Administration on Developmental Disabilities: Availability of Financial Assistance for American Indian Consortiums to Provide Protection and Advocacy Services for Fiscal Year 1995

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

[Program Announcement No. 93630-95-1]

Administration on Developmental Disabilities: Availability of

Financial Assistance for American Indian Consortiums to Provide

Protection and Advocacy Services for Fiscal Year 1995

AGENCY: Administration on Developmental Disabilities (ADD),

Administration for Children and Families (ACF), Department of Health

and Human Services (DHHS).

ACTION: Announcement of the availability of funds for American Indian

Consortiums to provide Protection and Advocacy (P&A) services for

Fiscal Year 1995.

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SUMMARY: The Administration on Developmental Disabilities,

Administration for Children and Families, announces the availability of

fiscal year 1995 funding for two American Indian Consortiums. Financial

funding provided by ADD to American Indian Consortiums is designed to

provide P&A services to Native Americans with developmental

disabilities.

DATES: The closing date for submittal of applications is June 8, 1995.

ADDRESSES: Applications should be mailed to: Administration on

Developmental Disabilities, Administration for Children and Families,

Department of Health and Human Services, Room 329-D, HHH Building, 200

Independence Avenue SW., Washington, DC 20201, Attn: 93.630-95-1

American Indian Consortium.

Hand delivered applications are accepted during the normal working

hours of 8 a.m. to 4:30 p.m. Monday through Friday, on or prior to the

established closing date at the above address.

FOR FURTHER INFORMATION CONTACT: Isadora Wills, Division of Program

Operations, Administration on Developmental Disabilities, (202) 690-

5791.

SUPPLEMENTARY INFORMATION:

Part I. Program Purpose

The Administration on Developmental Disabilities is the lead agency

within ACF and DHHS responsible for planning and administering programs

which promote the self-sufficiency and protect the rights of

individuals with developmental disabilities.

The 1994 Amendments (Pub. L. 103-230) to the Developmental

Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6000 et seq.)

(the Act) authorizes assistance to States and public and private

nonprofit agencies and organizations to assure that individuals with

developmental disabilities and their families participate in the design

of and have access to culturally competent services, supports, and

other assistance and opportunities that promote independence,

productivity and integration and inclusion into the community.

Programs Funded Under the Act Are:

Federal assistance to State developmental disabilities

councils;

State system for the protection and advocacy of individual

rights;

Grants to university affiliated programs for

interdisciplinary training, exemplary services, technical assistance,

and information dissemination; and

Grants for Projects of National Significance.

Part II. General Information for P&A Consortium

Based on section 142(b) of the Act (42 U.S.C. 6042(b)), an American

Indian Consortium established to provide protection and advocacy

services under Part C of the Act may submit an application to the

Secretary to receive funding pursuant to section 142(c)(5). Such

consortium shall coordinate activities with existing P&A systems.

Currently, the States' have difficulties which prohibit the P&A

systems from adequately serving large populations of American Indians

who reside in isolated, expansive reservations. Despite their efforts,

P&A systems in these States have not been able to overcome linguistic,

geographic and cultural barriers in order to provide adequate

protection and advocacy services to these populations. The American

Indian Consortium will help alleviate this problem by allowing certain

tribes to join together and apply to the Secretary for a Consortium

award similar to those received by the territories. It is expected that

the Consortium, when established, will work cooperatively with the

existing P&A systems in the States where the Consortium operates and

develop cooperative agreements on how to best serve Native Americans

with developmental disabilities.

For the purpose of this announcement an American Indian Consortium

is ``any confederation of two or more recognized American Indian

tribes, created through the official action of each participating

tribe, that has a combined total resident population of 150,000

enrolled tribal members and a contiguous territory of Indian lands in

two or more States.'' (section 102(1) (42 U.S.C. 6001(1)).

Part III. P&A Description and Requirements for Consortiums

A. Under the Act categorical grants are made to States and American

Indian Consortiums for the protection and advocacy of individual rights

through P&A systems. Systems must advocate on behalf of, and provide

services to, all persons who are or who may be eligible for treatment,

services, or habilitation, or who are being considered for a change in

living arrangements. The P&A systems have been expanding their efforts

on behalf of institutionalized people, with special attention on behalf

of minorities and other traditionally underserved populations.

Typically, these systems provide direct services to clients during a

fiscal year, and also provide information and referral services to

others. Assistance is provided for education, habilitation services,

financial entitlement, consent, architectural barriers removal, day

care, employment, rights or privacy, abuse and neglect cases,

sterilization, transportation, voting and zoning.

B. Statutory Authority

The Developmental Disabilities Assistance and Bill of Rights Act,

as amended, 42 U.S.C. 6000 et seq.

