Notice2025-21585

Request for Information; Disability Clinical Care

Primary source

Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.

Published
December 1, 2025

Issuing agencies

National Council on Disability

Abstract

NCD is requesting information to help inform a policy brief it will be publishing concerning the need for disability clinical care and competency training of medical professionals.

Full Text

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<title>Federal Register, Volume 90 Issue 228 (Monday, December 1, 2025)</title>
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[Federal Register Volume 90, Number 228 (Monday, December 1, 2025)]
[Notices]
[Pages 55181-55182]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-21585]


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NATIONAL COUNCIL ON DISABILITY


Request for Information; Disability Clinical Care

AGENCY: National Council on Disability (NCD).

ACTION: Notice; request for information.

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SUMMARY: NCD is requesting information to help inform a policy brief it 
will be publishing concerning the need for disability clinical care and 
competency training of medical professionals.

DATES: Electronic comments on the notice must be submitted by 11:59 EST 
on January 6, 2025.

ADDRESSES: You may submit comments and information via email to 
<a href="/cdn-cgi/l/email-protection#2f4e5c404346424e416f414c4b01484059"><span class="__cf_email__" data-cfemail="4021332f2c292d212e002e23246e272f36">[email&#160;protected]</span></a>. Please note that late, untimely filed comments will 
not be considered.

FOR FURTHER INFORMATION CONTACT: Amged Soliman, Senior Attorney 
Advisor, National Council on Disability, <a href="/cdn-cgi/l/email-protection#dbbaa8b4b7b2b6bab59bb5b8bff5bcb4ad"><span class="__cf_email__" data-cfemail="1170627e7d787c707f517f72753f767e67">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION:

I. Background

    The lack of comprehensive disability clinical-care education and 
disability competency training among medical, nursing and other 
healthcare professionals can perpetuate discrimination in healthcare 
against people with disabilities and significantly contributes to the 
disparate health outcomes of people with disabilities. Most Federally 
financed medical, nursing, healthcare professional, and allied health 
professional schools, as well as post-graduate residency and fellowship 
programs, do not incorporate disability clinical care into curricula or 
training. Consequently, physicians often lack the knowledge, 
experience, and skills to distinguish clinical concerns arising from 
disability from those related to other health conditions. One's 
apparent disability--even when unrelated to the reason for one's health 
care visit--can result in diagnostic overshadowing the clinical concern 
and can have negative impact during the health care visit. This lack of 
familiarity and understanding of disability is detrimental to quality 
of care, contributing to delays in diagnosis and treatment, unsafe 
care, and inequities in care.
    Due to a lack of training and familiarity, people with disabilities 
are sometimes viewed as asexual.\i\ These assumptions may contribute to 
the finding that women with disabilities undergo colon cancer screening 
at similar rates as their nondisabled peers, but experience disparities 
in breast cancer and cervical cancer screening.\ii\

[[Page 55182]]

The sexual health of women with intellectual disabilities is 
particularly ignored in terms of screening for breast and cervical 
cancer.\iii\ An abundance of research indicates the lack of disability 
competency and interdisciplinary training among medical professionals 
contributes to the health disparities of people with disabilities 
across the nation.\iv\
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    \i\ Milligan MS, Neufeldt AH. ``The myth of asexuality: A survey 
of social and empirical evidence.'' Sex Disabil. 2001;19(2):91-109. 
doi:10.1023/A:1010621705591.
    \ii\ Horner-Johnson W, Dobbertin K, Andresen EM, Iezzoni LI. 
Breast and cervical cancer screening disparities associated with 
disability severity. Womens Health Issues. 2014;24(1):e147-53. See 
also, Pharr JR, Bungum T. ``Health disparities experienced by people 
with disabilities in the United States: A behavioral risk factor 
surveillance system study.'' Glob J Health Sci. 2012;4(6):99-108. 
doi:10.5539/gjhs.v4n6p99. See also, Andresen EM, Peterson-Besse JJ, 
Krahn GL, Walsh ES, Horner-Johnson W, Iezzoni LI. ``Pap, 
mammography, and clinical breast examination screening among women 
with disabilities: a systematic review.'' Womens Health Issues. 
2013;23(4):e205-14.
    \iii\ Havercamp SM, Scott HM. ``National health surveillance of 
adults with disabilities, adults with intellectual and developmental 
disabilities, and adults with no disabilities.'' Disabil Health J. 
2015;8(2):165-172. doi:10.1016/j.dhjo.2014.11.002.
    \iv\ Krahn et al. (2015). Persons with Disabilities as an 
Unrecognized Health Disparity Population, 105 Am. J. Pub. Health 
S198, S204 (``Every major report addressing the poor health of 
people with disabilities has called for improvements in training of 
health care providers about adults with disabilities.'').
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    While some medical schools in the US do provide disability 
competency training, the overwhelming majority do not. Standard, 
comprehensive disability clinical-care education and training of 
medical, nursing, and other healthcare professionals is essential for a 
better educated healthcare workforce trained with an understanding of 
disability as a natural part of the human condition versus conditions 
that must be avoided, prevented or fixed. Comprehensive disability 
clinical-care competency should be woven into the curricula 
requirements of all US undergraduate medical, nursing, healthcare 
professional, and allied health professional education, as well as 
postgraduate residency and fellowship programs that are conducted in 
over 1,100 teaching hospitals.

II. Issues for Consideration and Request for Information

    With respect to the status of disability clinical care and 
competency training within the US, NCD invites comments based on the 
questions below. Please explain your answers and provide references and 
data, if possible.
    1. What are the challenges and obstacles for schools within the US 
to adopt and incorporate an appropriate disability clinical care 
curriculum over the course of their students' training?
    2. What is the connection between clinical confidence and changes 
in behavior and attitudes among healthcare providers?
    3. What are the transferable skills that clinicians can learn from 
``disability competency training'' to apply to all other patient 
populations (for instance people who are elderly, those with complex 
and chronic co-existing conditions, etc.)?
    4. What are the existing curriculum resources that can be adopted 
and incorporated into current provider training?
    5. What are examples of existing curriculum or standards of 
learning inclusive of disability clinical care/competency training that 
could be consulted for development of new required standards of 
learning across medical schools; and/or adopted wholesale as part of a 
program's education of medical professionals?
    The information provided will be kept confidential and will not be 
attributed to specific individuals or organizations.

Disclaimer

    This Request for Information is for information gathering purposes 
only and does not constitute a commitment by NCD to take any specific 
action based on the responses received.
    Further, this Request for Information is not an invitation to apply 
for funding or a Request for Proposals.

    Dated: November 25, 2025.
Anne Sommers McIntosh,
Director of Legislative Affairs and Outreach.
[FR Doc. 2025-21585 Filed 11-28-25; 8:45 am]
BILLING CODE 8421-02-P


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