projects that address devices or technologies applicable to one of the rehabilitation states.
From page 250...
... aRehabilitation science: Projects that address movement among states in the enabling-disabling process. Rehabilitation engineering: Projects that address devices or technologies applicable to one of the rehabilitation states.
From page 251...
... In contrast, only one percent of the rehabilitation science projects dealt with subjects with no disabling conditions. In addition to individual research projects, broader-based center grants and community clinical oncology programs that also include rehabilitation-related activities receive funds amounting to $125 million dollars (see Table 10-2~.
From page 252...
... Although NIH provides more than half of the gross federal effort in rehabilitation-related research, this seems to be more a result of the size of the aggregate budget than any special attention on the part of NIH. National Center for Medical Rehabilitation Research NCMRR was established within NIH by legislation passed in 1990 (Public Law 101-613~.
From page 253...
... of NIDRR, the MRCC, with the director of NCMRR as its chair, is authorized by legislation to "review and assess Federal research priorities, activities, and findings regarding medical rehabilitation research, and shall advise the Director of the Center and the Director of the Institute on the provisions of the Research plan" (Public Law 101-613~. Its goals have actually been more modest in scope, choosing to work within NIH rather than across federal agencies.
From page 254...
... $1,153,000 17 8 Not related $3,266,000 27 22 Totals $14,624,000 110 100 FIGURE 10-5 Percentage of research funding (not including center grants) in four categories of relevance to rehabilitation research for the fiscal year 1995 program at the National Center for Medical Rehabilitation Research.
From page 255...
... NOTE: Many abstracts address multiple states. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 256...
... Research Priorities and Funding The research funded by NIDRR covers almost every aspect of disability including brain injury, spinal cord injury, multiple sclerosis, and back pain, as well as broader areas such as technology, accessibility, aging, service delivery, policy, ethics, recreation, and community integration. In fiscal year 1995, NIDRR funded approximately $57 million in rehabilitation-related research, which included individual research grants, center grants, and fellowships.
From page 257...
... A large portion of this ($44 million) supports centersRehabilitation Research and Training Centers, Rehabilitation Engineering Research Centers, and Model Spinal Cord Injury Centers (see Table 10-3~.
From page 258...
... $3,430,5673231 Not related$374,61833 Total$11,188,982106100 FIGURE 10-7 Percentage of research funding (not including center grants, disability studies, or Americans with Disability Act-assistance projects; these are summarized in Table 10-3) in four categories of relevance to rehabilitation research for the fiscal year 1995 program at the National Institute on Disability and Rehabilitation Research.
From page 259...
... In addition, the core funding of center grants consumes a large portion of the agency's funds for 5-year periods, thereby reducing flexibility. The weaknesses in the peer review process are manifold.
From page 260...
... NOTE: Many abstracts address multiple states. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 261...
... Service, and the Rehabilitation Research and Development (Rehab R&D) Service.
From page 262...
... The rehabilitation program is geared to improving functional independence and the quality of life of veterans with disabling conditions.
From page 263...
... . Analysis3 of the abstracts indicated that 33 percent were rehabilitation science (See Figure 10-9~; rehabilitation engineering represented a full 46 percent of the studies funded in fiscal year 1995; 20 percent of the abstracts covered single-state research, and 1 percent were not related to rehabilitation.
From page 264...
... in four categories of relevance to rehabilitation research for the fiscal year 1995 program at the Department of Veterans Affairs. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 265...
... NOTE: Many abstracts address multiple states. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 266...
... The goals of the Division of Acute Care, Rehabilitation Research, and Disability Prevention are to maximize the quality of life and productivity, minimize the health care costs of injured people, and reduce the impacts of injuries by improving acute care and rehabilitation services and systems. The division spends $500,000 to $600,000 annually on disability prevention, with a special interest in community-based injury and outcomes surveillance and research to prevent the occurrence of or reduce the severity of secondary conditions among people with traumatic brain
From page 267...
... The projects funded by CDC consistently address prevention, specifically of secondary conditions among individuals with cerebral palsy, postpolio syndrome, spinal cord injury, or traumatic brain injury. All of the CDC abstracts were considered pertinent to rehabilitation research and a valuable contribution to the field.
From page 268...
... Most of the rehabilitation-related projects are supported through the Directorate for Engineering, which funds research pertinent to rehabilitation science and engineering through its Division of Bioengineering and Environmental Systems. The division operates two programs that support research for people with disabling conditions: the Biomedical Engineering Program and Research Aiding Persons with Disabilities (RAPD)
From page 269...
... Although NSF does support faculty and graduate work, roughly three quarters of the training grants related to rehabilitation science and engineering went to undergraduate training. Abstracts from NSF for fiscal year 1995 were retrieved from FastLane, the agency's on-line database, for the RAPD program.
From page 270...
... Rehabilitation science: Projects that address movement among states in the enabling-disabling process. Rehabilitation engineering: Projects that address devices or technologies applicable to one of the rehabilitation states.
From page 271...
... NOTE: Many abstracts address multiple states. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 272...
... Department of Defense would be engaged in rehabilitation science and engineering research, but a survey conducted at the committee's request by the Assistant Secretary of Defense for Health Affairs revealed an insignificant volume of rehabilitation research being conducted within the military medical services.
From page 273...
