[Federal Register Volume 62, Number 151 (Wednesday, August 6, 1997)]
[Notices]
[Pages 42334-42361]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-20519]
[[Page 42333]]
_______________________________________________________________________
Part III
Department of Health and Human Services
_______________________________________________________________________
Administration for Children and Families
_______________________________________________________________________
Development Disabilities: Availability of Financial Assistance for
Projects of National Significance for Fiscal Year 1997; Notice
Federal Register / Vol. 62, No. 151 / Wednesday, August 6, 1997 /
Notices
[[Page 42334]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. 93631-97-02]
Developmental Disabilities: Availability of Financial Assistance
for Projects of National Significance for Fiscal Year 1997
AGENCY: Administration on Developmental Disabilities (ADD),
Administration for Children and Families (ACF).
ACTION: Announcement of availability of financial assistance for
Projects of National Significance for fiscal year 1997.
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SUMMARY: The Administration on Developmental Disabilities,
Administration for Children and Families, announces that applications
are being accepted for funding of Fiscal Year 1997 Projects of National
Significance.
This program announcement consists of five parts. Part I, the
Introduction, discusses the goals and objectives of ACF and ADD. Part
II provides the necessary background information on ADD for applicants.
Part III describes the review process. Part IV describes the priority
under which ADD requests applications for Fiscal Year 1997 funding of
projects. Part V describes in detail how to prepare and submit an
application. All of the forms and instructions necessary to submit an
application are published as part of this announcement following Part
V.
No separate application kit is either necessary or available for
submitting Project of National Significance grant application. If you
have a copy of this announcement, you have all the information and
forms required to submit an application.
Grants will be awarded under this program announcement subject to
the availability of funds for support of these activities.
DATES: The closing date for submittal of applications under this
announcement is September 5, 1997. Mailed or handcarried applications
received after 4:30 p.m. on the closing date will be classified as
late.
Deadline: Mailed applications shall be considered as meeting an
announced deadline if they are received on or before the deadline time
and date at the U.S. Department of Health and Human Services, ACF/
Administration on Developmental Disabilities, Third Floor, 200
Independence Avenue SW, Washington, DC 20201, Attention: Joan Rucker.
Applications handcarried by applicants, applicant couriers, other
representatives of the applicant, or by overnight/express mail couriers
shall be considered as meeting an announced deadline if they are
received on or before the deadline date, between the hours of 8:00 a.m.
and 4:30 p.m., EST, at the U.S. Department of Health and Human
Services, ACF/Administration on Developmental Disabilities, Mailroom,
Rm. G644, 330 Independence Avenue SW, Washington, DC 20201, between
Monday and Friday (excluding Federal holidays). This address must
appear on the envelope/package containing the application with the note
``Attention: Joan Rucker''. Applicants using express/overnight services
should allow two working days prior to the deadline date for receipt of
applications. (Applicants are cautioned that express/overnight mail
services do not always deliver as agreed.) Any applications received
after 4:30 p.m. on the deadline date will not be considered for
competition.
ADD cannot accommodate transmission of applications by fax or
through other electronic media. Therefore, applications transmitted to
ADD electronically will not be accepted regardless of date or time of
submission and time of receipt.
Late Applications: Applications which do not meet the criteria
above are considered late applications. ADD shall notify each late
applicant that its application will not be considered in the current
competition.
Extension of Deadlines: ADD may extend the deadline for all
applicants because of acts of God such as floods and hurricanes, or
when there is widespread disruption of the mails. However, if ADD does
not extend the deadline for all applicants, it may not waive or extend
the deadline for any applicants.
FOR FURTHER INFORMATION CONTACT: Adele Gorelick (202-690-5982) or Pat
Laird (202-690-7447), Program Development Division, Administration on
Developmental Disabilities.
Notice of Intent to Submit Application: If you intend to submit an
application, please send a post card with the number and title of this
announcement, your organization's name and address, and your contact
person's name, phone and fax numbers, and e-mail address to:
Administration on Developmental Disabilities, 200 Independence Avenue,
Rm. 329D, Washington, DC, 20201, Attn: Projects of National
Significance.
This information will be used to determine the number of expert
reviewers needed and to update the mailing list to whom program
announcements are sent.
SUPPLEMENTARY INFORMATION:
Part I. General Information
A. Goals of the Administration on Developmental Disabilities
The Administration on Developmental Disabilities (ADD) is located
within the Administration for Children and Families (ACF), Department
of Health and Human Services (DHHS). Although different from the other
ACF program administrations in the specific populations 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, ACF and ADD envision:
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;
A strong commitment to working with Native Americans,
persons with developmental disabilities, refugees and migrants to
address their needs, strengths and abilities; and
A community-based approach that recognizes and expands on
the resources and benefits of diversity.
Emphasis on these goals and progress toward them will help more
individuals, including people 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.
B. Purpose of the Administration on Developmental Disabilities
The Administration on Developmental Disabilities (ADD) is the lead
agency within ACF and DHHS responsible for planning and administering
programs which promote the self-sufficiency and protect the rights of
persons with developmental disabilities.
[[Page 42335]]
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, integration and inclusion into
the community.
In the Act, Congress expressly found 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,
integration 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 established as the policy of the United States:
Individuals with developmental disabilities, including
those with the most severe developmental disabilities, are capable of
achieving independence, productivity, 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 people 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 people with developmental disabilities to achieve
their maximum potential to support the increasing ability of people
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.
The four programs funded under the Act are:
Federal assistance to State developmental disabilities
councils;
State system for the protection and advocacy of
individuals rights;
Grants to University Affiliated Programs for
interdisciplinary training, exemplary services, technical assistance,
and information disssemination; and
Grants for Projects of National Significance.
C. Statutory Authorities Covered Under This Announcement
The Developmental Disabilities Assistance and Bill of Rights Act of
1996, 42 U.S.C. 6000, et.seq. The Projects of National Significance is
Part E of the Developmental Disabilities Assistance and Bill of Rights
Act of 1996, 42 U.S.C. 6081, et.seq.
Part II. Background Information For Applicants
A. Description of Projects of National Significance
Under Part E of the Act, grants and contracts are awarded for
projects of national significance that support the development of
national and State 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 people 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 minority and ethnic groups in
public and private sector initiatives in developmental disabilities;
--Transition of youth with developmental disabilities from school to
adult life; and
--Special pilots and evaluation studies to explore the expansion of
programs under part B (State developmental disabilities councils) to
individuals with severe disabilities other than developmental
disabilities.
B. Comments on FY 1997 Proposed Priority Areas
The notice requesting comments on the FY 1997 proposed priority
areas was published in the Federal Register on April 16, 1997 (62 FR
18633). A 60-day period was required to allow the public to comment on
the proposed areas. After review and analysis of these comments, ADD is
publishing its final priority in this announcement.
The public comment notice requested specific comments and
suggestions on the proposed funding priorities and recommendations for
additional priority areas to help bring about the increased
independence, productivity, and integration into the community of
people with developmental disabilities.
ADD received 34 letters by the closing date in response to the
public comment notice. Commentary was from the following sources:
Advocacy agencies, including national organizations and
associations, national advocacy groups and State/local advocacy groups;
Service organizations, including agencies that provide
services for individuals with developmental disabilities as well as
providing advocacy services on behalf of a particular disability,
including developmental disabilities councils;
Educational systems, including schools, colleges, and
universities, programs located within a university setting and
University Affiliated Programs;
Private agencies, including national, State, and local
nonprofit organizations;
Government agencies, including Federal, State, county, and
local government agencies; and
Private individuals.
Comments ranged from requests for copies of the final application
solicitation, to general support, to informative, clarifying responses
for this year's proposed funding priorities and recommendations for
other priority areas. The vast majority supported and expanded upon
what we proposed in the announcement, in addition to relating
specifically to the program goals and priorities of the particular
agencies submitting the comments.
[[Page 42336]]
The comments helped highlight the concerns of the developmental
disabilities field and have been used in refining the final priority
areas.
After careful review of comments on ``Priority Area 1: Managed Care
and Disability'', ADD has decided to defer funding a project in this
area. ADD received little specific guidance on what should be the
critical activities conducted in this area. This may be due to the fact
that this is still an unknown area where much activity is taking place
but no results or best practices have been identified as yet as it
relates to people with developmental disabilities and families of
children with developmental disabilities. Many of the activities taking
place are projects supported by federal agencies such as the Office of
Planning and Evaluation and the Health Care Financing Administration/
Department of Health and Human Services, and the National Institute on
Disability and Rehabilitation Research/Department of Education. ADD has
also supported various activities in managed care through funding of a
national clearinghouse on managed care and long-term support and
services for adults with developmental disabilities and their families;
a joint task force of the American Association of University Affiliated
Programs and the Center for the Health Professions (Univ. of
California/ San Francisco) which is studying the implications of
managed care on professional education, service delivery, and research
issues; and video and training materials for individuals with
developmental disabilities and families. ADD realizes this is a
critical area for the constituency it represents and will re-examine
this topic again when it is developing its priorities for next fiscal
year.
In some of the proposed priority areas ADD used the phrase ``people
with developmental disabilities and families of children with
developmental disabilities''; it became apparent that a point of
clarification is needed regarding the latter part of the phrase as it
relates to the role of families of adults with developmental
disabilities. ADD believes that the individual with a developmental
disability should be afforded both the opportunity and necessary
assistance to express and make decisions over their own lives but
understands that under certain circumstances it may be appropriate and
necessary for parents or guardians of such individuals to be consulted
as primary decision-makers. However, even when some form of surrogate
decision making is deemed necessary, adults with developmental
disabilities should be provided the opportunities and supports to
express personal preferences and choices affecting their own lives and
futures to the maximum extent feasible. Applicants are encouraged to
give this due consideration in their proposals.
ADD further recognizes issues around surrogate decision making and
decision making supports for people with developmental disabilities to
be critical and timely ones and will also re-examine these topics again
when it is developing its priorities for the next fiscal year.
Part III. The Review Process
A. Eligible Applicants
Before applications under this Announcement are reviewed, each will
be screened to determine that the applicant is eligible for funding as
specified under the selected priority area. Applications from
organizations which do not meet the eligibility requirements for the
priority area will not be considered or reviewed in the competition,
and the applicant will be so informed.
Only public or non-profit private entities, not individuals, are
eligible to apply under any of the priority areas. All applications
developed jointly by more than one agency or organization must identify
only one organization as the lead organization and official applicant.
The other participating agencies and organizations can be included as
co-participants, subgrantees or subcontractors.
Nonprofit organizations must submit proof of nonprofit status in
their applications at the time of submission. One means of
accomplishing this is by providing a copy of the applicant's listing in
the Internal Revenue Service's most recent list of tax-exempt
organizations described in section 501 (c) (3) of the IRS code or by
providing a copy of the currently valid IRS tax exemption certificate,
or by providing a copy of the articles of incorporation bearing the
seal of the State in which the corporation or association is domiciled.
ADD cannot fund a nonprofit applicant without acceptable proof of
its nonprofit status.
B. Review Process and Funding Decisions
Timely applications under this Announcement from eligible
applicants received by the deadline date will be reviewed and scored
competitively. Experts in the field, generally persons from outside of
the Federal Government, will use the appropriate evaluation criteria
listed later in this Part to review and score the applications. The
results of this review are a primary factor in making funding
decisions.
ADD reserves the option of discussing applications with, or
referring them to, other Federal or non-Federal funding sources when
this is determined to be in the best interest of the Federal Government
or the applicant. It may also solicit comments from ADD Regional Office
staff, other Federal agencies, interested foundations, national
organizations, specialists, experts, States and the general public.
These comments, along with those of the expert reviewers, will be
considered by ADD in making funding decisions.
In making decisions on awards, ADD will consider whether
applications focus on or feature: services to culturally diverse or
ethnic populations among others; a substantially innovative strategy
with the potential to improve theory or practice in the field of human
services; a model practice or set of procedures that holds the
potential for replication by organizations administering or delivering
of human services; substantial involvement of volunteers; substantial
involvement (either financial or programmatic) of the private sector; a
favorable balance between Federal and non-Federal funds available for
the proposed project; the potential for high benefit for low Federal
investment; a programmatic focus on those most in need; and/or
substantial involvement in the proposed project by national or
community foundations.
To the greatest extent possible, efforts will be made to ensure
that funding decisions reflect an equitable distribution of assistance
among the States and geographical regions of the country, rural and
urban areas, and ethnic populations. In making these decisions, ADD may
also take into account the need to avoid unnecessary duplication of
effort.
C. Evaluation Criteria
Using the evaluation criteria below, a panel of at least three
reviewers (primarily experts from outside the Federal Government) will
review the applications. To facilitate this review, applicants should
ensure that they address each minimum requirement in the priority area
description under the appropriate section of the Program Narrative
Statement.
Reviewers will determine the strengths and weaknesses of each
application in terms of the evaluation criteria, provide comments, and
assign numerical scores. The point value following each criterion
heading
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indicates the maximum numerical weight that each section may be given
in the review process.
All applications will be evaluated against the following criteria:
1. Objectives and Need for Assistance (20 points)
The extent to which the application pinpoints any relevant
physical, economic, social, financial, institutional or other problems
requiring a solution; demonstrates the need for the assistance; states
the principal and subordinate objectives of the project; provides
supporting documentation or other testimonies from concerned interests
other than the applicant; and includes and/or footnotes relevant data
based on the results of planning studies. The application must identify
the precise location of the project and area to be served by the
proposed project. Maps and other graphic aids should be attached.
