Developmental Disabilities: Availability of Financial Assistance for Projects of National Significance for Fiscal Year 1996

SUMMARY: The Administration on Developmental Disabilities,

Administration for Children and Families, announces that applications

are being accepted for funding of Fiscal Year 1996 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 solicits applications for Fiscal Year 1996 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 an 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.

DATE: The closing date for submittal of applications under this

announcement is September 11, 1996.

ADDRESSES: Applications should be mailed to: Department of Health and

Human Services, ACF/Division of Discretionary Grants, Sixth Floor, 370

L'Enfant Promenade SW, Washington, DC 20447, Attn: 93.631 ADD--Projects

of National Significance.

Applications handcarried by applicants, applicant couriers, 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., at the U.S. Department of

Health and Human Services, Administration for Children and Families,

Division of Discretionary Grants, ACF Mailroom, 2nd Floor Loading Dock,

Aerospace Center, 901 D Street, S.W., Washington, D.C. 20024, between

Monday and Friday (excluding weekends and Federal holidays). Any

applications received after 4:30 p.m. on the deadline date will not be

considered for competition. 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.)

FOR FURTHER INFORMATION CONTACT: Adele Gorelick, Program Development

Division, Administration on Developmental Disabilities, (202) 690-5982.

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.

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

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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 individual

rights;

Grants to University Affiliated Programs for

interdisciplinary training, exemplary services, technical assistance,

and information dissemination; and

Grants for Projects of National Significance.

C. Statutory Authorities Covered Under This Announcement

The Developmental Disabilities Assistance and Bill of Rights Act of

1994, 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 1994, 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 1996 Proposed Priority Areas

The notice soliciting comments on the FY 1996 proposed priority

areas was published in the Federal Register on April 12, 1996 (60 FR

2760). 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 priority 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 105 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;

Private individuals; and

Foundations.

Comments ranged from requests for copies of the final application

solicitation, to general support, to substantive, insightful responses

for this year's proposed funding priority 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.

The comments helped highlight the concerns of the developmental

disabilities field and have been used in refining the final priority

area.

Comment: Twenty-two letters recommended additional funding

priorities for FY 1996. Suggestions included projects addressing: the

need for best practices in service delivery as related to direct care/

supports and the development of curriculum; inclusion activities in the

adult population that empower adults and family members; information on

the impact of creative arts experiences on children and adults with

developmental disabilities; effective models of community-based support

or community building; data collection and analysis on the employment

and economic status of adults with mental retardation who participate

in sheltered workshop programs; providing on-going support services to

individuals who don't need intensive services; the use of personal

futures planning with youths with developmental disabilities in

juvenile institutions; exploring inclusion within generic community

development; support to the rehabilitation, training, and service

delivery networks which serve children at-risk and with special needs;

exploring the applicability of the Baldridge principles to

Developmental Disabilities Councils; developing a system to identify

clinical guidelines/pathways/protocols appropriate to the long-term

health needs of persons with disabilities who receive medicaid managed

care services; collecting consumer input on major topics through

electronic town meetings; interdisciplinary training and coordination

of medical and educational professionals to promote early and accurate

diagnosis and treatment of individuals with learning disabilities;

consumers and families having access to information on services and

programs at

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the local, state, and federal levels; studying the characteristics of

successful systems change activities; studies on rare disorders and

orphan diseases; and pilot testing and further development of outcome

measures model for ADD's component programs.

Response: Inclusion and integration of individuals with

developmental disabilities is a key element in the mission and purpose

of ADD. ADD funding priorities have always required projects to be

implemented in an inclusive manner and inclusiveness is a thread that

runs through all facets of ADD.

The comments on the need for continued efforts to promote and

achieve inclusiveness whether in building bridges with generic

community resources, assisting those to return to their communities

after incarceration, or exploring total quality management principles

to improve our programs and services represent the gauges/measures that

indicate directions for change. Our commitment to inclusiveness is

reflected in ADD's existing PNS projects in child care, criminal

justice, first jobs and others.

Managed care is an emerging trend that is rapidly becoming the

major means to secure health care services for low-income, publicly

assisted individuals. ADD is very much aware of the issues and problems

encountered by people with developmental disabilities and their

families. We share the concerns of many people in the field of

developmental disabilities and will explore ways for ADD to play a role

in assisting States and others to ensure that managed care plans are

equitable and appropriate for all.

There were a few inquiries about the technical assistance projects

for the three developmental disabilities programs not being included in

this announcement. These contracts are not expiring this year; thus

they do not need to be competed.