C. Funding Period

In Fiscal Year 1995, ADD has set aside approximate $272,322 for

funding two American Indian Consortiums. Each grant will be approximate

$136,161. As specified in 45 CFR 1386.2 of the ADD regulations, Fiscal

Year 1995 funds must be obligated by September 30, 1996. These funds

must be liquidated by September 30, 1997, in accordance with 45 CFR

1386.3 of the ADD regulations. Funding is authorized through Fiscal

Year 1996. [[Page 20097]]

Part IV. Specific Responsibilities of the Applicant

An applicant under this announcement must:

A. Provide the resolutions from the participating tribes

designating the applicant to operate the Protection and Advocacy

system, to receive the federal funds available for this program, and to

be responsible for reporting and accounting for such funds to ADD.

B. Indicate that the System shall have the authority to:

1. Pursue legal, administrative, and other appropriate remedies or

approaches to ensure the protection of, and advocacy for, the rights of

individuals with developmental disabilities within the exterior

boundaries of the Tribes who are or who may be eligible for treatment,

services, or habilitation, or who are being considered for a change in

living arrangements, with particular attention to enrolled members of

the Tribes (142(a)(2)(A)(i));

2. Provide information on and referral to programs and services

addressing the needs of persons with developmental disabilities

(142(a)(2)(A)(ii));

3. Investigate incidents of abuse and neglect of persons with

developmental disabilities if the incidents are reported to the system

or if there is probable cause to believe that the incidents occurred

(142(a)(2)(B)); and

4. Educate policymakers (142(a)(2)(K)).

C. Specify that the system, on an annual basis:

1. Develops a statement of objectives and priorities for the

system's activities (142(a)(2)(C)); and

2. Provide to the public including individuals with developmental

disabilities attributable to either physical impairment, mental

impairments, and their representatives, as appropriate, or a

combination of physical or mental impairments, non-Tribal agency

representatives, and non-State agency representatives of the State

Developmental Disabilities Council, and the university affiliated

program (if applicable within a State,) an opportunity to comment on--

(a) The objectives and priorities established by the system and the

rationale for the establishment of such objectives; and

(b) The activities of the system, including the coordination with

the advocacy programs under the Rehabilitation Act of 1973, the Older

Americans Act of 1965, and the Protection and Advocacy for Mentally Ill

Individual Act of 1986 and with other related programs, including the

parent training and information centers, education ombudsman programs

and assistive technology projects (142(a)(2)(D)).

D. Demonstrate that the system:

1. Has or will establish a grievance procedure for clients or

prospective clients of the system to assure that persons with

developmental disabilities have full access to services of the system

(142(a)(2)(E));

2. Is not being administered by the State Developmental

Disabilities Council authorized under Part B (142(a)(2)(F));

3. Is independent of any agency which provides treatment, services,

or habilitation to individuals with developmental disabilities

(142(a)(2)(G));

4. Has access at reasonable times and locations to any resident who

is an individual with a developmental disability in a facility that is

providing services, supports, and other assistance to such a resident

(142(a)(2)(H));

5. Has access to all records of--

(a) Any individual with developmental disabilities who is a client

of the system if such individual, or the legal guardian, conservator,

or other legal representative of such individual, has authorized the

system to have such access (142(a)(2)(I)(i));

(b) Any individual with developmental disabilities--

(i) Who, by reason of such individual's mental or physical

condition, is unable to authorize the system to have access

(142(a)(2)(I)(ii)(I));

(ii) Who does not have a legal guardian, conservator, or other

legal representative, or for whom the legal guardian is the Tribe

(142(a)(2)(I)(ii)(II)); and

(iii) With respect to whom a complaint has been received by the

system or with respect to whom as a result of monitoring or other

activities there is probable cause to believe that such individual has

been subject to abuse or neglect (142(a)(2)(I)(ii)(III)); and

(c) Any individual with a developmental disability who has a legal

guardian, conservator, or other legal representative with respect to

whom a complaint has been received by the system or with respect to

whom there is probable cause to believe the health or safety of the

individual is in serious and immediate jeopardy whenever--

(i) Such representative has been contacted by the system upon

receipt of the name and address of such representative

(142(a)(2)(I)(iii)(I));

(ii) The system has offered assistance to such representative to

resolve the situation (142(a)(2)(I)(iii)(II)); and

(iii) Such representative have failed or refused to act on behalf

of the individual (142(a)(2)(I)(iii)(III));

6. Has hired and maintains sufficient numbers and types of staff,

qualified by training and experience, to carry out such system's

function except that such system shall not apply hiring freezes,

reductions in force, or prohibitions on staff travel, or other

policies, to the extent that such policies would impact staff or

functions funded with Federal funds and would prevent the system from

carrying out its functions under the Act (142(a)(2)(J));

7. Will provide assurances to the Secretary that funds awarded to

the consortium under this section will be used to supplement and

increase the level of funds that would otherwise be made available for

the purposes for which Federal funds are provided and not to supplant

such non-Federal funds (142(a)(2)(L)); and

8. Will submit to: Administration on Developmental Disabilities,

Division of Program Operation, Room 329-D, HHH Building, 200

Independence Avenue, SW, Washington, DC 20201 the following reports:

Financial status reports (269s) bi-annually, Program Performance Report

(PPRs) annually and the Statement of Objectives and Priorities (SOPs)

annually.