2. Results or Benefits Expected (20 points)
The extent to which the application identifies the results and
benefits to be derived, the extent to which they are consistent with
the objectives of the application, and the extent to which the
application indicates the anticipated contributions to policy,
practice, theory and/or research. The extent to which the proposed
project costs are reasonable in view of the expected results.
3. Approach (35 points)
The extent to which the application outlines a sound and workable
plan of action pertaining to the scope of the project, and details how
the proposed work will be accomplished; cites factors which might
accelerate or decelerate the work, giving acceptable reasons for taking
this approach as opposed to others; describes and supports any unusual
features of the project, such as design or technological innovations,
reductions in cost or time, or extraordinary social and community
involvements; and provides for projections of the accomplishments to be
achieved. Activities to be carried out should be listed in
chronological order, showing a reasonable schedule of accomplishments
and target dates.
The extent to which, when applicable, the application identifies
the kinds of data to be collected and maintained, and discusses the
criteria to be used to evaluate the results and successes of the
project. The extent to which the application describes the evaluation
methodology that will be used to determine if the needs identified and
discussed are being met and if the results and benefits identified are
being achieved. The application also lists each organization, agency,
consultant, or other key individuals or groups who will work on the
project, along with a description of the activities and nature of their
effort or contribution.
4. Staff Background and Organization's Experience (25 points)
The application identifies the background of the project director/
principal investigator and key project staff (including name, address,
training, educational background and other qualifying experience) and
the experience of the organization to demonstrate the applicant's
ability to effectively and efficiently administer this project. The
application describes the relationship between this project and other
work planned, anticipated or under way by the applicant which is being
supported by Federal assistance.
D. Structure of Priority Area Descriptions
The priority area description is composed of the following
sections:
Eligible Applicants: This section specifies the type of
organization which is eligible to apply under the particular priority
area. Specific restrictions are also noted, where applicable.
Purpose: This section presents the basic focus and/or
broad goal(s) of the priority area.
Background Information: This section briefly discusses the
legislative background as well as the current state-of-the-art and/or
current state-of-practice that supports the need for the particular
priority area activity. Relevant information on projects previously
funded by ACF and/or other State models are noted, where applicable.
Minimum Requirements for Project Design: This section
presents the basic set of issues that must be addressed in the
application. Typically, they relate to project design, evaluation, and
community involvement. This section also asks for specific information
on the proposed project. Inclusion and discussion of these items is
important since they will be used by the reviewers to evaluate the
applications against the evaluation criteria. Project products,
continuation of the project after Federal support ceases, and
dissemination/utilization activities, if appropriate, are also
addressed.
Project Duration: This section specifies the maximum
allowable length of the project period; it refers to the amount of time
for which Federal funding is available.
Federal Share of Project Costs: This section specifies the
maximum amount of Federal support for the project.
Matching Requirement: This section specifies the minimum
non-Federal contribution, either cash or in-kind match, required.
Anticipated Number of Projects To Be Funded: This section
specifies the number of projects ADD anticipates funding under the
priority area.
CFDA: This section identifies the Catalog of Federal
Domestic Assistance (CFDA) number and title of the program under which
applications in this priority area will be funded. This information is
needed to complete item 10 on the SF 424.
Please note that applications under this Announcement that do not
comply with the specific priority area requirements in the section on
``Eligible Applicants'' will not be reviewed.
Applicants under this Announcement must clearly identify the
specific priority area under which they wish to have their applications
considered, and tailor their applications accordingly. Experience has
shown that an application which is broader and more general in concept
than outlined in the priority area description is less likely to score
as well as an application more clearly focused on, and directly
responsive to, the concerns of that specific priority area.
E. Available Funds
ADD intends to award new grants resulting from this announcement
during the fourth quarter of fiscal year 1997, subject to the
availability of funding. The size of the awards will vary. Each
priority area description includes information on the maximum Federal
share of the project costs and the anticipated number of projects to be
funded.
The term ``budget period'' refers to the interval of time (usually
12 months) into which a multi-year period of assistance (project
period) is divided for budgetary and funding purposes. The term
``project period'' refers to the total time a project is approved for
support, including any extensions.
Where appropriate, applicants may propose shorter project periods
than the maximums specified in the various priority areas. Non-Federal
share contributions may exceed the minimums specified in the various
priority areas.
For multi-year projects, continued Federal funding beyond the first
budget period, but within the approved project period, is subject to
the availability of funds, satisfactory progress of the grantee and a
determination that
[[Page 42338]]
continued funding would be in the best interest of the Government.
F. Grantee Share of Project Costs
Grantees must provide at least 25% percent of the total approved
cost of the project. The total approved cost of the project is the sum
of the ACF share and the non-Federal share. The non-Federal share may
be met by cash or in-kind contributions, although applicants are
encouraged to meet their match requirements through cash contributions.
Therefore, a project requesting $100,000 in Federal funds (based on an
award of $100,000 per budget period) must include a match of at least
$33,333 (25% total project cost).
An exception to the grantee cost-sharing requirement relates to
applications originating from American Samoa, Guam, the Virgin Islands,
and the Commonwealth of the Northern Mariana Islands. Applications from
these areas are covered under Section 501(d) of Pub. L. 95-134, which
requires that the Department waive ``any requirement for local matching
funds for grants under $200,000.''
The applicant contribution must generally be secured from non-
Federal sources. Except as provided by Federal statute, a cost-sharing
or matching requirement may not be met by costs borne by another
Federal grant. However, funds from some Federal programs benefitting
Tribes and Native American organizations have been used to provide
valid sources of matching funds. If this is the case for a Tribe or
Native American organization submitting an application to ADD, that
organization should identify the programs which will be providing the
funds for the match in its application. If the application successfully
competes for PNS grant funds, ADD will determine whether there is
statutory authority for this use of the funds. The Administration for
Native Americans and the DHHS Office of General Counsel will assist ADD
in making this determination.
G. Cooperation in Evaluation Efforts
Grantees funded by ADD may be requested to cooperate in evaluation
efforts funded by ADD. The purpose of these evaluation activities is to
learn from the combined experience of multiple projects funded under a
particular priority area.
H. Closed Captioning for Audiovisual Efforts
Applicants are encouraged to include ``closed captioning'' in the
development of any audiovisual products.
Part IV. Fiscal Year 1997 Priority Areas for Projects of National
Significance--Description and Requirements
The following section presents the final priority areas for Fiscal
Year 1997 Projects of National Significance (PNS) and solicits the
appropriate applications.
Fiscal Year 1997 Priority Area 1: Technical Assistance and Knowledge
Transfer on Welfare Reform and Individuals with Developmental
Disabilities and their Families
Eligible Applicants: State agencies, public or private
nonprofit organizations, institutions or agencies, including a
consortia of some or all of the above
Purpose: Under this priority area, ADD will issue a
Financial Assistance Award through the instrument of a cooperative
agreement that will outline the terms of ADD's involvement as well as
the responsibilities of the recipient organization or agency in the
development of a national technical assistance and knowledge transfer
center on effective Welfare Reform for people with developmental
disabilities and their families.
Background Information: ADD finds its mission of promoting
the independence, productivity, inclusion, and integration of
individuals with developmental disabilities into their communities to
be strikingly similar in many ways to the goals of welfare reform.
When we view welfare reform as an effort not only to assist people
to leave welfare rolls and poverty, the empowerment of individuals and
families is very much like the outcomes ADD hopes to see from its
efforts at partnerships to achieve community-based and consumer-driven
programs and services.
Over a million children and adults with disabilities and their
families will be directly affected by the implementation of all aspects
of the Personal Responsibility and Work Opportunity Reconciliation Act
of 1996. Such individuals and families should have an equal opportunity
to realize the full promise of Welfare Reform, including the chance to
work their way out of poverty, while keeping their families healthy,
safe and intact.
Minimum Requirements for Project Design: Significant
research, best practices and lessons learned exist in regard to
assisting children and adults with the full range of developmental
disabilities to live, work and become contributing members of their
families, communities and nation. States, communities, businesses,
disability constituencies and others can benefit from technical
assistance aimed at assisting them to transfer, adapt and apply such
knowledge and practice to Welfare Reform activities.
Such technical assistance should seek to better equip these major
stakeholders with the skills, knowledge and expertise necessary to
apply what is already known to work for persons with developmental
disabilities and their families to the Welfare Reform context with
respect to:
(1) Assuring the basic civil rights of, and equal opportunity for,
individuals with developmental disabilities and their families on the
Temporary Assistance for Needy Families (TANF) Program;
(2) Making work pay for low-income parents with disabilities and
parents of children with developmental disabilities on TANF;
(3) Encouraging job/business creation by and for low-income
families and individuals with developmental disabilities;
(4) Increasing the access and responsiveness of Head Start and
Child Care Programs to families of children with developmental
disabilities and parents with disabilities;
(5) Supporting and strengthening poor families experiencing issues
surrounding the challenges of living with developmental disabilities;
(6) Promoting the safety, healthy development, permanency and well-
being of children with developmental disabilities and their families;
(7) Making welfare reform work for teen parents and other at-risk
young people with developmental disabilities;
(8) Making tribal welfare reform work for Native Americans with
developmental disabilities and their families;
(9) Making welfare reform work for ``Qualified Aliens'' (as defined
in 8 U.S.C. Sec. 1612) with developmental disabilities and their
families; and
(10) Enhancing child support enforcement.
The mission of a national technical assistance and knowledge
transfer center on effective Welfare Reform for people with
developmental disabilities and their families would be to work with
States, the disability community, businesses and others to enhance the
likelihood that adults and children with developmental disabilities as
well as their families on TANF would have an opportunity to benefit
from all aspects of Welfare Reform.
Specifically, the center would establish partnerships with a number
of states each year to develop plans for
[[Page 42339]]
targeted knowledge transfer strategies and work with all relevant
stakeholders to:
Track and report on trends and practices in welfare reform
affecting children and adults with developmental disabilities and their
families;
Convene working conferences to develop and share
strategies for responding to opportunities and risks in Welfare Reform
for such individuals and families;
Disseminate relevant research findings pertaining to: (i)
the effects of Welfare Reform on persons with developmental
disabilities and their families; and, (ii) relationships between
disability, poverty, gender, ethnicity and dependency on Aid For
Dependent Children (AFDC) and Temporary Aid to Needy Families (TANF);
Function as a clearinghouse on all relevant information,
emerging knowledge, policy, best practices and research;
Broker technical assistance, especially peer-to-peer
consultations, designed to assist such stakeholders to work together to
apply to Welfare Reform research and best practices regarding what
works for persons with developmental disabilities and their families;
Assist researchers conducting evaluations of Welfare
Reform to assure that such studies are designed and carried out with
sensitivity to a wide range of disability policy concerns;
Track, synthesize, disseminate, facilitate the adaptation
and/or replication of best or promising approaches, as well as lessons
learned, especially those supported by investments of ADD in DD
Councils, Protection and Advocacy Systems, University Affiliated
Programs, Projects of National Significance and other Federal or State
agencies or foundations;
Expand leadership development opportunities among
individuals and families experiencing developmental disabilities in
economically disadvantaged communities; and,
Sponsor forums, on-line conferences and other ongoing
exchanges to facilitate a greater understanding of the impacts of
Welfare Reform on individuals with developmental disabilities and their
families on the part of States, the disability community, foundations,
researchers and others.
There are a number of agencies engaged in projects or the design of
projects involving research into welfare reform. ADD award recipients
will be expected to track these electronically and consolidate
information on findings and contact persons. In particular, awardees
will coordinate with two projects of the Administration for Children
and Families: Welfare Reform Studies and Analyses, funded by the Office
of Planning, Research, and Evaluation; and the Child Care Inclusion
Technical Assistance Project for Children with Disabilities, funded by
the Child Care Bureau.
In addition, ADD will be funding two other national center
priorities in the areas of self-determination and responsible
leadership by and for individuals with developmental disabilities and
families of children with developmental disabilities and of analysis of
major trends and outcomes data regarding individuals with developmental
disabilities and their families. To avoid redundancy in inevitable
areas of overlap as we focus on capacity building and to facilitate
consistency, it is expected that all awardees will meet with ADD to
share their approaches and methodology. ADD will be actively involved
in the design of the project, with details of the relationship with the
awardee and any subcontractors to be set forth in the cooperative
agreement. Proposals should include provisions for travel by key
personnel for this purpose.
As a general guide, ADD will expect to fund only those applications
for projects that incorporate the following elements:
Consumer/self-advocate orientation and participation;
Key project personnel with direct life, parental, or
familial experience with living with a disability;
Strong advisory components that consist of a majority of
individuals with disabilities and a structure where individuals with
disabilities make real decisions that determine the outcome of the
project;
Research reflecting the principles of participatory
action;
Cultural competency;
A description of how individuals with disabilities and
their families will be involved in all aspects of the design,
implementation, and evaluation of the project;
Attention to unserved and inadequately served individuals,
having a range of disabilities from mild to severe, from diverse
backgrounds, rural and inner-city areas, and migrant, homeless, and
legal immigrant and refugee families;
Attention to individuals with learning disabilities, which
in many instances may meet the definition of developmental
disabilities;
Attention to issues of mental health, which may require
work flexibility;
Compliance with the Americans with Disabilities Act and
section 504 of the Rehabilitation Act of 1973 as amended (29 U.S.C.