ADD appreciates the suggestions for additional priority areas. It

is a valuable process that allows ADD to gain insight into the

strengths and weaknesses of programs and services at the community

level, and identify avenues to explore for improvement. These comments

are a reminder that the goals of independence, integration,

productivity, and integration of individuals with developmental

disabilities have not been fulfilled and that we must be vigilant in

their pursuit. We hope that the next fiscal year will allow us to offer

an array of project possibilities and at that time your suggestions for

new priority areas will be most helpful.

Comment: ADD received 83 comments on the Proposed Priority Area,

Ongoing Data Collection and Information Dissemination. There was strong

support for the data collection projects; especially the National Study

of Public Spending. Many letters cited the usefulness of the data in

comparing progress with other States; as a benchmark for measuring

effectiveness; in preparing legislative budget requests; and in

analyzing trends and project future needs and service costs. One

commenter noted, ``The current projects funded under this priority area

are essential to policy makers, state planning agencies, advocates,

educational institutions and service providers.'' Others stated that

the information isn't available from any other source, no one State or

organization has the capability to collect and assess such data, and

it's vital for developing of both State and national policy. A common

concern expressed by many was that the current effort to curtail

spending makes it more critical to keep track of where money is going

and how it's being used. Another reported that the ``Data is

particularly important as we try to address cultural competence and

service equity within our state.''

The need to develop employment models involving trends and analyses

that accurately predict employment outcomes of persons with

developmental disabilities was a suggested addition to the employment

data study. Systemic factors that both impede and motivate

organizations and agencies to restructure in order to provide

integrated employment should be studied.

Dissemination is a critical piece of these data collection projects

and the importance of making this information available and accessible

to a broader community via the internet or by some other means was

suggested as a focus for these projects. New data bases were suggested;

one that would study the use by young families of generic community

resources versus the existing special delivery system; another on the

outcomes experienced by individuals with disabilities who receive

publicly funded residential services; and a third that would examine

the impact of managed care and changes in Federal-State partnerships.

The comprehensiveness and comparability of the data bases to capture

such information as the environments where people receive services and

how much is spent per person served and how one State compares with

other States was expressed as a needed change.

Response: ADD was very pleased to receive such positive comments

about its three data collection projects. At this time when we are

moving toward outcome measurements that indicate impact and quality we

can look toward the work of these projects as examples. Yet we know we

must continue striving to improve the lives of persons with

developmental disabilities and their families; your suggestions have

given ADD ideas for doing so.

Because the Internet has enormous potential for accessing and

sharing information, we would expect these projects, along with newly

funded PNS initiatives, to explore this and other forms of effective,

accessible, and affordable communication and technical assistance to

those who may have an interest.

Part III. The Review Process

A. Eligible Applicants

Before applications 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 from eligible applicants received by the

deadline date

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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 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.

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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 that do not comply with the specific

priority area requirements in the section on ``Eligible Applicants''

will not be reviewed.

Applicants 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 1996, 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 continued funding would be in the best interest of

the Government.

F. Grantee Share of Project Costs

Grantees must provide at least 25% 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).

Applications originating from American Samoa, Guam, the Virgin

Islands, and the Commonwealth of the Northern Mariana Islands are

exempted from the grantee cost-sharing requirements. Applications from

these jurisdictions are covered under Section 501(d) of Public Law 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 1996 Priority Area for Projects of National

Significance--Description and Requirements

The following section presents the final priority area for Fiscal

Year 1996 Projects of National Significance (PNS) and solicits the

appropriate applications.

Fiscal Year 1996 Priority Area: Ongoing Data Collection and

Information Dissemination

Eligible Applicants: State agencies, public or private

nonprofit organizations, institutions or agencies.

Purpose: Under this priority area, ADD will award grant

funds through a cooperative agreement which will collect data on public

expenditures, employment and economic status, residential services, and

other factors as they impact the independence, productivity,

integration and inclusion into the community of persons with

developmental disabilities. ADD is particularly interested in the

maximum use of existing data bases and in fostering the broadest

dissemination to, and use of, the data by consumers, families and

advocacy audiences. Examples of successful projects that ADD has funded

include:

University of Minnesota: National Recurring Data Set Project on

Residential Services--Ongoing National and State-by-State Data

Collection and Policy/Impact Analysis on Residential Services for

Persons with Developmental Disabilities (Charles Lakin: 612/624-2097)

University of Illinois at Chicago: Fourth National Study of Public

Mental Retardation/Developmental Disabilities Spending (David Braddock:

312/413-1647)

Boston Children's Hospital: Ongoing National Collection on Data and

Employment Services for Citizens with Developmental Disabilities (Bill

Kiernan: 617/735-6506)

Examples of projects include activities which would:

Identify, collect and disseminate new data bases.