E. Describe how the system will assure that a multimember governing

board is selected according to the policies and procedures of the

system except that--

1. The governing board shall be composed of members who broadly

represent or are knowledgeable about the needs of the individuals

served by the system and include individuals with developmental

disabilities who are eligible for services, or have received or are

receiving services, or parents, family member, guardians, advocates, or

authorized representative of such individuals;

2. Not more than \1/3\ of the membership of the governing board may

be appointed by the chief executive officers of the tribes involved, in

the case of any tribe in which such officer has the authority to

appoint the membership of the board; and

3. Any vacancy in the board shall be filled not later than 60 days

after the date on which the vacancy occurs.

Part V. Intergovernmental Review of Federal Programs

This program is covered by the State Plan Consolidation Section of

E.O. 12372, but is excluded from intergovernmental consultation review.

[[Page 20098]]

Part VI. The Application Process

A. Application Submission

To be considered as an applicant for an allotment, interested

Consortiums must submit an application to the Administration for

Children and Families at the address specified in the Program

Announcement. There is no application kit; the Consortium's

applications may be in a format chosen by the applicant. It must,

however contain resolutions from two or more tribes and be signed by an

individual authorized to act for the applicant and to assume

responsibility for the obligations imposed by the terms and conditions

of the grant award and contain the following:

1. The name and Employer Identification Number (EIN) of the agency

designated by the Tribes to implement the Protection and Advocacy

system.

2. The name address, and telephone number of the director of the

system or a contact person, if different from the director.

3. Assurances that:

a. One signed original and two copies of the application including

all attachments, have been submitted on or before June 8, 1995 to:

Administration on Developmental Disabilities, Administration for

Children and Families, Department of Health and Human Services, Room

329-D, HHH Building, 200 Independence Avenue SW., Washington, DC 20201,

Attn: 93.630-95-1 American Indian Consortium.

b. Not more than five percent of the total funds will be used for

monitoring the administration of the system.

4. Appropriate Certifications:

a. Non-Profit Status. Any non-profit organization submitting an

application must submit proof of its non-profit status in its

application at the time of submission. The non-profit agency can

accomplish this by providing a copy of the applicant's listing in the

Internal Revenue Service's (IRS) 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.

b. Applicants requesting financial assistance for a non-

construction project must file the Standard Form 424B, ``Assurances:

Non-Construction Programs.'' Applicants must sign and return the

Standard Form 424B with their applications.

c. Lobbying. Prior to receiving an award in excess of $100,000,

applicants shall furnish an executed copy of the lobbying

certification. Applicants must sign and return the certification with

their applications.

d. Compliance with the Drug-Free Workplace Act of 1988. By signing

and submitting the applications, applicants are providing the

certification and need not mail back the certification with the

applications.

c. Debarment, suspension or otherwise ineligible for award. By

signing and submitting the applications, applicants are providing the

certification and need not mail back the certification with the

applications. Copies of the certifications and assurance are located at

the end of this announcement.

d. Certification regarding environmental tobacco smoke. 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 children's

services and that all subgrantees shall certify accordingly.

B. Application Consideration

The Commissioner of the Administration on Developmental

Disabilities determines the final action to be taken with respect to

each application received under this announcement. The following points

should be taken into consideration by all applicants:

Incomplete applications and applications that do not

conform to this announcement will not be accepted for review.

Applicants will be notified in writing of any such determinations by

ADD.

The Commissioner's funding decision takes into account the

analysis of the application, recommendation and comments of the Federal

reviewing officials.

The Commissioner makes grant awards consistent with the

purpose of the Act, all relevant statutory and regulatory requirements,

this program announcement, and the availability of funds.

Part VII. Review Process and Criteria

Applications submitted by the closing date and verified by the

postmark under this program announcement will undergo a pre-review to

determine:

That the applicant is eligible in accordance with the

definition of an American Indian Consortium in Part II; and

That the application forms and materials submitted are

adequate to allow an indepth evaluation (all required materials and

forms are included in this announcement)

Competing application from Consortiums will be reviewed and

evaluated against the following criteria.