794);
Collaboration through partnerships and coalitions;
Development of the capacity to communicate and disseminate
information through electronic and other effective, affordable, and
accessible formats;
A community-based approach;
Identification of barriers and strategies for overcoming
barriers;
An outcome orientation;
Measurement and ongoing evaluation, including the
participation of individuals with disabilities in formulation and
implementation;
Development and establishment of practices and programs
beyond the project period.
Applications should also include provisions for the travel of two
key personnel during the first and last year of the project to
Washington, DC for a one day meeting with ADD staff.
As noted earlier, the award will be made as a cooperative
agreement. While an organization receiving an award will not be
conducting its project on behalf of ADD, ADD and the awardee will work
cooperatively in the development and implementation of the project's
agenda as described below.
Under the cooperative agreement mechanism, ADD and the awardee will
share the responsibility for planning the objectives of the project.
The awardee will have the primary responsibility for developing and
implementing the activities of the project. ADD will jointly
participate with the awardee in such activities as clarifying the
specific issue areas to be addressed through periodic briefings and
ongoing consultation, sharing with awardee its knowledge of the issues
being addressed by past and current projects, and providing feedback to
awardee about the usefulness to the field of written products and
information sharing activities. The details of the relationship between
ADD and awardee will be set forth in the cooperative agreement to be
developed and signed prior to issuance of the award.
Project Duration: This announcement is requesting
applications for project periods up to three years under this priority
area. Awards, on a competitive basis, will be for a one-year budget
period, although project periods may be for three years. Applications
for continuation grants funded under this priority area beyond the one-
year budget period, but within the three-year project period, will be
entertained in subsequent years on a
[[Page 42340]]
non-competitive basis, subject to the availability of funds,
satisfactory progress of the grantee, and determination that continued
funding would be in the best interest of the Government.
Federal Share of Project Costs: The Federal share is a
range of $300,000-$400,000 for the first 12-month budget period or a
minimum of $900,000 for a three-year project period. There is a
possibility of increased funding in year two and three contingent on
additional funds.
Matching Requirement: Grantees must provide at least 25
percent of the total approved cost of the project. The total approved
cost of the project is the sum of the ACF share and the non-Federal
share. The non-Federal share may be met by cash or in-kind
contributions, although applicants are encouraged to meet their match
requirements through cash contributions. Therefore, a project
requesting $300,000 in Federal funds (based on an award of $300,000 per
budget period) must include a match of at least $100,000 (25% total
project cost).
Anticipated Number of Projects to be Funded: It is
anticipated that one (1) project will be funded. Subject to
availability of additional resources in FY 1998 and the number of
acceptable applications received as a result of this program
announcement, the ADD Commissioner may elect to select recipients for
the FY 1998 cohort of programs out of the pool of applications
submitted for FY 1997 funds.
CFDA: ADD's CFDA (Code of Federal Domestic Assistance)
number is 93.631--Developmental Disabilities--Projects of National
Significance. This information is needed to complete item 10 on the SF
424.
Fiscal Year 1997 Priority Area 2: Technical Assistance and Knowledge
Transfer on Self-Determination and Responsible Leadership by and for
Individuals with Developmental Disabilities and Families of Children
with Developmental Disabilities
Eligible Applicants: State agencies, public or private
nonprofit organizations, institutions or agencies, including a
consortia of some or all of the above.
Purpose: Under this priority area, ADD will award a grant
through a cooperative agreement to establish a national technical
assistance and knowledge transfer center on self-determination and 21st
Century leadership development. The mission of such a center would be
to work with all relevant stakeholders to expand and sustain
responsible leadership by and for people with developmental
disabilities and families of children with developmental disabilities
in shaping and guiding the implementation of policies, practices and
approaches which enhance their own self-determination and self-
efficacy.
Background Information: All Americans, including people
with developmental and other disabilities, should experience
opportunities and a sense of community and responsibility in their
lives. One of the central tasks facing us is to devise ways we as
individuals, families, communities and a nation can actively promote
the responsibility people with disabilities have for their own and our
collective lives and futures. Federal legislation such as the
Developmental Disabilities Act, the Individuals with Disabilities
Education Act and the Americans with Disabilities Act are all grounded
in the fundamental principle that persons with disabilities and their
families have a critical need to be, and as a matter of right ought to
be, primary decision-makers in decisions affecting their lives and
futures.
The majority of the progress we have made as a society in this
regard in the past quarter century has shown us that responsible
leadership for and by people with developmental and other disabilities
and their families is a prerequisite to increasing independence,
productivity, integration and inclusion of such individuals and their
families. ADD and individual DD Councils, Protection and Advocacy
Systems and University Affiliated Programs have found that developing,
nurturing and sustaining strategic, creative and responsible leadership
on the part of individuals with developmental and other disabilities
and their families have been among the most high-yielding long-term
investments made.
Through Projects of National Significance, ADD has assisted its
grantees to develop and replicate a variety of innovative, successful
approaches to develop leadership and self-determination among people
with developmental disabilities and their families. Most notably, this
has taken the form of early and formative support of such endeavors as
Partners in Policy, the active participation of families of children
with developmental disabilities in designing and implementing of State
family support policies and programs, the Home of Your Own initiative,
personal assistance system change projects, and targeted leadership
efforts among people of color with developmental disabilities.
Now more than ever, the States, the disability community and others
require support and assistance in strategically working through the
cumulative effects of such issues as Welfare Reform, SSI changes,
managed care and Medicaid restructuring might have on adults and
children with developmental disabilities as well as their families.
Responsible leadership by people with developmental and other
disabilities and their families, is value driven and recognizes the new
and emerging realities facing State and local governments today. Such
leadership is critical to finding responsible and cost effective ways
to strengthen the abilities and opportunities of individuals with
developmental disabilities and families of children with developmental
disabilities to exercise choice and self-determination throughout their
daily lives. This is true in respect to most people with developmental
disabilities and families of children with developmental disabilities,
but is particularly the case in regard to those living in poverty.
ADD is particularly interested in applications from organizations
or coalitions that have a strong self-advocacy/consumer base. Such
applicants should demonstrate significant involvement by people with
developmental disabilities in the governance, management, and operation
of the center; that is, not just as advisors but in management and
other key staff positions as well as any subgrantees that may have a
critical role in the project.
Minimum Requirements for Project Design: ADD will support
a project that seeks to strengthen and expand leadership for the 21st
Century by and for people with developmental disabilities and families
of children with developmental disabilities through:
Building, expanding and strengthening what works in this
regard.
Brokering technical assistance, especially peer-to-peer
consultations, designed to assist such stakeholders to work together to
apply research and best practices to enhance the self-determination and
self-efficacy of persons with developmental disabilities and families
of children with developmental disabilities (especially in States and
communities and tribal governments that have not taken part in similar
initiatives relating to Partners in Policy, family support, home
ownership, personal assistance, self-determination, etc.)
Expanding self-determination opportunities and roles for
young
[[Page 42341]]
people with and without developmental disabilities (ages 12-25) as well
as individuals with significant developmental disabilities and families
of children with developmental disabilities from economically
disadvantaged communities.
Convening working conferences to develop and share
strategies for enhancing self-determination in the context of the
changing roles of the State and Federal Governments, governmental
reinvention activities, a heightened focus on achieving results and
cost effectiveness in such areas as welfare reform, changes in SSI,
managed care and proposals for Medicaid restructuring.
Assisting in and disseminating relevant research findings
pertaining to the prospects for enhancing self-determination and
supporting the development of national and State policy in the changing
Federal and State context described above.
Functioning as a clearinghouse on all relevant
information, emerging knowledge, policy, best practices and research.
Tracking, synthesizing, disseminating, facilitating the
adaptation and/or replication of best or promising approaches, and
lessons learned, especially those supported by investments of ADD in DD
Councils, Protection and Advocacy Systems, University Affiliated
Programs, Projects of National Significance and other Federal or State
agencies or foundations.
Sponsoring forums, on-line conferences and other ongoing
exchanges to facilitate a greater understanding of the impacts of
welfare reform, managed care, and other critical issues on individuals
with developmental disabilities and their families on the part of
States, tribal governments, the disability community, foundations,
researchers and others.
As a general guide, ADD will expect to fund only those applications
for projects that incorporate the following elements:
Consumer/self-advocate orientation and participation.
Key project personnel with direct life, parental, or
familial experience with living with a disability.
Strong advisory components that consist of a majority of
individuals with disabilities and a structure where individuals with
disabilities make real decisions that determine the outcome of the
grant.
Research reflecting the principles of participatory
action.
Cultural competency.
A description of how individuals with disabilities and
their families will be involved in all aspects of the design,
implementation, and evaluation of the project.
Attention to unserved and inadequately served individuals,
having a range of disabilities from mild to severe, from diverse
backgrounds, rural and inner-city areas, migrant, homeless, and refugee
families, with severe disabilities.
Compliance with the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act of 1973 as amended (29 U.S.C.
794);
Collaboration through partnerships and coalitions.
Development of the capacity to communicate and disseminate
information and technical assistance through e-mail and other
effective, affordable, and accessible forms of electronic
communication.
A community-based approach.
Responsiveness through systems change.
Identification of barriers and strategies for overcoming
barriers.
Outcome orientation.
Measurement and ongoing evaluation, including the
participation of individuals with disabilities in formulation and
implementation.
Development and establishment of practices and programs
beyond project period.
Dissemination of models, products, best practices, and
strategies for distribution between the networks and beyond. A plan
describing initial activities is needed between funded projects as well
as at the end of the project period. These activities should maintain
and share ongoing information, existing resources of consultants/
experts, and curriculum/materials with funded projects and within the
network.
Applications should also include provisions for the travel of two
key personnel during the first and last year of the project to
Washington, DC for a one day meeting with ADD staff.
As noted earlier, the award will be made as a cooperative
agreement. While an organization receiving an award will not be
conducting its project on behalf of ADD, ADD and the awardee will work
cooperatively in the development and implementation of the project's
agenda as described below.
Under the cooperative agreement mechanism, ADD and the awardee will
share the responsibility for planning the objectives of the project.
The awardee will have the primary responsibility for developing and
implementing the activities of the project. ADD will jointly
participate with the awardee in such activities as clarifying the
specific issue areas to be addressed through periodic briefings and
ongoing consultation, sharing with awardee its knowledge of the issues
being addressed by past and current projects, and providing feedback to
awardee about the usefulness to the field of written products and
information sharing activities. The details of the relationship between
ADD and awardee will be set forth in the cooperative agreement to be
developed and signed prior to issuance of the award.
Project Duration: This announcement is requesting
applications for project periods up to three years under this priority
area. Awards, on a competitive basis, will be for a one-year budget
period, although project periods may be for three years. Applications
for continuation grants funded under this priority area beyond the one-
year budget period, but within the three-year project period, will be
entertained in subsequent years on a non-competitive basis, subject to
the availability of funds, satisfactory progress of the grantee, and
determination that continued funding would be in the best interest of
the Government.
Federal Share of Project Costs: The Federal share is a
range of $300,000-$400,000 for the first 12-month budget period or a
minimum of $900,000 for a three-year project period. There is a
possibility of increased funding in year two and three contingent on
additional funds.
Matching Requirement: Grantees must provide at least 25
percent of the total approved cost of the project. The total approved
cost of the project is the sum of the ACF share and the non-Federal
share. The non-Federal share may be met by cash or in-kind
contributions, although applicants are encouraged to meet their match
requirements through cash contributions. Therefore, a project
requesting $300,000 in Federal funds (based on an award of $300,000 per
budget period) must include a match of at least $100,000 (25% total
project cost).
Anticipated Number of Projects to be Funded: It is
anticipated that one (1) project will be funded. Subject to
availability of additional resources in FY 1998 and the number of
acceptable applications received as a result of this program
announcement, the ADD Commissioner may elect to select recipients for
the FY 1998 cohort of programs out of the pool of applications
submitted for FY 1997 funds.
CFDA: ADD's CFDA (Code of Federal Domestic Assistance)
number is 93.631--Developmental Disabilities--
[[Page 42342]]
Projects of National Significance. This information is needed to
complete item 10 on the SF 424.
Fiscal Year 1997 Priority Area 3: The National Center for the Analysis
of Major Trends and Outcomes Data Regarding Individuals with
Developmental Disabilities and Their Families
Eligible Applicants: State agencies, public or private
nonprofit organizations, institutions or agencies, including a
consortia of some or all of the above.
Purpose: ADD is interested in awarding a grant through a
cooperative agreement that would accurately measure, track and report
on the extent to which our society is progressing toward the goals of
strengthening the capabilities and expanding the opportunities of
individuals with developmental disabilities and families of children
with developmental disabilities to exercise choice and self-
determination throughout their daily lives. This is crucial to
assessing both the overall effectiveness of the ADD programs and that
of the Nation as a whole in carrying on this endeavor.
Background Information: ADD has supported a number of
initiatives particularly through PNS, and ongoing projects designed to
strengthen, expand and sustain our collective understanding of the
changing status of Americans with developmental disabilities. Most
notably was the state consumer surveys conducted in preparation for the
1990 Report. This support has also taken the form of both the formative
and ongoing support for such endeavors as:
ADD's three national data collection and dissemination
projects;
The development of the ADD Management Information System;
The Data Trends Conference cosponsored with the National
Institute on Disability and Rehabilitation Research;
The AAUAP data collection project; and
The disability supplement to the National Health Interview
Survey.