Modify, expand and/or reformulate existing data bases.

Connect, integrate or analyze available data bases.

Project and model the cost-benefit impact of alternative

future decisions based on the analysis of discrete programmatic options

in the areas of residential services and employment.

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Allow for the comprehensiveness and comparability of data

bases.

Minimum Requirements for Project Design: Given its

interest in promoting the increased independence, productivity,

integration and inclusion of people with developmental disabilities in

a cost-beneficial manner, ADD is open to applications that address

additional quantitative and qualitative analysis in the following

areas:

Trends in the movement of people with developmental

disabilities from institutional to community settings (especially

domiciles of their own) and the outcomes experienced by individuals

with disabilities who receive publicly funded residential services.

The impact of managed care plans on the delivery and

efficacy of residential and support services to individuals with

developmental disabilities, and on the relationship between Federal and

State governments.

The efficacy of various approaches to the full inclusion

of people with developmental disabilities in local community activities

where the majority of participants do not have a disability.

The employment status of people with developmental

disabilities on a state and national basis.

Employment models that accurately predict employment

outcomes of persons with developmental disabilities, and the systemic

factors that lead to integrated employment.

The use of generic community resources versus the existing

special delivery system by people with developmental disabilities and

their families.

Any sampling techniques used as part of this analysis should be

broadly representative of persons with developmental disabilities of

employment age on a national basis, including people with severe

disabilities. Quantitative data should provide statistical information

on current placement patterns and their cost as well as projections

regarding future placement options and associated costs. It is also

recognized that certain areas may be more appropriate for qualitative

analysis, although a summary of any quantitative data (if available)

should be included in the proposal.

All projects funded under this priority area must provide evidence

of the soundness of their proposed research methods and analytic

techniques. In addition, proposals should clearly delineate (via a

comprehensive literature review) existing data sets, how these data

sets will be incorporated into the research design, and what new

knowledge will be gained through the proposed project.

All projects shall provide for the widespread distribution of their

products (reports, summary documents, audio-visual materials, and the

like) in accessible formats to a national audience consisting of, at a

minimum, people with developmental disabilities and their families,

advocacy groups, State Developmental Disabilities Councils, Protection

and Advocacy Systems, University Affiliated Programs, State Mental

Retardation/ Developmental Disabilities Directors, State Governor's

Offices, Federal agencies represented on the Interagency Committee on

Developmental Disabilities, as well as the Secretaries of Health and

Human Services and Education at the federal level.

Applications should also include provisions for the travel of two

key personnel during the first and last years of the project to

Washington, DC for a one-day meeting with ADD staff.

The application must also respond to the following:

Describe the physical setting, the administrative and

organizational structure within which the program will function, and

internal and external organizational relationships relevant to this

project. Include charts outlining these relationships, and any formal

agreements defining them in the appendices.

Describe staff, space, equipment, research facilities, and

other supports available to carry out the project.

Describe briefly how the additional resources sought to

accomplish the purposes of this effort will be integrated into, and

augmented by, other resources available to, or accessible by, the

applicant.

Develop and implement an evaluation process to ensure that

systematic, objective information is available about the utilization

and effectiveness of the products of this project. Specific outcomes

must be built into the project for evaluation. The evaluation should be

performed by an independent evaluator.

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 developing and implementing the project's agenda as

described below.

Under the cooperative agreement mechanism, ADD and the awardees

will share responsibility for planning the objectives of the projects.

Awardees will have the primary responsibility for developing and

implementing the activities of the project. ADD will jointly

participate with awardees in such activities as: clarifying the

specific issue areas to be addressed through periodic briefings and

ongoing consultation; sharing with awardees its knowledge of the issues

addressed by past and current projects; and providing feedback to

awardees about the usefulness to the field of written products and

information sharing activities. Details of the relationship between ADD

and awardees will be set forth in the cooperative agreement to be

developed and signed prior to issuance of the award.

Project Duration: This announcement solicits applications

for project periods up to three years. 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 maximum Federal share

is not to exceed $200,000 for the first 12-month budget period or a

maximum of $600,000 for a 3-year project period.

Matching Requirement: The minimum non-Federal matching

requirement in proportion to the maximum Federal share of $600,000 is

$200,000 for a 3-year project period. This constitutes 25 percent of

the total project budget.