... Foremost among these are the need for improved coordination among the various and numerous federal research programs and the need for additional research in rehabilitation science and engineering that will help to improve the health, quality of life, and productivity of the 49 million Americans with disabling conditions. Further analysis of these programs including the related efforts outside NCMRR at NIH revealed certain trends in the overall federal research effort in rehabilitation science and engineering (see Figures 10-13 and 10-14~.
From page 274...
... Not related Totals $101,105,292 $44,129,995 $100,540,664 $30,207,510 $275,983,461 543 293 540 193 1,569 37 16 36 11 100 FIGURE 10-13 Percentage of research funding (not including center grants) in four categories of relevance to rehabilitation research for the fiscal year 1995 program for overall federal research.
From page 275...
... NOTE: Many abstracts address multiple states. Rehabilitation science: Projects that address movement among states in the enabling-disabling process.
From page 276...
... This is especially true for the set of federal research programs in rehabilitation science and engineering because of their distribution among so many different agencies and departments. Moreover, given the relatively limited amount of funding that is available for these research programs, good coordination is essential to maximize their combined productivity.
From page 277...
... Moreover, with respect to NIH specifically, the lack of a study section to review rehabilitation-related research applications raises the question of whether there is a well-coordinated research effort in this field among the Institutes. By law, the responsibility for coordinating federal disability research programs rests with ICDR, which is to be chaired by the director of NIDRR and whose membership includes 11 different agencies.
From page 278...
... , · identify and establish clear research priorities that would be complementary and mutually beneficial among the different federal programs, · ensure interagency collaboration and joint research activities and reduce unnecessary duplication of effort, · enhance the development of a cadre of rehabilitation scientists and engineers, · develop effective technology transfer activities, · help establish and maintain the use of consistent definitions and terminologies among agencies, · optimize productivity through resource sharing and other costsaving activities, and · conduct clinical trials of therapeutic and environmental strategies to reduce and prevent disabling and secondary conditions. The remainder of this chapter describes three of the many options that the committee developed and considered as means of addressing the problems and needs associated with inadequate support and coordination of federal programs in rehabilitation science and engineering.
From page 279...
... If there is one program, however, that not only has possibly the largest potential for contributing to this effort but that is also the most limited by administrative and organizational constraints, it is NIDRR. The NIDRR mission and its constituency of people with disabling conditions are fundamentally important to the research agenda of rehabilitation science and engineering espoused by this committee.
From page 280...
... The advantages of keeping NIDRR in U.S. Department of Education include the following: constituencies remain intact, continuity of funding is ensured for Rehabilitation Research and Training Centers and Rehabilitation Engineering Research Centers, and costs of relocation are avoided.
From page 281...
... The committee believes that the unique mission of NIDRR needs to be preserved because it is fundamentally important to the research agenda of rehabilitation science and engineering espoused by this committee. NIDRR has vigorously pursued this mission as best as possible within the constraints of its administrative location.
From page 282...
... The committee therefore recommends that this option be implemented as a means of enhancing the overall federal effort in rehabilitation research and improving the health, quality of life, and productivity of people with disabling conditions (see Recommendation 10.1 below)
From page 283...
... Move NIDRR to Create ADRR The major purposes of moving NIDRR are threefold: first, to explant it administratively to a more nurturing and supportive environment; secondly, to raise the visibility of disability and rehabilitation research as important health issues; and lastly to serve more effectively as the core of an interagency coordinating body. In serving as the basis for a new agency, the move would provide an opportunity to develop a better coordinated federal effort with enhanced visibility and well-defined, complementary goals for the overall effort.
From page 284...
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From page 285...
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From page 286...
... ADRR should be provided with the authority to award research grants, contracts, cooperative agreements, and research and development with a rehabilitation science or engineering focus. Eligible entities would include universities, rehabilitation facilities, nonprofit organizations, and for-profit corporations.
From page 287...
... The interagency committee would be composed of rehabilitation experts outside government, representatives of the major government funding agencies, major foundations funding rehabilitation-related research, leaders of organizations that provide services to people with disabling conditions, and people with potentially disabling conditions who represent major constituencies. Multiple-Agency Projects A second branch of this division would support linkage projects that cross the boundaries of the missions of the various agencies.
From page 288...
... The program would be divided into two broad branches: rehabilitation science and disability studies. Rehabilitation Science The rehabilitation science branch could be organized by topic areas rather than by the type of funding mechanism (i.e., via centers and field-initiated research)
From page 289...
... Engineering and Environmental Research Division The activities of this committee revealed a significant weakness in the overall research activities related to rehabilitation engineering and environmental modification. Notably, the lives of people with disabling conditions can be enhanced through environmental strategies, including assistive technology and universal design, among others.
From page 290...
... Additional efforts should be made to expand this program to train personal assistance providers, urban planners, architects, environmental specialists, lawyers, tax consultants, and other professionals who are beginning to develop programs for enhancing the lives of people with potentially disabling conditions. Recruitment of Scientists with Potentially Disabling Conditions The third branch of this division would provide funding for training people with potentially disabling conditions and their families in the skills needed to understand, conduct, and participate in research.
From page 291...
... The general levels of research activities within each program are the primary barrier to adequate attention to the pressing issues in rehabilitation research. The priorities within each program, although in need of coordination, seem appropriate within their respective missions.
From page 292...
... Placement within the CDC Director's office would afford rehabilitation science and engineering the visibility that it deserves and help to ensure that these issues would be integrated into all programmatic activities. Summary By moving NIDRR to create ADRR, the federal government would take a very important step in enhancing the productivity, relevance, and coordination of the programs which support rehabilitation research.


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