Minimum Requirements for Project Design: To build on these
and other efforts and to further foster the pursuit of excellence
through its leadership and that of its programs, ADD proposes to fund a
National Center for the Analysis of Major Trends and Outcomes Data
Regarding Individuals with Developmental Disabilities and Their
Families. The mission of such a center would be to work with all
relevant stakeholders around a number of tasks that could include the
following:
(1) Build and expand upon current and past efforts undertaken by
ADD and others in this area;
(2) Identify, synthesize, and report on major data sources on major
trends affecting the lives, well being and futures of all Americans,
including those with developmental and other disabilities as well as
their families;
(3) Identify, synthesize, and report on major data sources on major
trends specific to the lives, well being and futures of individuals
with developmental disabilities and their prospects for their increased
independence, productivity, integration and inclusion as well as
greater choice and self determination throughout their everyday lives;
(4) Develop, continually improve, and work with ADD, its programs
and all other relevant Federal, State and private entities to infuse
outcome measures and other indicators which accurately reflect the
status of persons with developmental disabilities and the families of
children with developmental disabilities into major surveys and
studies;
(5) Develop in close consultation and collaboration with
individuals with developmental disabilities and families of children
with developmental disabilities a prototypical survey instrument to
assess the extent to which such individuals and families believe they
have opportunities to exercise meaningful choice and self determination
as well as to carry out personal responsibilities in life, and which:
(a) Is compatible with the state consumer survey used in preparation
for the 1990 Report, (b) can be reliably and cost effectively
administered to a representative national sample, (c) can be easily
adapted and used for a variety of related purposes, and (d) accurately
assesses the status of individuals with developmental disabilities and
families of children with developmental disabilities who are members of
racial, cultural or ethnic minority groups;
(6) Develop a prototypical public opinion survey instrument which
can be reliably and cost effectively administered to a representative
national sample of the general public at least once every five years to
assess the extent to which the public (a) perceives individuals with
developmental disabilities and families with children with
developmental disabilities as having opportunities to exercise choice
and self determination as well as to carry out personal
responsibilities; and (b) values the exercise of self determination and
personal responsibilities both in their own lives and in the lives of
persons with developmental disabilities and their families;
(7) Develop, in close consultation and collaboration with ADD, its
programs and all other relevant Federal, State and private entities,
cost effective and readily implementable strategies for, and providing
technical assistance in, carrying out activities related to the survey
instruments described above;
(8) Produce, in close consultation and collaboration with ADD, its
programs and all other relevant Federal, State and private entities, a
State of Americans with developmental disabilities and their families
report which then could be replicated at least once every five years;
(9) Function as a clearinghouse on all relevant information,
emerging knowledge, and research concerning the status of individuals
with developmental disabilities and the families of children with
developmental disabilities in American society; and,
(10) Sponsor forums, on line conferences and other on-going
exchanges relative to activities or strategies for continually
improving efforts to accurately measure, track and report on the extent
to which our society is making progress toward achieving its goals of
increasing the self determination, personal responsibility,
independence, productivity, integration and inclusion of Americans with
developmental disabilities in everyday life.
As a general guide, ADD will expect to fund only those applications
for projects that incorporate the following elements:
Consumer/self-advocate orientation and participation.
Key project personnel with direct life, parental, or
familial experience with living with a disability.
Strong advisory components that consist of a majority of
individuals with disabilities and a structure where individuals with
disabilities make real decisions that determine the outcome of the
grant.
Research reflecting the principles of participatory
action.
Cultural competency.
A description of how individuals with disabilities and
their families will be involved in all aspects of the design,
implementation, and evaluation of the project.
Attention to unserved and inadequately served individuals,
having a range of disabilities from mild to severe, from diverse
backgrounds, rural and inner-city areas, migrant, homeless, and refugee
families, with severe disabilities.
[[Page 42343]]
Compliance with the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act of 1973 as amended (29 U.S.C.
794);
Collaboration through partnerships and coalitions.
Development of the capacity to communicate and disseminate
information and technical assistance through e-mail and other
effective, affordable, and accessible forms of electronic
communication.
Details of the relationship between ADD and awardee will be set
forth in the cooperative agreement to be developed and signed prior to
issuance of the award.
Project Duration: This announcement is requesting
applications for project periods up to three years under this priority
area. Awards, on a competitive basis, will be for a one-year budget
period, although project periods may be for three years. Applications
for continuation grants funded under this priority area beyond the one-
year budget period, but within the three-year project period, will be
entertained in subsequent years on a non-competitive basis, subject to
the availability of funds, satisfactory progress of the grantee, and
determination that continued funding would be in the best interest of
the Government.
Federal Share of Project Costs: The Federal share is a
range of $300,000-$400,000 for the first 12-month budget period or a
minimum of $900,000 for a three-year project period. There is a
possibility of increased funding in year two and three contingent on
additional funds.
Matching Requirement: Grantees must provide at least 25
percent of the total approved cost of the project. The total approved
cost of the project is the sum of the ACF share and the non-Federal
share. The non-Federal share may be met by cash or in-kind
contributions, although applicants are encouraged to meet their match
requirements through cash contributions. Therefore, a project
requesting $300,000 in Federal funds (based on an award of $300,000 per
budget period) must include a match of at least $100,000 (25% total
project cost).
Anticipated Number of Projects To Be Funded: It is
anticipated that one (1) project will be funded. Subject to
availability of additional resources in FY 1998 and the number of
acceptable applications received as a result of this program
announcement, the ADD Commissioner may elect to select recipients for
the FY 1998 cohort of programs out of the pool of applications
submitted for FY 1997 funds.
CFDA: ADD's CFDA (Code of Federal Domestic Assistance)
number is 93.631--Developmental Disabilities--Projects of National
Significance. This information is needed to complete item 10 on the SF
424.
Part V. Instructions for the Development and Submission of Applications
This part contains information and instructions for submitting
applications in response to this announcement. Application forms are
provided along with a checklist for assembling an application package.
Please copy and use these forms in submitting an application.
Potential applicants should read this section carefully in
conjunction with the information contained within the specific priority
area under which the application is to be submitted. The priority area
descriptions are in part IV.
A. Required Notification of the State Single Point of Contact
This program is covered under Executive Order (E.O.) 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR Part 100,
``Intergovernmental Review of Department of Health and Human Services
Program and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs. Note: State/Territory participation in the
Intergovernmental Review Process does not signify applicant eligibility
for financial assistance under a program. A potential applicant must
meet the eligibility requirements of the program for which it is
applying prior to submitting an application to its SPOC, if applicable,
or to ACF.
As of June 1997, the following jurisdictions have elected not to
participate in the Executive Order process. Applicants from these
jurisdictions or for projects administered by Federally-recognized
Indian Tribes need take no action in regard to E.O. 12372:
Alabama
Alaska
Colorado
Connecticut
Hawaii
Idaho
Kansas
Louisiana
Massachusetts
Minnesota
Montana
Nebraska
New Jersey
Oklahoma
Oregon
Pennsylvania
South Dakota
Tennessee
Vermont
Virginia
Washington
American Samoa
Palau
All remaining jurisdictions participate in the Executive Order
process and have established Single Point of Contact (SPOCs).
Applicants from participating jurisdictions should contact their SPOCs
as soon as possible to alert them of the prospective applications and
receive instructions. Applicants must submit any required material to
the SPOCs as soon as possible so that the program office can obtain and
review SPOC comments as part of the award process. The applicant must
submit all required materials, if any, to the SPOC and indicate the
date of this submittal (or the date of contact if no submittal is
required) on the Standard Form 424, item 16a.
SPOCs are encouraged to eliminate the submission of routine
endorsements as official recommendations.
Additionally, SPOCs are requested to clearly differentiate between
mere advisory comments and those official State process recommendations
which may trigger the ``accommodate or explain'' rule.
When comments are submitted directly to ADD, they should be
addressed to: Department of Health and Human Services, ACF/
Administration on Developmental Disabilities, Third Floor, 200
Independence Avenue SW, Washington, DC 20201, Attn: 93.631 ADD--
Projects of National Significance.
A list of the Single Points of Contact for each State and Territory
is included at the end of this Part.
B. Notification of State Developmental Disabilities Planning Councils
A copy of the application must also be submitted for review and
comment to the State Developmental Disabilities Council in each State
in which the applicant's project will be conducted. A list of the State
Developmental Disabilities Councils is included at the end of this
announcement.
C. Instructions for Preparing the Application and Completing
Application Forms
The SF 424, SF 424A, SF 424A, Page 2 and Certifications have been
reprinted for your convenience in preparing the application. You should
reproduce single-sided copies of these forms from
[[Page 42344]]
the reprinted forms in the announcement, typing your information onto
the copies. Please do not use forms directly from the Federal Register
announcement, as they are printed on both sides of the page.
Please prepare your application in accordance with the following
instructions:
1. SF 424 Page 1, Application Cover Sheet
Please read the following instructions before completing the
application cover sheet. An explanation of each item is included.
Complete only the items specified.
Top of Page. Enter the single priority area number under which the
application is being submitted under the Announcement. An application
under this Announcement should be submitted under only one priority
area.
Item 1. ``Type of Submission''--Preprinted on the form.
Item 2. ``Date Submitted'' and ``Applicant Identifier'' --Date
application is submitted to ACF and applicant's own internal control
number, if applicable.
Item 3. ``Date Received By State''--State use only (if applicable).
Item 4. ``Date Received by Federal Agency''--Leave blank.
Item 5. ``Applicant Information''.
``Legal Name''--Enter the legal name of applicant organization. For
applications developed jointly, enter the name of the lead organization
only. There must be a single applicant for each application.
``Organizational Unit''--Enter the name of the primary unit within
the applicant organization which will actually carry out the project
activity. Do not use the name of an individual as the applicant. If
this is the same as the applicant organization, leave the
organizational unit blank.
``Address''--Enter the complete address that the organization
actually uses to receive mail, since this is the address to which all
correspondence will be sent. Do not include both street address and
P.O. box number unless both must be used in mailing.
``Name and telephone number of the person to be contacted on
matters involving this application (give area code)''--Enter the full
name (including academic degree, if applicable) and telephone number of
a person who can respond to questions about the application. This
person should be accessible at the address given here and will receive
all correspondence regarding the application.
Item 6. ``Employer Identification Number (EIN)''--Enter the
employer identification number of the applicant organization, as
assigned by the Internal Revenue Service, including, if known, the
Central Registry System suffix.
Item 7. ``Type of Applicant''--Self-explanatory.
Item 8. ``Type of Application''--Preprinted on the form.
Item 9. ``Name of Federal Agency''--Preprinted on the form.
Item 10. ``Catalog of Federal Domestic Assistance Number and
Title''--Enter the Catalog of Federal Domestic Assistance (CFDA) number
assigned to the program under which assistance is requested and its
title. For all applications for PNS funding, the following should be
entered, ``93.631--Developmental Disabilities: Projects of National
Significance.''
Item 11. ``Descriptive Title of Applicant's Project''--Enter the
project title. The title is generally short and is descriptive of the
project, not the priority area title.
Item 12. ``Areas Affected by Project''--Enter the governmental unit
where significant and meaningful impact could be observed. List only
the largest unit or units affected, such as State, county, or city. If
an entire unit is affected, list it rather than subunits.
Item 13. ``Proposed Project''--Enter the desired start date for the
project and projected completion date.
Item 14. ``Congressional District of Applicant/Project''--Enter the
number of the Congressional district where the applicant's principal
office is located and the number of the Congressional district(s) where
the project will be located. If Statewide, a multi-State effort, or
nationwide, enter ``00.''
Items 15. Estimated Funding Levels
In completing 15a through 15f, the dollar amounts entered should
reflect, for a 17-month or less project period, the total amount
requested. If the proposed project period exceeds 17 months, enter only
those dollar amounts needed for the first 12 months of the proposed
project.
Item 15a. Enter the amount of Federal funds requested in accordance
with the preceding paragraph. This amount should be no greater than the
maximum amount specified in the priority area description.
Items 15b-e. Enter the amount(s) of funds from non-Federal sources
that will be contributed to the proposed project. Items b-e are
considered cost-sharing or ``matching funds.'' The value of third party
in-kind contributions should be included on appropriate lines as
applicable. For more information regarding funding as well as
exceptions to these rules, see Part III, Sections E and F, and the
specific priority area description.
Item 15f. Enter the estimated amount of program income, if any,
expected to be generated from the proposed project. Do not add or
subtract this amount from the total project amount entered under item
15g. Describe the nature, source and anticipated use of this program
income in the Project Narrative Statement.
Item 15g. Enter the sum of items 15a-15e.
Item 16a. ``Is Application Subject to Review By State Executive
Order 12372 Process? Yes.''--Enter the date the applicant contacted the
SPOC regarding this application. Select the appropriate SPOC from the
listing provided at the end of Part IV. The review of the application
is at the discretion of the SPOC. The SPOC will verify the date noted
on the application.
Item 16b. ``Is Application Subject to Review By State Executive
Order 12372 Process? No.''--Check the appropriate box if the
application is not covered by E.O. 12372 or if the program has not been
selected by the State for review.
Item 17. ``Is the Applicant Delinquent on any Federal Debt?''--
Check the appropriate box. This question applies to the applicant
organization, not the person who signs as the authorized
representative. Categories of debt include audit disallowances, loans
and taxes.
Item 18. ``To the best of my knowledge and belief, all data in this
application/preapplication are true and correct. The document has been
duly authorized by the governing body of the applicant and the
applicant will comply with the attached assurances if the assistance is
awarded.''--To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for signature
of this application by this individual as the official representative
must be on file in the applicant's office, and may be requested from
the applicant.