Anticipated Number of Projects to be Funded: It is

anticipated that at least three data collection projects will be

funded.

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.

[[Page 41902]]

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

All applications under the ADD priority areas are required to

follow the Executive Order (E.O.) 12372 process, ``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.

All States and territories, except Alaska, Colorado, Connecticut,

Hawaii, Idaho, Kansas, Louisiana, Massachusetts, Minnesota, Montana,

Nebraska, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee,

Virginia, Washington, American Samoa and Palau, have elected to

participate in the Executive Order process and have established a State

Single Point of Contact (SPOC). Applicants from these 19 jurisdictions

need take no action regarding E.O. 12372. Applications for projects to

be administered by Federally-recognized Indian Tribes are also exempt

from the requirements of E.O. 12372. Otherwise, applicants should

contact their SPOCs as soon as possible to alert them of the

prospective applications and receive any necessary instructions.

Applicants must submit all required materials to the SPOC as soon

as possible so that the program office can obtain and review SPOC

comments as part of the award process. It is imperative that the

applicant submit all required materials and indicate the date of this

submittal (or date SPOC was contacted, if no submittal is required) on

the SF 424, item 16a.

Under 45 CFR 100.8(a), a SPOC has 60 days from the application due

date to comment on proposed new or competing continuation awards.

However, there is insufficient time to allow for a complete SPOC

comment period. Therefore under 45 CFR 100.8(a), we have reduced the

comment period to 45 days from the closing date for applications. These

comments are reviewed as part of the award process. Failure to notify

the SPOC can result in delays in awarding grants.

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 ACF, they should be

addressed to: Department of Health and Human Services, Administration

for Children and Families, Division of Discretionary Grants, Sixth

Floor, 370 L'Enfant Promenade, SW, Washington, DC 20447, Attn: 93.631

ADD--Projects of National Significance.

Contact information for each State's SPOC is found 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. Deadline for Submittal of Applications

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,

Administration for Children and Families, Division of Discretionary

Grants, 370 L'Enfant Promenade, S.W., Mail Stop 6C-462, Washington,

D.C. 20447, Attention: Application for [insert Program Name].

Applicants are responsible for mailing applications well in advance,

when using all mail services, to ensure that the applications are

received on or before the deadline time and date. Applications

handcarried by applicants, applicant couriers, 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., at the U.S. Department of Health and Human

Services, Administration for Children and Families, Division of

Discretionary Grants, ACF Mailroom, 2nd Floor Loading Dock, Aerospace

Center, 901 D Street, S.W., Washington, D.C. 20024, between Monday and

Friday (excluding weekends and Federal holidays). Any applications

received after 4:30 p.m. on the deadline date will not be considered

for competition. 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.)

ACF cannot accommodate transmission of applications by fax or

through other electronic media. Therefore, applications transmitted to

ACF electronically will not be accepted regardless of date or time of

submission and time of receipt.

Late applications: Applications which do not meet the criterion

stated above are considered late applications. ACF/ADD shall notify

each late applicant that its application will not be considered in the

current competition.

Extension of deadlines: ACF may extend the deadline for all

applicants because of acts of God such as floods, hurricanes, etc., or

when there is a widespread disruption of the mails. However, if ACF

does not extend the deadline for all applicants, it may not waive or

extend the deadline for any applicants.

D. 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 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. An application 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.

[[Page 41903]]

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 of ADD's priority areas, 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.

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 17 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

[[Page 41904]]

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, including

Federally recognized Indian Tribes, ``equipment'' is tangible, non-

expendable personal property having a useful life of more than one year

and acquisition cost of $5,000 or more per unit.

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.

(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.

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.'' In-kind

contributions are defined in title 45 of the Code of Federal

Regulations, Parts 74.51 and 92.24, as ``property or services which

benefit a grant- supported project or program and which are contributed

by non-Federal third parties without charge to the grantee, the

subgrantee, or a cost-type contractor under the grant or subgrant.''

[[Page 41905]]

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. 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 are required to file an SF 424B, Assurances--Non-

Construction Programs and the Certification Regarding Lobbying. Both

must be signed and returned with the application. Applicants must also

provide certifications regarding: (1) Drug-Free Workplace Requirements;

and (2) Debarment and Other Responsibilities. These two certifications

are self-explanatory. Copies of these assurances/certifications are

reprinted at the end of this announcement and should be reproduced, as

necessary. A duly authorized representative of the applicant

organization must certify that the applicant is in compliance with

these assurances/certifications. A signature on the SF 424 indicates

compliance with the Drug Free Workplace Requirements, and Debarment and

Other Responsibilities certifications, and need not be mailed back 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 (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.