A. Objectives and Priorities (60 points)

The applicant's description of objectives and priorities to be

established. Information provided in response to the items under Part

IV of this announcement ``Specific Responsibilities of the Applicant''

will be used to review and evaluate applications.

B. Approach (40 points)

The applicants description of the system's operations/approach

toward accomplishing the objectives and priorities. Evidence of the

applicant's ability to manage a P&A System is well defined.

Part VII. Paperwork Reduction Act

Under the Paperwork Reduction Act of 1980, Pub. L. 96-511, the

Department is required to submit to the Office of Management and Budget

(OMB) for review and approval any reporting and recordkeeping

requirements in regulations including program announcements. This

program announcement does not contain information collection

requirement beyond those approved for ADD.

Part VIII. Receipt of Applications

Applications shall be considered as meeting an announced deadline

if they are either:

1. Received on or before the deadline date at the Office specified

in this announcement; or

2. Sent on or before the deadline date and received by ACF in time

for the review. (Applicants are cautioned to request a legibly dated

U.S. Postal Service postmark or to obtain a legibly dated receipt from

a commercial carrier of U.S. Postal Services. Private metered postmarks

shall not be acceptable as proof of timely mailing).

A. Late Applications

Applications which do not meet the criteria stated above are

considered late applications. ACF/ADD shall notify each late applicant

that its application will not be considered in the competition.

B. Extension of Deadlines

ACF may extend the deadline for all applicants due to acts of God,

such as floods, hurricanes or earthquakes; or [[Page 20099]] when there

is a widespread disruption of the mails. However, if the granting

agency does not extend the deadline for all applicants, it may not

waive or extend the deadline for any applicant.

C. Effective Date

We anticipate that successful applications shall be funded no later

than June 30, 1995.

(Catalog of Federal Domestic Assistance Program Number 93.630

Developmental Disabilities--Protection and Advocacy Program)

Dated: April 17, 1995.

Bob Williams,

Commissioner, Administration on Developmental Disabilities.

Attachment A--Assurances--Non-Construction Programs

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 CFR 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. Secs. 1601-6107), 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 nondiscrimination

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 for project purposes regardless of Federal participation in

purchases.

8. Will comply 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. Sec. 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. Sec. 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.

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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Title

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Applicant Organization

Date Submitted--------------------------------------------------------

Attachment B--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:

(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 any

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, [[Page 20100]] 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.

State for Loan Guarantee 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

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[GRAPHIC][TIFF OMITTED]TN24AP95.000

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BILLING CODE 4484-01-C [[Page 20104]]

Attachment D--Certification Regarding Debarment, Suspension, and Other

Responsibility Matters-Primary Covered Transactions

By signing and submitting this proposal, the applicant, defined

as the primary participant in accordance with 45 CFR Part 76,

certifies to the best of its knowledge and believe that it and its

principals:

(a) are not presently debarred, suspended, proposed for

debarment, declared ineligible, or voluntarily excluded from covered

transactions by any Federal Department or agency;

(b) have not within a 3-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 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 3-year period preceding this application/

proposal had one or more public transactions (Federal, State, or

local) terminated for cause or default.

The inability of a person to provide the certification required

above will not necessarily result in denial of participation in this

covered transaction. If necessary, the prospective participant shall

submit an explanation of why it cannot provide the certification.

The certification or explanation will be considered in connection

with the Department of Health and Human Services (HHS) 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.

The prospective primary participant agrees that by submitting

this proposal, it will include the clause entitled ``Certification

Regarding Debarment, Suspension, Ineligibility, and Voluntary

Exclusion-Lower Tier Covered Transaction. ``provided below without

modification in all lower tier covered transactions and in all

solicitations for lower tier covered transactions.

Certificaiton Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion-Lower Tier Covered Transactions (To Be Supplied to

Lower Tier Participants)

By signing and submitting this lower tier proposal, the

prospective lower tier participant, as defined in 45 CFR Part 76,

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 from

participation in this transaction by any federal department or

agency.

(b) where the prospective lower tier participant is unable to

certify to any of the above, such prospective participant shall

attach an explanation to this proposal.

The prospective lower tier participant further agrees by

submitting this proposal that it will include this clause entitled

``certification Regarding Debarment, Suspension, Ineligibility,

Voluntary Exclusion-Lower Tier Covered Transactions. ``without

modification in all lower tier covered transactions and in all

solicitations for lower tier covered transactions.

Attachment E--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 facility owned or

leased or contracted for by an entity and used routinely or

regularly for the 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 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 children's services and that all subgrantees shall

certify accordingly.

[FR Doc. 95-10029 Filed 4-21-95; 8:45 am]

BILLING CODE 4184-01-P