Item 18a-c. ``Typed Name of Authorized Representative, Title,
Telephone Number''--Enter the name, title and telephone number of the
authorized representative of the applicant organization.
Item 18d. ``Signature of Authorized Representative'' --Signature of
the authorized representative named in Item 18a. At least one copy of
the application must have an original signature. Use colored ink (not
black) so that the original signature is easily identified.
Item 18e. ``Date Signed''--Enter the date the application was
signed by the authorized representative.
[[Page 42345]]
2. SF 424A--Budget Information--Non-Construction Programs
This is a form used by many Federal agencies. For this application,
Sections A, B, C, E and F are to be completed. Section D does not need
to be completed.
Sections A and B should include the Federal as well as the non-
Federal funding for the proposed project covering (1) the total project
period of 17 months or less or (2) the first year budget period, if the
proposed project period exceeds 15 months.
Section A--Budget Summary. This section includes a summary of the
budget. On line 5, enter total Federal costs in column (e) and total
non-Federal costs, including third party in-kind contributions, but not
program income, in column (f). Enter the total of (e) and (f) in column
(g).
Section B--Budget Categories. This budget, which includes the
Federal as well as non-Federal funding for the proposed project, covers
(1) the total project period of 17 months or less or (2) the first-year
budget period if the proposed project period exceeds 17 months. It
should relate to item 15g, total funding, on the SF 424. Under column
(5), enter the total requirements for funds (Federal and non-Federal)
by object class category.
A separate budget justification should be included to explain fully
and justify major items, as indicated below. The types of information
to be included in the justification are indicated under each category.
For multiple year projects, it is desirable to provide this information
for each year of the project. The budget justification should
immediately follow the second page of the SF 424A.
Personnel--Line 6a. Enter the total costs of salaries and wages of
applicant/grantee staff. Do not include the costs of consultants, which
should be included on line 6h, ``Other.''
Justification: Identify the principal investigator or project
director, if known. Specify by title or name the percentage of time
allocated to the project, the individual annual salaries, and the cost
to the project (both Federal and non-Federal) of the organization's
staff who will be working on the project.
Fringe Benefits--Line 6b. Enter the total costs of fringe benefits,
unless treated as part of an approved indirect cost rate.
Justification: Provide a break-down of amounts and percentages that
comprise fringe benefit costs, such as health insurance, FICA,
retirement insurance, etc.
Travel--6c. Enter total costs of out-of-town travel (travel
requiring per diem) for staff of the project. Do not enter costs for
consultant's travel or local transportation, which should be included
on Line 6h, ``Other.''
Justification: Include the name(s) of traveler(s), total number of
trips, destinations, length of stay, transportation costs and
subsistence allowances.
Equipment--Line 6d. Enter the total costs of all equipment to be
acquired by the project. For State and local governments, non-profit
organizations, including Federally recognized Indian Tribes,
``equipment'' is tangible personal property having a useful life of
more than one year and acquisition cost of $5,000 or more per unit.
Grantees may use their own definitions if it does not exceed these
limits. (45 CFR 74.2 and 92.3)
Justification: Equipment to be purchased with Federal funds must be
justified. The equipment must be required to conduct the project, and
the applicant organization or its subgrantees must not have the
equipment or a reasonable facsimile available to the project. The
justification also must contain plans for future use or disposal of the
equipment after the project ends.
Supplies--Line 6e. Enter the total costs of all tangible expendable
personal property (supplies) other than those included on Line 6d.
Justification: Specify general categories of supplies and their
costs.
Contractual--Line 6f. Enter the total costs of all contracts,
including (1) procurement contracts (except those which belong on other
lines such as equipment, supplies, etc.) and (2) contracts with
secondary recipient organizations, including delegate agencies. Also
include any contracts with organizations for the provision of technical
assistance. Do not include payments to individuals on this line. If the
name of the contractor, scope of work, and estimated total costs are
not available or have not been negotiated, include on Line 6h,
``Other.''
Justification: Attach a list of contractors, indicating the names
of the organizations, the purposes of the contracts, and the estimated
dollar amounts of the awards as part of the budget justification.
Whenever the applicant/grantee intends to delegate part or all of the
program to another agency, the applicant/grantee must complete this
section (Section B, Budget Categories) for each delegate agency by
agency title, along with the supporting information. The total cost of
all such agencies will be part of the amount shown on Line 6f. Provide
backup documentation identifying the name of contractor, purpose of
contract, and major cost elements.
Construction--Line 6g. Not applicable. New construction is not
allowable.
Other--Line 6h. Enter the total of all other costs. Where
applicable, such costs may include, but are not limited to: insurance;
medical and dental costs; noncontractual fees and travel paid directly
to individual consultants; local transportation (all travel which does
not require per diem is considered local travel); space and equipment
rentals; printing and publication; computer use; training costs,
including tuition and stipends; training service costs, including wage
payments to individuals and supportive service payments; and staff
development costs. Note that costs identified as ``miscellaneous'' and
``honoraria'' are not allowable.
Justification: Specify the costs included.
Total Direct Charges--Line 6i. Enter the total of Lines 6a through
6h.
Indirect Charges--6j. Enter the total amount of indirect charges
(costs). If no indirect costs are requested, enter ``none.'' Generally,
this line should be used when the applicant (except local governments)
has a current indirect cost rate agreement approved by the Department
of Health and Human Services or another Federal agency.
Local and State governments should enter the amount of indirect
costs determined in accordance with HHS requirements. When an indirect
cost rate is requested, these costs are included in the indirect cost
pool and should not be charged again as direct costs to the grant.
In the case of training grants to other than State or local
governments (as defined in title 45, Code of Federal Regulations, part
74), the Federal reimbursement of indirect costs will be limited to the
lesser of the negotiated (or actual) indirect cost rate or 8 percent of
the amount allowed for direct costs, exclusive of any equipment
charges, rental of space, tuition and fees, post-doctoral training
allowances, contractual items, and alterations and renovations.
For training grant applications, the entry under line 6j should be
the total indirect costs being charged to the project. The Federal
share of indirect costs is calculated as shown above. The applicant's
share is calculated as follows:
(a) Calculate total project indirect costs (a*) by applying the
applicant's approved indirect cost rate to the total project (Federal
and non-Federal) direct costs.
[[Page 42346]]
(b) Calculate the Federal share of indirect costs (b*) at 8 percent
of the amount allowed for total project (Federal and non-Federal)
direct costs exclusive of any equipment charges, rental of space,
tuition and fees, post-doctoral training allowances, contractual items,
and alterations and renovations.
(c) Subtract (b*) from (a*). The remainder is what the applicant
can claim as part of its matching cost contribution.
Justification: Enclose a copy of the indirect cost rate agreement.
Applicants subject to the limitation on the Federal reimbursement of
indirect costs for training grants should specify this.
Total--Line 6k. Enter the total amounts of lines 6i and 6j.
Program Income--Line 7. Enter the estimated amount of income, if
any, expected to be generated from this project. Do not add or subtract
this amount from the total project amount. Please cite the page numbers
where program income is discussed.
Justification: Describe the nature, source, and anticipated use of
program income in the Program Narrative Statement.
Section C--Non-Federal Resources. This section summarizes the
amounts of non-Federal resources that will be applied to the grant.
Enter this information on line 12 entitled ``Totals.'' Third Party In-
kind contributions are defined in title 45 of the Code of Federal
Regulations, Parts 74.2 and 92.3, as ``the value of non-cash
contributions provided by non-Federal third parties. Third party in-
kind contributions may be in the form of real property, equipment,
supplies and other expendable property, and the value of goods and
services directly benefiting and specifically identifiable to the
project or program.''
Justification: Describe third party in-kind contributions, if
included.
Section D--Forecasted Cash Needs. Not applicable.
Section E--Budget Estimate of Federal Funds Needed For Balance of
the Project. This section should only be completed if the total project
period exceeds 17 months.
Totals--Line 20. For projects that will have more than one budget
period, enter the estimated required Federal funds for the second
budget period (months 13 through 24) under column ``(b) First.'' If a
third budget period will be necessary, enter the Federal funds needed
for months 25 through 36 under ``(c) Second.'' Columns (d) and (e) are
not applicable in most instances, since ACF funding is almost always
limited to a three-year maximum project period. They should remain
blank.
Section F--Other Budget Information.
Direct Charges--Line 21. Not applicable.
Indirect Charges--Line 22. Enter the type of indirect rate
(provisional, predetermined, final or fixed) that will be in effect
during the funding period, the estimated amount of the base to which
the rate is applied, and the total indirect expense.
Remarks--Line 23. If the total project period exceeds 17 months,
you must enter your proposed non-Federal share of the project budget
for each of the remaining years of the project.
3. Project Summary Description
Clearly mark this separate page with the applicant name as shown in
item 5 of the SF 424, the priority area number as shown at the top of
the SF 424, and the title of the project as shown in item 11 of the SF
424. The summary description should not exceed 300 words. These 300
words become part of the computer database on each project.
Care should be taken to produce a summary description which
accurately and concisely reflects the proposal. It should describe the
objectives of the project, the approaches to be used and the outcomes
expected. The description should also include a list of major products
that will result from the proposed project, such as software packages,
materials, management procedures, data collection instruments, training
packages, or videos (please note that audiovisuals should be closed
captioned). The project summary description, together with the
information on the SF 424, will constitute the project ``abstract.'' It
is the major source of information about the proposed project and is
usually the first part of the application that the reviewers read in
evaluating the application.
4. Program Narrative Statement
The Program Narrative Statement is a very important part of an
application. It should be clear, concise, and address the specific
requirements mentioned under the priority area description in Part IV.
The narrative should also provide information concerning how the
application meets the evaluation criteria, using the following
headings:
(a) Objectives and Need for Assistance;
(b) Results and Benefits Expected;
(c) Approach; and
(d) Staff Background and Organization's Experience.
The specific information to be included under each of these
headings is described in Section C of Part III, Evaluation Criteria.
The narrative should be typed double-spaced on a single-side of an
8\1/2\'' x 11'' plain white paper, with 1'' margins on all sides. All
pages of the narrative (including charts, references/footnotes, tables,
maps, exhibits, etc.) must be sequentially numbered, beginning with
``Objectives and Need for Assistance'' as page number one. Applicants
should not submit reproductions of larger size paper, reduced to meet
the size requirement.
The length of the application, including the application forms and
all attachments, should not exceed 60 pages. This will be strictly
enforced. A page is a single side of an 8\1/2\ x 11'' sheet of paper.
Applicants are requested not to send pamphlets, brochures or other
printed material along with their application as these pose xeroxing
difficulties. These materials, if submitted, will not be included in
the review process if they exceed the 60-page limit. Each page of the
application will be counted to determine the total length.
5. Organizational Capability Statement
The Organizational Capability Statement should consist of a brief
(two to three pages) background description of how the applicant
organization (or the unit within the organization that will have
responsibility for the project) is organized, the types and quantity of
services it provides, and/or the research and management capabilities
it possesses. This description should cover capabilities not included
in the Program Narrative Statement. It may include descriptions of any
current or previous relevant experience, or describe the competence of
the project team and its demonstrated ability to produce a final
product that is readily comprehensible and usable. An organization
chart showing the relationship of the project to the current
organization should be included.
6. Part V--Assurances/Certifications
Applicants requesting financial assistance for non-construction
projects must file the Standard Form 424B, ``Assurances: Non-
Construction Programs.'' Applicants must sign and return the Standard
Form 424B with their applications.
Applicants must provide a certification regarding lobbying when
applying for an award in excess of $100,000. Applicants must sign and
return the certification with their application.
Applicants must disclose lobbying activities on the Standard Form
LLL
[[Page 42347]]
when applying for an award in excess of $100,000. Applicants who have
used non-Federal funds for lobbying activities in connection with
receiving assistance under this announcement shall complete a
disclosure form to report lobbbying. Applicants must sign and return
the disclosure form, if applicable, with their applications.
Applicants must make the appropriate certification that they are
not presently debarred, suspended or otherwise ineligible for an award.
By signing and submitting the application, the applicant is providing
the certification regarding environmental tobacco smoke and need not
mail back the certification with the applications.
Applicants must make the appropriate certification of their
compliance with the Drug Free Workplace Act of 1988. By signing and
submitting the application, the applicant is providing the
certification and need not mail back the certification with the
application.
Applicants must make the appropriate certification of their
compliance with the Pro-Children Act of 1994. By signing and submitting
the application, the applicant is providing the certification and need
not mail back the certification with the application.
In addition, applicants are required under Section 162(c)(3) of the
Act to provide assurances that the human rights of all individuals with
developmental disabilities (especially those individuals without
familial protection) who will receive services under projects assisted
under Part E will be protected consistent with section 110 of the Act
(relating to the rights of individuals with developmental
disabilities). Each application must include a statement providing this
assurance.
For research projects in which human subjects may be at risk, a
Protection of Human Subjects Assurance may be required. If there is a
question regarding the applicability of this assurance, contact the
Office for Research Risks of the National Institutes of Health at (301)
496-7041.
Copies of the certifications and assurances are located at the end
of this announcement.
E. Checklist for a Complete Application
The checklist below is for your use to ensure that your application
package has been properly prepared.
____ One original, signed and dated application, plus two copies.
Applications for different priority areas are packaged separately;
____ Application is from an organization which is eligible under the
eligibility requirements defined in the priority area description
(screening requirement);
____ Application length does not exceed 60 pages, unless otherwise
specified in the priority area description. A complete application
consists of the following items in this order:
____ Application for Federal Assistance (SF 424, REV 4-88);
____ A completed SPOC certification with the date of SPOC contact
entered in line 16, page 1 of the SF 424 if applicable.