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.

[[Page 41906]]

--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 of the Pro-Children Act of 1994; 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 3, 1996.

Bob Williams,

Commissioner, Administration on Developmental Disabilities.

Executive Order 12372--State Single Points of Contact

Alabama

John C. Strickland, Alabama Department of Economic and Community

Affairs, Planning and Economic Division, 401 Adams Avenue, Montgomery,

AL 36103-5690, Telephone: (205) 242-5483, FAX # (205) 242-5515.

Arizona

Janice Dunn, 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 & Research, 1400 Tenth

Street, Room 121, Sacramento, California 95814, Telephone (916) 323-

7480, FAX # (916) 323-3018.

Colorado

State Single Point of Contact, State Clearinghouse, Division of

Local Government, 1313 Sherman Street, Room 521, Denver, Colorado

80203, Telephone: (303) 866-2156, FAX # (303) 866-2251.

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

Rodney T. Hallman, 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

Suzanne Traub-Metlay, Florida State Clearinghouse,

Intergovernmental Affairs Policy Unit, Executive Office of the

Governor, The Capitol (Room 1603), Tallahassee, Florida 32399-0001,

Telephone: (904) 488-8114, FAX # (904) 488-9005.

Georgia

Charles H. Badger, Administrator, Georgia State Clearinghouse, 254

Washington Street, S.W., Room 401J, Atlanta, Georgia 30334, Telephone:

(404) 656-3855 or (404) 656-3829, FAX # (404) 656-7938.

Illinois

Steve Klokkenga, State Single Point of Contact, Office of the

Governor, 107 Stratton Building, Springfield, Illinois 62706,

Telephone: (217) 782-1671, FAX # (217) 782-6620.

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

Mr. Roland E. English III, Chief, State Clearinghouse for

Intergovernmental Assistance, Maryland Office of Planning, 301 W.

Preston Street, Room 1104, Baltimore, Maryland 21201-2365, Telephone:

(410) 225-4490, FAX # (410) 225-4480.

Michigan

Richard S. Pastula, Director, Office of Federal Grants, Michigan

Department of Commerce, P.O. Box 30225, Lansing, Michigan 48909,

Telephone: (517) 373-7356, FAX # (517) 373-6683.

Mississippi

Cathy Malette, Clearinghouse Officer, Office of Federal Grant

Management and Reporting, Department of Finance and Administration, 301

West Pearl Street,

[[Page 41907]]

Jackson, Mississippi 39203, Telephone: (601) 949-2174, FAX # (601) 949-

2125.

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 Jersey

Gregory W. Adkins, Director, Division of Community Resources, New

Jersey Department of Community Affairs.

Please direct all correspondence and questions about

intergovernmental review to: Andrew J. Jaskolka, State Review Process,

Division of Community Resources, CN 814, Room 609, Trenton, New Jersey

08625-0814, Telephone: (609) 292-9025, FAX # (609) 984-0386.

New Mexico

George Elliott, Deputy Director, 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

Daniel W. Varin, Associate Director, 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

Omeagia Burgess, State Single Point of Contact, Grant Services,

Office of the Governor, 1205 Pendleton Street, Room 477, Columbia,

South Carolina 29201, Telephone: (803) 734-0494, FAX # (803) 734-0385.

Texas

Tom Adams, Director, Intergovernmental Coordination, P.O. Box

13005, Austin, Texas 78711, Telephone: (512) 463-1771, FAX # (512) 463-

1984.

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.

Vermont

Nancy McAvoy, State Single Point of Contact, Pavilion Office

Building, 109 State Street, Montpelier, Vermont 05609, Telephone: (802)

828-3326, FAX # (802) 828-3339.

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

Martha Kerner, Section Chief, State/Federal Relations, Wisconsin

Department of Administration, 101 East Wilson Street, 6th Floor, P.O.

Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-2125, FAX #

(608) 267-6931.

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building,

4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone: (307) 777-

7574, FAX # (307) 638-8967.

Territories (SPOC)

Guam

Mr. Giovanni T. Sgambelluri, Director, Bureau of Budget and

Management Research, Office of the Governor, IP.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

State Single Point of Contact, Planning and Budget Office, Office

of the Governor, Saipan, CM, Northern Mariana Islands 96950.

Virgin Islands

Jose George, 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, 200 Interstate Park Dr., P.O. Box 3710,

Montgomery, Alabama 36193-5001, (205) 270-4680, 1-800-232-2158, FAX #

(205) 240-3195.