____ Budget Information--Non-Construction Programs (SF 424A, REV 4-
88);
____ Budget justification for Section B--Budget Categories;
____ Table of Contents;
____ Letter from the Internal Revenue Service, etc. to prove non-
profit status, if necessary;
____Copy of the applicant's approved indirect cost rate agreement,
if appropriate;
____Project summary description and listing of key words;
____Program Narrative Statement (See Part III, Section C);
____Organizational capability statement, including an organization
chart;
____Any appendices/attachments;
____Assurances--Non-Construction Programs (Standard Form 424B, REV
4-88);
____Certification Regarding Lobbying; and
____Certification of Protection of Human Subjects, if necessary.
____Certification Regarding Environmental Tobacco Smoke; signature
on the application represents certification.
____Certification Regarding Drug-Free Workplace; signature on the
application represents certification.
____Certification Regarding Debarment/Suspension; signature on the
application represents certification.
F. The Application Package
Each application package must include an original and two copies of
the complete application. Each copy should be stapled securely (front
and back if necessary) in the upper left-hand corner. All pages of the
narrative (including charts, tables, maps, exhibits, etc.) must be
sequentially numbered, beginning with page one. In order to facilitate
handling, please do not use covers, binders or tabs. Do not include
extraneous materials as attachments, such as agency promotion
brochures, slides, tapes, film clips, minutes of meetings, survey
instruments or articles of incorporation.
G. Paper Reduction Act
Under the Paperwork Reduction Act of 1995 (Pub. L. 104-13), the
Department is required to submit to OMB for review and approval any
reporting and record keeping requirements or program announcements.
This program announcement meets all information collection requirements
approved for ACF grant applications under OMB Control Number 0970-0139.
(Federal Catalog of Domestic Assistance Number 93.631 Developmental
Disabilities--Projects of National Significance)
Dated: July 29, 1997.
Bob Williams,
Commissioner, Administration on Developmental Disabilities.
Executive Order 12372--State Single Points of Contact
Arizona
Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue
Fourteenth Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315,
FAX # (602) 280-1305
Arkansas
Mr. Tracy L. Copeland, Manager, State Clearinghouse Office of
Intergovernmental Services, Department of Finance and
Administration, 1515 W. 7th St., Room 412, Little Rock, Arkansas
72203, Telephone: (501) 682-1074, FAX # (501) 682-5206
California
Grants Coordinator, Office of Planning and Research, 1400 Tenth
Street, Room 121, Sacramento, California 95814, Telephone (916) 323-
7480, FAX # (916) 323-3018
Delaware
Francine Booth, State Single Point of Contact Executive Department,
Thomas Collins Building, Dover, Delaware 19903, Telephone: (302)
739-3326, FAX # (302) 739-5661
District of Columbia
Charles Nichols, State Single Point of Contact Office of Grants
Management and Development, 717 14th Street, N.W.--Suite 500,
Washington, D.C. 20005, Telephone: (202) 727-6551, FAX # (202) 727-
1617
Florida
Florida State Clearinghouse, Department of Community Affairs, 2740
Centerview Drive, Tallahassee, Florida 32399-2100, Telephone: (904)
922-5438, FAX # (904) 487-2899
Georgia
Tom L. Reid, III, Coordinator, Georgia State Clearinghouse, 270
Washington Street, S.W.--8th Floor, Atlanta, Georgia 30334,
Telephone: (404) 656-3855, FAX # (404) 656-3828
Illinois
Virginia Bova, State Single Point of Contact, James R. Thompson
Center, 100 West Randolph, Suite 3-400, Chicago, Illinois
[[Page 42348]]
60601, Telephone: (312) 814-6028, FAX # (312) 814-1800
Indiana
Frances E. Williams, State Budget Agency, 212 State House,
Indianapolis, Indiana 46204, Telephone: (317) 232-2972, FAX # (317)
233-3323
Iowa
Steven R. McCann, Division for Community Assistance, Iowa Department
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa
50309, Telephone: (515) 242-4719, FAX # (515) 242-4859
Kentucky
Ronald W. Cook, Office of the Governor, Department of Local
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601-
8204, Telephone: (502) 573-2382, FAX # (502) 573-2512
Maine
Joyce Benson, State Planning Office, State House Station #38,
Augusta, Maine 04333, Telephone: (207) 287-3261, FAX # (207) 287-
6489
Maryland
William G. Carroll, Manager, Plan and Project Review, Maryland
Office of Planning, 301 W. Preston Street--Room 1104, Baltimore,
Maryland 21201-2365, Staff Contact: Linda Janey, Telephone: (410)
767-4490, FAX # (410) 767-4480
Michigan
Richard Pfaff, Southeast Michigan Council of Governments, 660 Plaza
Drive--Suite 1900, Detroit, Michigan 48226, Telephone: (313) 961-
4266, FAX # (313) 961-4869
Mississippi
Cathy Malette, Clearinghouse Officer, Department of Finance and
Administration, 455 North Lamar Street, Jackson, Mississippi 39202-
3087, Telephone: (601) 359-6762, FAX # (601) 359-6764
Missouri
Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Room 760, Truman Building, Jefferson
City, Missouri 65102, Telephone: (314) 751-4834, FAX # (314) 751-
7819
Nevada
Department of Administration, State Clearinghouse, Capitol Complex,
Carson City, Nevada 89710, Telephone: (702) 687-4065, FAX # (702)
687-3983
New Hampshire
Jeffrey H. Taylor, Director, New Hampshire Office of State Planning,
Attn: Intergovernmental Review Process, James E. Bieber, 2\1/2\
Beacon Street, Concord, New Hampshire 03301, Telephone: (603) 271-
2155, FAX # (603) 271-1728
New Mexico
Robert Peters, State Budget Division, Room 190 Bataan Memorial
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640
New York
New York State Clearinghouse, Division of the Budget, State Capitol,
Albany, New York 12224, Telephone: (518) 474-1605
North Carolina
Chrys Baggett, Director, N.C. State Clearinghouse, Office of the
Secretary of Admin., 116 West Jones Street, Raleigh, North Carolina
27603-8003, Telephone: (919) 733-7232, FAX # (919) 733-9571
North Dakota
North Dakota Single Point of Contact, Office of Intergovernmental
Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-
0170, Telephone: (701) 224-2094, FAX # (701) 224-2308
Ohio
Larry Weaver, State Single Point of Contact, State Clearinghouse,
Office of Budget and Management, 30 East Broad Street, 34th Floor,
Columbus, Ohio 43266-0411
Please direct correspondence and questions about
intergovernmental review to:
Linda Wise, Telephone: (614) 466-0698, FAX # (614) 466-5400
Rhode Island
Kevin Nelson, Review Coordinator, Department of Administration,
Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode
Island 02908-5870, Telephone: (401) 277-2656, FAX # (401) 277-2083
Please direct correspondence and questions to:
Review Coordinator, Office of Strategic Planning
South Carolina
Rodney Grizzle, State Single Point of Contact, Grant Services,
Office of the Governor, 1205 Pendleton Street--Room 331, Columbia,
South Carolina 29201, Telephone: (803) 734-0494, FAX # (803) 734-
0356
Texas
Tom Adams, Governors Office, Director, Intergovernmental
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512)
463-1771, FAX # (512) 463-1880
Utah
Carolyn Wright, Utah State Clearinghouse, Office of Planning and
Budget, Room 116 State Capitol, Salt Lake City, Utah 84114,
Telephone: (801) 538-1535, FAX # (801) 538-1547
West Virginia
Fred Cutlip, Director, Community Development Division, W. Virginia
Development Office, Building #6, Room 553, Charleston, West Virginia
25305, Telephone: (304) 558-4010, FAX # (304) 558-3248
Wisconsin
Jeff Smith, Section Chief, State/Federal Relations, Wisconsin
Department of Administration, 101 East Wilson Street--6th Floor,
P.O. Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-0267,
FAX # (608) 267-6931
Wyoming
Matthew Jones, State Single Point of Contact, Office of the
Governor, 200 West 24th Street, State Capitol, Room 124, Cheyenne,
Wyoming 82002, Telephone: (307) 777-7446, FAX # (307) 632-3909
Territories (SPOC)
Guam
Mr. Giovanni T. Sgambelluri, Director, Bureau of Budget and
Management Research, Office of the Governor, P.O. Box 2950, Agana,
Guam 96910, Telephone: 011-671-472-2285, FAX #011-671-472-2825
Puerto Rico
Norma Burgos/Jose E. Caro, Chairwoman/Director, Puerto Rico Planning
Board, Federal Proposals Review Office, Minillas Government Center,
P.O. Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (809)
727-4444; (809) 723-6190, FAX # (809) 724-3270; (809) 724-3103
Northern Mariana Islands
Mr. Alvaro A. Santos, Executive Officer, Office of Management and
Budget, Office of the Governor, Saipan, MP 96950, Telephone: (670)
664-2256, FAX: # (670) 664-2272
Contact person:
Ms. Jacoba T. Seman, Federal Programs Coordinator, Telephone: (670)
664-2289, FAX # (670) 664-2272
Virgin Islands
Nellon Bowry, Director, Office of Management and Budget, #41
Norregade Emancipation Garden Station, Second Floor, Saint Thomas,
Virgin Islands 00802
Please direct all questions and correspondence about
intergovernmental review to:
Linda Clarke, Telephone: (809) 774-0750, FAX # (809) 776-0069
State Developmental Disabilities Planning Councils
Alabama
Joan B. Hannah, Ed.D., Executive Director, Alabama Developmental
Disabilities Planning Council, RSA Union Building, PIPA, 100 North
Union Street, Post Office Box 301410, Montgomery, Alabama 36130-
1210, Phone: (334) 242-3973; 1-800-232-2158; 1-800-846-3735, FAX #
(334) 242-0797
Alaska
David Maltman, Exec. Director, Governor's Council on Disabilities
and Special Education, [email protected], P.O. Box 240249,
Anchorage, Alaska 99524-0249, Phone: (907) 269-8990, FAX # (907)
269-8995
American Samoa
Henry Sesepasara, Executive Director, American Samoa Developmental
Disabilities Council, P.O. Box 194, Pago Pago, American Samoa 96799,
Phone: 011 (684) 633-2919, FAX same as phone, call first
[[Page 42349]]
Arizona
Bill Hixon, Acting Executive Director, Governor's Council on
Developmental Disabilities, 1717 West Jefferson Street, Rm. 112,
Site Code 074Z, Phoenix, Arizona 85007, Phone: (602) 542-4049, TDD
(602) 542-4000, FAX #(602) 542-5320
Arkansas
Wilma Stewart, Director, Arkansas Governor's Developmental
Disabilities Council, Freeway Medical Tower, Suite 805, 5800 West
10th Street, Little Rock, Arkansas 72204, Phone: (501) 661-2589, TDD
(501-661-2736, FAX #(501) 661-2399
California
Judy McDonald, Executive Director, CA State Council on Developmental
Disabilities, 2000 ``O'' Street, Suite 100, Sacramento, California
95814, Phone: (916) 322-8481, TDD (916) 324-8420, FAX #(916) 443-
4957
Colorado
Donald St. Louis, Executive Director, Colorado Developmental
Disabilities Council, 777 Grant Street, Suite 304, EMail-
[email protected], Denver, Colorado 80203, Phone: (303) 894-2345, also
TDD, FAX (303) 894-2880
Commonwealth of the Northern Mariana Island
Thomas J. Camacho, Executive Director, CNMI Governor's D.D. Council,
Capitol Hill, Bldg. #1312, P.O. Box 2565, [email protected],
Saipan, MP 96950, Phone: (011) 670-322-3014 (Voice/TDD), FAX (011)
670-322-4168
Connecticut
Edward T. Preneta, Executive Director, Council on D.D., 460 Capitol
Avenue, EM[email protected], Hartford, Connecticut
06106-1308, Phone: (860) 418-6160, TTD (860) 418-6172, FAX #(860)
418-6003
Delaware
James F. Linehan, Ex. Director, Developmental Disabilities Council,
Townsend Building, Lower Level, Box 1401, Dover, Delaware 19903, FAX
#(302) 739-2015, EM[email protected], Phone: (302) 739-3333,
TDD 302-739-4894
District of Columbia
Mary Brown, Acting Ex. Dir., Developmental Disabilities Council, St.