Alaska

David Maltman, Director, Govenor's Council on Disabilities, and

Special Education, P.O. Box 240249, Anchorage, Alaska 99524-0249, (907)

563-5355,FAX # (907) 563-5357.

Arizona

Diane Skay, Director, Governor's Council on Developmental,

Disabilities, 1717 West Jefferson Street, Site Code 074Z, Phoenix,

Arizona 85007, (602) 542-4049, FAX # (602) 542-5339.

Arkansas

Orson Berry, Executive Director, Governor's Developmental

Disabilities, Planning Council, 4815 West Markham, Slot 12, Little

Rock, Arkansas 72205-

[[Page 41908]]

3867, (501) 661-2589, FAX # (501) 661-2399.

California

Roberta A. Marlowe, Ph.D., Executive Director, CA State Council on

Developmental, Disabilities, 2000 ``O'' Street, Suite 100, Sacramento,

California 95814, (916) 322-8481, FAX # (916) 443-4957.

Colorado

Donald St. Louis, Executive Director, Colorado Developmental

Disabilities, Planning Council, 777 Grant Street, Suite 304, Denver,

Colorado 80203, (303) 894-2345, FAX # (303) 894-2880.

Connecticut

Edward T. Preneta, Director, CT Council on Developmental

Disabilities, 90 Pitkin Street, East Hartford, Connecticut 06108, (203)

725-3829, FAX # (203) 528-3680.

Delaware

James F. Linehan, Director, Developmental Disabilities Planning

Council, Department of Administrative Services, Box 1401, Townsend

Building, Dover, Delaware 19901, (302) 739-3333, FAX # (302) 739-6704.

District of Columbia

Carol Boykins, Executive Director, Developmental Disabilities,

State Planning Council, 801 N. Capitol St., N.E., Suite 954,

Washington, D.C. 20002, (202) 279-6085, FAX # (202) 727-6587.

Florida

K. Joseph Krieger, Executive Director, Florida Developmental

Disabilities Planning Council, 820 East Park Avenue, Suite I-100,

Tallahassee, Florida 32301, (904) 488-4180, FAX # (904) 922-6702.

Georgia

Zebe Schmitt, Executive Director, Governor's Council on

Developmental Disabilities, 2 Peachtree St. N.E., Room 3-210, Atlanta,

Georgia 30303, (404) 657-2126, FAX # (404) 657-2132, TDD 657-2133.

Hawaii

Diana Tizard, Director, State Planning Council on Developmental

Disabilities, Five Waterfront Plaza, 500 Ala Moana Boulevard, Suite 5-

200, Honolulu, Hawaii 96813, (808) 586-8100, FAX # (808) 586-8129.

Idaho

John D. Watts, Director, Idaho State Council on Developmental

Disabilities, 280 North 8th Street, Suite 208, Boise, Idaho 83720,

(208) 334-2178, FAX # (208) 334-3417, 800-544-2433 (Idaho only).

Illinois

Rene Christensen-Leininger, Director, Illinois Council on

Developmental Disabilities, 830 S. Spring Street, Springfield, IL

62704, (217) 782-9696, FAX # (217) 524-5339.

Indiana

Ms. Suellen Jackson-Boner, Director, Governor's Planning Council

for People with Disabilities, 143 W. Market Street, Harrison Building,

Suite 404, Indianapolis, Indiana 46204, (317) 232-7770/3. FAX # (317)

233-3712.

Iowa

Mr. Jay Brewer, Executive Director, Governor's Planning Council for

Developmental Disabilities, Hoover State Office Building, 1st Floor,

Des Moines, Iowa 50319, (515) 281-7632, FAX # (515) 281-4597.

Kansas

Ms. Jane Rhys, Executive Director, Kansas Planning Council on

Developmental Disabilities, 915 Harrison, Room 141, Topeka, Kansas

66612, (913) 296-2608/9, FAX # (913) 296-1158.

Kentucky

Prudence Reilly, Executive Director, Kentucky Developmental

Disabilities Planning Council, Department for Mental Health and Mental

Retardation Services, 275 East Main Street, Frankfort, Kentucky 40621,

(502) 564-7842, FAX # (502) 564-3844.

Louisiana

Clarice Eichelberger, Executive Director, Louisiana State Planning

Council on Developmental Disabilities, P.O. Box 3455 Ben 14, 1201

Capitol Access, 5th Floor, DOT Edition, East Entrance, Baton Rouge,

Louisiana 70821-3455, (504) 342-6804, FAX # (504) 342-4419.

Maine

Peter R. Stowell, Executive Director, Maine Developmental

Disabilities Council, Nash Building, Station #139, Augusta, Maine

04333-0139, (207) 287-4213, FAX # (207) 287-4268.

Maryland

Mindy Morrell, Executive Director, Maryland State Planning Council

on Developmental Disabilities, One Market Center, Box 10, 300 West

Lexington Street, Baltimore, Maryland 21201-2323, (410) 333-3688, FAX #

(401) 333-6674.

Massachusetts

Jody Williams, Executive Director, Massachusetts Developmental

Disabilities Council, 600 Washington Street, Room 670, Boston,

Massachusetts 02111, (617) 727-6374, FAX # (617) 727-1174, TDD 617 727-

1885.

Michigan

Ms. Sharon Tipton, Executive Director, Dept. of Mental Health,

Michigan DD Council, Lewis Cass Building, 6th Floor, Lansing, Michigan

48913, (517) 334-6123, 7240, FAX # (517) 334-7353.

Minnesota

Ms. Colleen Wieck, Ph.D., Executive Director, Governor's Planning

Council on Developmental Disabilities, 300 Centennial Office Building,

658 Cedar Street, St. Paul, Minnesota 55155, (612) 296-4018, FAX #

(612) 296-3698.

Mississippi

Ed C. Bell, Staff Director, Mississippi Developmental Disabilities

Planning Council, 1101 Robert E. Lee Building, Jackson, Mississippi

39201, (601) 359-6238, FAX # (601) 359-6295.

Missouri

Ms. Kay Conklin, Director, Missouri Planning Council for

Developmental Disabilities, P.O. Box 687, 1706 East Elm Street,

Jefferson City, Missouri 65102, (314) 751-8611, FAX # (314) 751-9207.

Montana

Greg A. Olsen, Executive Director, Developmental Disabilities

Planning and Advisory Council, 111 N. Last Chance Gulch, Arcade Bldg.,

Unit C, Box 526, Helena, Montana 59620, (406) 444-1334, FAX # (406)

444-5999.

Nebraska

Ms. Mary Gordon, Director, Dept. of Health/Developmental

Disabilities, 301 Centennial Mall South, P.O. Box 95007, Lincoln,

Nebraska 68509, (402) 471-2330, FAX # (402) 471-0383.

Nevada

Donny Loux, Director, DD Council, Dept. of Rehab., 711 S. Stewart,

Carson City, Nevada 89710, (702) 687-4440, FAX # (702) 687-5980.

New Hampshire

Thomas Flayton, (Acting) Executive Director, New Hampshire

Developmental Disabilities Council, The Concord Center, Room 315, P.O.

Box 315, 10 Ferry Street, Concord, New Hampshire 03301-5022, (603) 271-

3236,7,8, FAX # (603) 225-6766.

[[Page 41909]]

New Jersey

Ethan B. Ellis, Executive Director, NJ Developmental Disabilities

Planning Council, 32 W. State Street, CN 700, Trenton, New Jersey

08625-0700, (609) 292-3745, FAX # (609) 292-7114.

New Mexico

Chris Isengard, Executive Director, Developmental Disabilities

Planning Council, State of New Mexico, 435 St. Michael's Drive,

Building D, Santa Fe, New Mexico 87501, (505) 827-7590, FAX # (505)

827-7589.

New York

Isabel T. Mills, Executive Director, New York State Developmental

Disabilities Planning Council, 155 Washington Avenue, 2nd Floor,

Albany, New York 12210, (518) 432-8233, FAX # 518-432-8238.

North Carolina

Holly Riddle, Executive Director, North Carolina Council on

Developmental Disabilities, 1508 Western Blvd., Raleigh, North Carolina

27606-1359, (919) 733-6566, FAX # (919) 733-1863.

North Dakota

Tom Wallner, Director, North Dakota Council on, Developmental

Disabilities, c/o Department of Human Services, State Capitol, 600 E.

Boulevard Avenue, Bismarck, North Dakota 58505-0250, (701) 224-3219,

FAX # (701) 224-2359.

Ohio

Mr. Ken Campbell, Executive Director, Ohio Developmental

Disabilities Planning Council, Department of Mental Retardation/

Developmental Disabilities, 8 East Long Street, 6th Floor, Columbus,

Ohio 43266-0523, (614) 466-5205, FAX # (614) 466-0298.