Elizabeth Campus, 2700 Martin Luther King Ave., S.E., Bldg. 801
East, Room 1301, Washington, D.C. 20032, (202) 279-6085, FAX (202)
279-6090
Gov't of Federated States of Micronesia,
Yosiro Suta, Director, Gov't of Federated States of Micronesia, Dept
of Ed., Palikir, Pohnpei, FM 96941, (691) 320-2609, FAX #(691) 320-
5500
Florida
Joseph Krieger, Director, Florida Developmental Disabilities
Council, 124 Marriott Drive, Suite 203, Tallahassee, Florida 32301-
2981, [email protected], (904) 488-4180; 800-580-7801, TDD (904)
488-0956, FAX #(904) 922-6702
Georgia
John E. Crews, DPA, Executive Director, Governor's Council on
Developmental Disabilities for Georgia, 2 Peachtree St., NW, 3rd
Floor, Suite 210, Atlanta, Georgia 30303 (404) 657-2126, FAX #(404)
657-2132, TDD 657-2133
Guam
Thomas J. Paulino, Executive Director, Guam Developmental
Disabilities Council, 104 E Street, Tiyan, Guam 96913, 011 (671)
475-9127/8, FAX #011 (671) 475-9128
Hawaii
Diana C. Tizard, Executive Director, State Planning Council on
Developmental Disabilities, 919 Ala Moana Blvd., Suite #113,
Honolulu, Hawaii 96814, (808) 586-8100, FAX # (808) 586-7543,
[email protected]
Idaho
Russ Spearman, Executive Director, Idaho State Council on
Developmental Disabilities, 280 North Eighth Street, Suite 208,
Boise, Idaho 83720-0280, [email protected], W (208) 334-
2178, FAX (208) 334-3417, TDD (208) 334-2179, 800-544-2433
Illinois
Rene Christensen-Leininger, Director, Illinois Planning Council on
Developmental Disabilities, 830 S. Spring Street, Springfield, IL
62704, W (217) 782-9696, 100 West Randolph, S.10-600, Chicago,
Illinois 60601, W (312) 814-2080, FAX # (217) 524-5339,
[email protected], Fax (312) 814-7141, TDD 312-814-7151
Indiana
Suellen Jackson-Boner, Director, Governor's Council for People with
Disabilities, 143 W. Market Street, Harrison Building, Suite 404,
Indianapolis, Indiana 46204, W (317) 232-7770, FAX # (317) 233-3712,
[email protected], [email protected], [email protected]
Iowa
Jay W. Brewer, Executive Director, Iowa Governor's Council for
Developmental Disabilities, 617 E. Second Street, Des Moines, Iowa
50309, W (515) 281-9083, FAX (515) 281-9087, 1-800-452-1936, E-mail
one ex [email protected]
Kansas
Jane Rhys, Executive Director, Kansas Council on Developmental
Disabilities, Docking State Office Bldg., 915 S.W. Harrison, Room
141, Topeka, Kansas 66612-1570, (913) 296-2608, FAX # (913) 296-
2861, [email protected]
Kentucky
Bob Glass, Executive Director, Kentucky Developmental Disabilities
Planning Council, Dept. of MH/MR Services, 275 East Main Street,
Frankfort, Kentucky 40621, (502) 564-7841, 1-800-928-6583, FAX #
(502) 564-9826
Louisiana
Clarice Eichelberger, Executive Director, Louisiana State Planning
Council on Developmental Disabilities, Post Office Box 3455, Mail
Bin #14, Baton Rouge, Louisiana 70821-3455, W (504) 342-6804, FAX #
(504) 342-1970
Maine
Peter R. Stowell, Executive Director, Developmental Disabilities
Council, 139 State House Station, Nash Building, Augusta, Maine
04333-0139, W (207) 287-4213, FAX # (207) 287-8001,
[email protected]
Maryland
Ms. Mindy Morrell, Executive Director, Maryland Developmental
Disabilities Council, 300 West Lexington Street, One Market Center,
Box 10, Baltimore, Maryland 21201, [email protected], (410) 333-
3688, FAX # (410) 333-3686
Massachusetts
Daniel M. Shannon, Executive Director, Administering Agency for Dev.
Disab., 174 Portland Street, 5th Floor, Boston, Massachusetts 02114,
[email protected], [email protected], (617) 727-6374-
ext.108, TDD (617) 727-1885, FAX # (617) 727-1174
Michigan
Ms. Vendella Collins, Executive Director, Michigan D.D. Council,
Lewis Cass Building 6th Floor, Lansing, Michigan 48933, (517) 334-
7298, 6123, 7240 (Secy.), FAX # (517) 334-7353, TDD (517) 334-7354
Minnesota
Colleen Wieck, Ph.D., Executive Director, Governor's Council on Dev.
Disabilities, Minnesota Dept. of Administration, 300 Centennial
Office Building, 658 Cedar Street, St. Paul, Minnesota 55155, W
(612) 296-4018, TDD 612-296-9962, FAX # (612) 297-7200,
[email protected]
Mississippi
Edwin L. Butler, Director, Mississippi Developmental Disabilities
Council, 1002 Robert E. Lee Building, 239 North Lamar Street,
Jackson, Mississippi 39201, (601) 359-1288, TDD 601-359-6230, FAX #
(601) 359-6295
Missouri
Kay Conklin, Director, Missouri Council for Developmental
Disabilities, P.O. Box 687, 1706 East Elm Street, Jefferson City,
Missouri 65102, (314) 751-8611 (Voice/TTD), FAX # (573) 526-2755,
800-500-7878, [email protected]
Montana
Greg A. Olsen, Ex. Director, Developmental Disabilities Planning and
Advisory Council, 111 N. Last Chance Gulch, Unit 1C, P.O. Box 526,
Helena, Montana 59624, (406) 444-1334, FAX # (406) 444-5999
Nebraska
Mary Gordon, Director, Governor's Council on DD, 301 Centennial
Mall, South, P.O. Box 95007, Lincoln, Nebraska 68509, (402) 471-
2330, TDD (402)-471-6421, FAX # (402) 471-0180,
[email protected]
Nevada
Paul Haugen, Director, Governor's Council on DD, 711 S. Stewart
Street, Carson City,
[[Page 42350]]
Nevada 89710, W (702) 687-4452, TDD 702-687-3388, FAX # (702) 687-
3292
New Hampshire
Alan Robichaud, Director, New Hampshire Developmental Disabilities
Council, The Concord Center, Unit 315, 10 Ferry Street, Concord, New
Hampshire 03301-5004, (603) 271-3236, TDD/Voice Relay 800-735-2964,
FAX # (603) 271-1156, [email protected], [email protected]
New Jersey
Ethan B. Ellis, Executive Director, NJ Developmental Disabilities
Council, 20 West State Street, CN 700, Trenton, New Jersey 08625-
0700, (609) 292-3745, FAX # (609) 292-7114
New Mexico
Chris Isengard, Director, NM Developmental Disabilities Planning
Council, 435 St. Michael's Drive, Building D, Santa Fe, New Mexico
87505, (505) 827-7590, FAX # (505) 827-7589
New York
Sheila M. Carey, Executive Director, New York State Developmental
Disabilities Council, 155 Washington Avenue, 2nd. Floor, Albany, New
York 12210, W (518) 432-8233; (800) 395-3372, TDD 518-432-8245, FAX
# 518-432-8238, [email protected]
North Carolina
Holly Riddle, Executive Director, North Carolina Council on
Developmental Disabilities, 1508 Western Blvd., Raleigh, North
Carolina 27606, (919) 733-6566, FAX # (919) 733-1863,
[email protected]
North Dakota
Tom Wallner, Director, North Dakota State Council on Developmental
Disabilities, Dept. of Human Services, 600 East Boulevard Avenue,
Bismarck, North Dakota 58505-0250, W (701) 328-8953, FAX # (701)
328-8969, [email protected]
Ohio
Ken Campbell, Executive Director, Ohio Developmental Disabilities
Planning Council, 8 East Long Street, 6th Floor, Columbus, Ohio
43215-0415, W (614) 466-5205, TDD 614-644-5530, FAX # (614) 466-
0298, [email protected]
Oklahoma
Ann Trudgeon, Executive Director, Council for Dev. Disabilities,
P.O. Box 25352, Oklahoma City, OK 73125, 3033 N. Walnut, Suite 105-
E, Oklahoma City, Oklahoma 73105, W (405) 528-4984, FAX # (405) 528-
0956, [email protected], 1-800-836-4470 (toll-free)
Oregon
Charlotte Duncan, Executive Director, Oregon Developmental
Disabilities Council, 540 24th Place, NE, Salem, Oregon 97301-4517,
(503) 945-9942; 1-800-292-4154, FAX # (503) 945-9947, [email protected]
Pennsylvania
Graham Mulholland, Executive Director, Developmental Disabilities
Council, Room 569 Forum Building, Commonwealth Avenue, Harrisburg,
Pennsylvania 17120, W (717) 787-6057, FAX 717-772-0738
Puerto Rico
Ms. Ethel M. Torres, Acting Executive Director, Developmental
Disabilities Council, Apartado 9543, Santurce, Puerto Rico 00908-
0543, Pda. 18, Ponce de Leon Ave., Caso Building #1225 Santurce, PR
00908, 809 722-8850 (direct line), W (809) 722-0595, FAX (809) 721-
3622
Rhode Island
Marie V. Citrone, Executive Director, Rhode Island Developmental
Disabilities Council, 600 New London Avenue, Cranston, Rhode Island
02920-3028, (401) 464-3191, FAX # (401) 464-3570,
[email protected]
South Carolina
Charles B. Lang, Executive Director, South Carolina Developmental
Disabilities Council, Office of the Governor, 1205 Pendleton Street,
Suite 372, Edgar Brown Building, Columbia, South Carolina 29201-
3731, (803) 734-0465, FAX # (803) 734-0241
South Dakota
Charlie A. Anderson, Executive Director South Dakota Council on
Developmental Disabilities, Hills View Plaza, East Highway 34, c/o
500 East Capitol, Pierre, South Dakota 57501-5070, (605) 773-6415,
TDD 605-773-5990, FAX (605) 773-5483
Tennessee
Wanda Willis, Ex. Director, Developmental Disabilities Council,
Gateway Plaza, 11th Floor, 710 James Robertson Parkway, Nashville,
Tennessee 37243-0675, (615) 532-6615, TTY 615-741-4562, FAX # (615)
532-6964, K[email protected]
Texas
Roger A. Webb, Executive Director, Texas Planning Council for
Developmental Disabilities, 4900 North Lamar Blvd., Austin, Texas
78751-2399, (512) 424-4080, TDD 512-424-4099, FAX 512-424-4097, E-
Mail:[email protected], (800) 262-0334
Utah
Catherine E. Chambless, Executive Director, Utah Governor's Council
for People with Disabilities, 555 East 300 South, Suite 201, Salt
Lake City, Utah 84102, (801) 533-4128 (V/TDD), FAX # (801) 533-5305,
[email protected], [email protected]
Vermont
Thomas A. Pombar, Exec. Director, Vermont Developmental Disabilities
Council, 103 South Main Street, Waterbury, Vermont 05671-0206, (802)
241-2612, FAX # (802) 241-2979, [email protected]
Virginia
Mr. Brian S. Parsons, Director, Virginia Board for People with
Disabilities, Ninth Street Office Building, 202 North 9th Street,
9th Floor, Richmond, Virginia 23219, (804) 786-0016, FAX # (804)
786-1118, TDD 1-800-846-4464
Virgin Islands
Mark Vinzant, Director, VI Developmental Disabilities Council, P.O.
Box 2671, Kings Hill, St. Croix, Virgin Islands 00851, (809) 778-
9681, FAX 809-778-9250
Washington
Edward M. Holen, Executive Director, Developmental Disabilities
Council, P.O. Box 48314, 906 Columbia Street, S.W., Olympia,
Washington 98504-8314, (360) 753-3908, TDD 1-800-634-4473, FAX (360)
586-2424, [email protected], [email protected]
West Virginia
Donna Heuneman, Exective Director, West Virginia Developmental
Disabilities Council, 110 Stockton Street, Charleston, West Virginia
25312-2521, (304) 558-0416 (Voice), (304) 558-2376 (TDD), FAX #
(304) 558-0941
Western Carolina Islands (Trust Territories of the Pacific)
Dr. Minoru Ueki, MD, Trust Terr. Hlth. Cncl., MacDonald Mem. Hosp.
KOROR, Palau, WCI 96940
Wisconsin
Jayn Wittenmyer, Executive Director, Council on Developmental
Disabilities, (722 Williamson Street, 2nd Floor), Office Box 7851,
Madison, Wisconsin 53707-7851, (608) 266-7826, FAX (608) 267-3906,
[email protected]
Wyoming
Lynn Achter, Executive Director, Council on Developmental
Disabilities, 122 West 25th Street, Hersch Bldg., 1st Floor, West,
Cheyenne, Wyoming 82002, (307) 777-7230, 1-800-438-5791 (in-state-
only), FAX # (307) 777-5690
BILLING CODE 4184-01-P
[[Page 42351]]
[GRAPHIC] [TIFF OMITTED] TN06AU97.000
BILLING CODE 4184-01-C
[[Page 42352]]
Instructions for the SF 424
Public reporting burden for this collection of information is
estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
Please do not return your completed form to the Office of
Management and Budget, send it to the address provided by the
sponsoring agency.
This is a standard form used by applicants as a required
facesheet for preapplications and applications submitted for Federal
assistance. It will be used by Federal agencies to obtain applicant
certification that States which have established a review and
comment procedure in response to Executive Order 12372 and have
selected the program to be included in their process, have been
given an opportunity to review the applicant's submission.
Item and Entry
1. Self-explanatory.
2. Date application submitted to Federal agency (or State, if
applicable) & applicant's control number (if applicable).
3. State use only (if applicable).
4. If this application is to continue or revise an existing
award, enter present Federal identifier number. If for a new
project, leave blank.
5. Legal name of applicant, name of primary organizational unit
which will undertake the assistance activity, complete address of
the applicant, and name and telephone number of the person to
contact on matters related to this application.
6. Enter Employer Identification Number (EIN) as assigned by the
Internal Revenue Service.
7. Enter the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
space(s) provided:
--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance is being
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities.)
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit allowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-P
[[Page 42353]]
[GRAPHIC] [TIFF OMITTED] TN06AU97.001
[[Page 42354]]
[GRAPHIC] [TIFF OMITTED] TN06AU97.002
BILLING CODE 4184-01-C
[[Page 42355]]
Instructions for the SF 424A
Public reporting burden for this collection of information is
estimated to average 180 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
Please do not return your completed form to the Office of
Management and Budget, send it to the address provided by the
sponsoring agency.
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget, adhere to
any existing Federal grantor agency guidelines which prescribe how
and whether budgeted amounts should be separately shown for
different functions or activities within the program. For some
programs, grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor agencies
may require a breakdown by function or activity. Sections A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which requires Federal authorization in
annual or other funding period increments. In the latter case,
Sections A, B, C, and D should provide the budget for the first
budget period (usually a year) and Section E should present the need
for Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary Lines 1-4
Columns (a) and (b)
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring a
functional or activity breakdown, enter on Line 1 under Column (a)
the catalog program title and the catalog number in Column (b).
For applications pertaining to a single program requiring budget
amounts by multiple function or activities, enter the name of each
activity or function on each line in Column (a), and enter the
catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a breakdown by
function or activity, enter the catalog program title on each line
in Column (a) and the respective catalog number of each line in
Column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity, prepare a
separate sheet for each program requiring the breakdown. Additional
sheets should be used when one form does not provide adequate space
for all breakdown of data required. However, when more than one
sheet is used, the first page should provide the summary totals by
programs.
Lines 1-4, Columns (c) Through (g)
For new applications, leave Columns (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (f), and
(g) the appropriate amounts of funds needed to support the project
for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in Columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease of non-Federal funds. In Column
(g) enter the new total budgeted amount (Federal and non-Federal)
which includes the total previous authorized budgeted amounts plus
or minus, as appropriate, the amounts shown in Columns (e) and (f).
The amount(s) in Column (g) should not equal the sum of amounts in
Columns (e) and (f).
Line 5--Show the total for all columns used.
Section B. Budget Categories
In the column headings (1) through (4), enter the titles of the
same programs, functions, and activities shown in Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program,
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Lines 6a-i--Show the totals of Lines 6a to 6h in each column.
Line 6j--Show the amount of indirect cost.
Line 6k--Enter the total of amounts of Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in Columns (1)-(4), Line 6k, should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7--Enter the estimated amount of income, if any, expected
to be generated from this project. Do not add or subtract this
amount from the total project amount. Show under the program
narrative statement the nature and source of income. The estimated
amount of program income may be considered by the federal grantor
agency in determining the total amount of the grant.
Section C. Non-Federal Resources
Lines 8-11--Enter amounts of non-Federal resources that will be
used on the grant. If in-kind contributions are included, provide a
brief explanation on a separate sheet.
Column (a)--Enter the program titles identical to
Column (a), Section A. A breakdown by function or activity is
not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals in Columns (b), (c), and (d).
Line 12--Enter the total for each of Columns (b)-(e). The amount
in Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13--Enter the amount of cash needed by quarter from the
grantor agency during the first year.
Line 14--Enter the amount of cash from all other sources needed
by quarter during the first year.
Line 15--Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed for Balance of
the Project
Lines 16-19--Enter in Column (a) the same grant program titles
shown in Column (a), Section A. A breakdown by function or activity
is not necessary. For new applications and continuation grant
applications, enter in the proper columns amounts of Federal funds
which will be needed to complete the program or project over the
succeeding funding periods (usually in years). This section need not
be completed for revisions (amendments, changes, or supplements) to
funds for the current year of existing grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20--Enter the total for each of the Columns (b)-(e). When
additional schedules are prepared for this Section, annotate
accordingly and show the overall totals on this line.
Section F. Other Budget Information
Line 21--Use this space to explain amounts for individual direct
object-class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal
grantor agency.
Line 22--Enter the type of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate
is applied, and the total indirect expense.
Line 23--Provide any other explanations or comments deemed
necessary.
Assurances--Non-Construction Programs
Public reporting burden for this collection of information is
estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing
[[Page 42356]]
the collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
Please do not return your completed form to the Office of
Management and Budget. Send it to the address provided by the
sponsoring agency.
Note: Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may
require applicants to certify to additional assurances. If such is
the case, you will be notified.
As the duly authorized representative of the applicant I certify
that the applicant:
1. Has the legal authority to apply for Federal assistance and
the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project costs) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or
personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the nineteen statutes
or regulations specified in Appendix A of OPM's Standards for a
Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b)
Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973,
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on
the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. Sec. 6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616), as amended, relating to nondiscrimination on the
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3),
as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. Sec. 3601 et seq.), as amended, relating to non-
discrimination in the sale, rental or financing of housing; (i) any
other nondiscrimination provisions in the specific statute(s) under
which application for Federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may
apply to the application.
7. Will comply, or has already complied, with the requirements
of Titles II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which
provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally
assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal
participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch
Act (5 U.S.C. Secs. 1501-1508 and 7324-7328) which limit the
political activities of employees whose principal employment
activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40
U.S.C. Secs. 276c and 18 U.S.C. Secs. 874), and the Contract Work
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding
labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act
of 1973 (P.L. 93-234) which requires recipients in a special flood
hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and
acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order
(EO) 11514; (b) notification of violating facilities pursuant to EO
11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance with EO
11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal
actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C.
Secs. 7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93-523); and (h) protection of endangered species
under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. Secs. 1271 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with
Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 470), EO 11593 (identification and protection of
historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966
(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the
care, handling, and treatment of warm blooded animals held for
research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention
Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead
based paint in construction or rehabilitation of residence
structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act of 1984 or
OMB Circular No. A-133, Audits of Institutions of Higher Learning
and other Non-profit Institutions.
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations and policies governing
this program.
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Signature of Authorized Certifying Official
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Applicant Organization
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Title
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Date submitted
Appendix B
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an explanation shall disqualify such person from
participation in this transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this
[[Page 42357]]
transaction. If it is later determined that the prospective primary
participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause or
default.
4. The prospective primary participant shall provide immediate
written notice to the department or agency to which this proposal is
submitted if at any time the prospective primary participant learns
that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meanings set out in the
Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to
which this proposal is being submitted for assistance in obtaining a
copy of those regulations.
6. The prospective primary participant agrees by submitting this
proposal that, should the proposed covered transaction be entered
into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR
part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by
the department or agency entering into this covered transaction,
without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
9. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of
these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may
terminate this transaction for cause or default.
* * * * *
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters--Primary Covered Transactions
(1) The prospective primary participant certifies to the best of
its knowledge and belief, that it and its principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded by any
Federal department or agency;
(b) Have not within a three-year period preceding this proposal
been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transactions (Federal,
State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Appendix C
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation
of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government the
department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide
immediate written notice to the person to which this proposal is
submitted if at any time the prospective lower tier participant
learns that its certification was erroneous when submitted or had
become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meaning set out in the
Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting
this proposal that, [[Page 33043]] should the proposed covered
transaction be entered into, it shall not knowingly enter into any
lower tier covered transaction with a person who is proposed for
debarment under 48 CFR part 9, subpart 9.4, debarred, suspended,
declared ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by
submitting this proposal that it will include this clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that is not proposed for debarment under 48 CFR part 9,
subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
8. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,
debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including
suspension and/or debarment.
* * * * *
[[Page 42358]]
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
(1) The prospective lower tier participant certifies, by
submission of this proposal, that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this
transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Appendix D
This certification is required by the regulations implementing
the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F.
Sections 76.630(c) and (d)(2) and 76.645(a)(1) and (b) provide that
a federal agency may designate a central receipt point for STATE-
WIDE AND STATE AGENCY-WIDE certifications, and for notification of
criminal drug convictions. For the Department of Health and Human
Services, the central point is: Division of Grants Management and
Oversight, Office of Management and Acquisition, Department of
Health and Human Services, Room 517-D, 200 Independence Avenue, SW
Washington, DC 20201.
Certification Regarding Drug-Free Workplace Requirements
(Instructions for Certification)
1. By signing and/or submitting this application or grant
agreement, the grantee is providing the certification set out below.
2. The certification set out below is a material representation
of fact upon which reliance is placed when the agency awards the
grant. If it is later determined that the grantee knowingly rendered
a false certification, or otherwise violates the requirements of the
Drug-Free Workplace Act, the agency, in addition to any other
remedies available to the Federal Government, may take action
authorized under the Drug-Free Workplace Act.
3. For grantees other than individuals, Alternate I applies.
4. For grantees who are individuals, Alternate II applies.
5. Workplaces under grants, for grantees other than individuals,
need not be identified on the certification. If known, they may be
identified in the grant application. If the grantee does not
identify the workplaces at the time of application, or upon award,
if there is no application, the grantee must keep the identity of
the workplace(s) on file in its office and make the information
available for Federal Inspection. Failure to identify all known
workplaces constitutes a violation of the grantee's drug-free
workplace requirements
6. Workplace identifications must include the actual address of
buildings (or parts of buildings) or other sites where work under
the grant takes place. Categorical descriptions may be used (e.g.,
all vehicles of a mass transit authority or State highway department
while in operation, State employees in each local unemployment
office, performers in concert halls or radio studios).
7. If the workplace identified to the agency changes during the
performance of the grant, the grantee shall inform the agency of the
change(s), if it previously identified the workplaces in question
(see paragraph five).
8. Definitions of terms in the Nonprocurement Suspension and
Debarment common rule and Drug-Free Workplace common rule apply to
this certification. Grantees' attention is called, in particular, to
the following definitions from these rules:
Controlled substance: means a controlled substance in Schedules
I through V of the Controlled Substances Act (21 U.S.C. 812) and as
further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction: means a finding of guilt (including a plea of nolo
contendere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the
Federal or State criminal drug statutes;
Criminal drug statute: means a Federal or non-Federal criminal
statute involving the manufacture, distribution, dispensing, use, or
possession of any controlled substance;
Employee: means the employee of a grantee directly engaged in
the performance of work under a grant, including: (i) All direct
charge employees; (ii) All indirect charge employees unless their
impact or involvement is insignificant to the performance of the
grant; and, (iii) Temporary personnel and consultants who are
directly engaged in the performance of work under the grant and who
are on the grantee's payroll. This definition does not include
workers not on the payroll of the grantee (e.g., volunteers, even if
used to meet a matching requirement; consultants or independent
contractors not on the grantee's payroll; or employees of
subrecipients or subcontractors in covered workplaces).
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will or will continue to provide a
drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to
inform employees about--
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in
the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by
paragraph (a) that, as a condition of employment under the grant,
the employee will--
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for
a violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction;
(e) Notifying the agency in writing, within ten calendar days
after receiving notice under paragraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title,
to every grant officer or other designee on whose grant activity the
convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice
shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days
of receiving notice under paragraph (d)(2), with respect to any
employee who is so convicted--
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c),
(d), (e) and (f).
(B) The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with the
specific grant:
Place of Performance (Street address, city, county, state, zip code)
----------------------------------------------------------------------
----------------------------------------------------------------------
Check {time} if there are workplaces on file that are not
identified here.
Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he
or she will not engage in the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance in
conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, he or
she will report the conviction, in writing, within 10 calendar days
of the conviction, to every grant officer or other designee, unless
the Federal agency designates a central point for the receipt of
such notices. When notice is made to such a central point, it shall
include the identification number(s) of each affected grant.
[55 FR 21690, 21702, May 25, 1990]
Appendix E
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge
and belief, that:
[[Page 42359]]
(1) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
(2) if any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and
submit Standard Form--LLL, ``Disclosure Form to Report Lobbying,''
in accordance with its instructions.
(3) The undersigned shall require that the language of this
certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon
which reliance was placed when this transaction was made or entered
into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and
belief, that:
If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
commitment providing for the United States to insure or guarantee a
loan, the undersigned shall complete and submit Standard Form--LLL,
``Disclosure Form to Report Lobbying,'' in accordance with its
instructions. Submission of this statement is a prerequisite for
making or entering into this transaction imposed by section 1352,
title 31, U.S. Code. Any person who fails to file the required
statement shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
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Signature
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Title
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Organization
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Date
BILLING CODE 4184-01-P
[[Page 42360]]
[GRAPHIC] [TIFF OMITTED] TN06AU97.003
BILLING CODE 4184-01-C
[[Page 42361]]
Appendix F
Certification Regarding Environmental Tobacco Smoke
Public Law 103-227, Part C--Environmental Tobacco Smoke, also
known as the Pro-Children Act of 1994 (Act), requires that smoking
not be permitted in any portion of any indoor routinely owned or
leased or contracted for by an entity and used routinely or
regularly for provision of health, day care, education, or library
services to children under the age of 18, if the services are funded
by Federal programs either directly or through State or local
governments, by Federal grant, contract, loan, or loan guarantee.
The law does not apply to children's services provided in private
residences, facilities funded solely by Medicare or Medicaid funds,
and portions of facilities used for inpatient drug or alcohol
treatment. Failure to comply with the provisions of the law may
result in the imposition of a civil monetary penalty of up to $1,000
per day and/or the imposition of an administrative compliance order
on the responsible entity.
By signing and submitting this application the applicant/grantee
certifies that it will comply with the requirements of the Act. The
applicant/grantee further agrees that it will require the language
of this certification be included in any subawards which contain
provisions for the children's services and that all subgrantees
shall certify accordingly.
[FR Doc. 97-20519 Filed 8-5-97; 8:45 am]
BILLING CODE 4184-01-P