Oklahoma

Ann Trudgeon, Director, Developmental Disabilities Planning

Council, Department of Human Services, P.O. Box 25352, Oklahoma City,

Oklahoma 73125-0352, (405) 521-4984(5), FAX # (405) 521-6684.

Oregon

Charlotte Duncan, Executive Director, Oregon Developmental

Disabilities, Planning Council, 540 24th Place NE, Salem, Oregon 97301-

4517, (503) 373-7555, FAX # (503) 373-7172.

Pennsylvania

David B. Schwartz, Executive Director, Developmental Disabilities

Planning Council, Forum Building, Room 569, Commonwealth Avenue,

Harrisburg, Pennsylvania 17120, (717) 787-6057.

Rhode Island

Marie V. Citrone, Executive Director, Rhode Island Developmental

Disabilities Council, State Executive Department, 600 New London

Avenue, Cranston, Rhode Island 02920-3028, (401) 464-3191, FAX # (401)

464-3570.

South Carolina

Charles Lang, Interim Executive Director, South Carolina

Developmental Disabilities Planning Council, Edgar Brown Building, Room

372, 1205 Pendleton Street, Columbia, South Carolina 29201-3731, (803)

734-0465, FAX # (803) 734-0356.

South Dakota

Charles A. Anderson, Director, South Dakota Governor's Planning

Council on Developmental Disabilities, Hillsview Plaza, c/o 500 East

Capitol, Pierre, South Dakota 57501-5070, (605) 77- 6415, FAX # (605)

773-5483.

Tennessee

Wanda Willis, Director, Developmental Disabilities Planning

Council, Department of Mental Health and Mental Retardation, 706 Church

Street, 3rd Floor, Doctor's Building, Nashville, Tennessee 37219-5393,

(615) 741-9791, FAX # (615) 741-0770.

Texas

Roger A. Webb, Executive Director, Texas Planning Council for

Developmental Disabilities, 4900 North Lamar Blvd., Austin, Texas

78751-2399, (512) 483-4080, FAX # (512) 483-4097.

Utah

Catherine E. Chambless, Director, Utah Governor's Council for

People with Disabilities, P.O. Box 1958, Salt Lake City, Utah 84110-

1958, (801) 533-4128, FAX # (801) 533-5302.

Vermont

Thomas A. Pombar, Executive Secretary, Vermont Developmental

Disabilities Council, Waterbury Office Complex, 103 South Main Street,

Waterbury, Vermont 05671-1534, (802) 241-2612, FAX # (802) 241-2979.

Virginia

Sandy Reen, Director, Virginia Board for People with Disabilities,

Post Office Box 613, Richmond, Virginia 23205-0613, (804) 786-0016, FAX

# (804) 786-1118.

Washington

Edward M. Holen, Executive Director, Developmental Disabilities

Planning Council, Department of Community Development, 906 Columbia

St., S.W., Post Office Box 48314, Olympia, Washington 98504-8314, (206)

753-3908, 1-800-634-4473, FAX # (206) 586-2424.

West Virginia

Julie Pratt, Director, West Virginia Developmental Disabilities

Planning Council, 1601 Kanawha Blvd., West, Suite 200, Charleston, West

Virginia 25312-2500, (304) 558-0416 (Voice), (304) 558-2376 (TDD), FAX

# (304) 558-0941.

Wisconsin

Ms. Jayn Wittenmyer, Executive Director, Council on Developmental

Disabilities, State of Wisconsin, 722 Williamson Street, P.O. Box 7851,

Madison, Wisconsin 53707-7851, (608) 266-7826, FAX # (608) 267-3906.

Wyoming

Sharron C. Kelsey, Executive Director, Governor's Planning Council

on Developmental Disabilities, 122 West 25th Street, Herschler Bldg.,

First Floor East, Cheyenne, Wyoming 82002, (307) 777-7230, 1-800-442-

4333 (in-state-only), FAX # (307) 777-5690.

Territories (DDCs)

American Samoa

Henry Sesepasara, Executive Director, American Samoa Developmental

Disabilities Council, P.O. Box 184, Pago Pago, American Samoa 96799,

(684) 633-2919, FAX # (684) 633-1139.

Commonwealth of the Northern Mariana Islands

Juanita S. Malone, CNMI DD Council, P.O. Box 2565, Saipan, MP

96950, (011) 670-323-3014/16, FAX # (011) 670-322-4168.

Government of Federated State of Micronesia

Yosiro Suta, Gov't of Federated States of Micronesia, Dept of Ed.,

Palikir, Pohnpei, FM 96941, (691) 320-2609, FAX # (691) 320-5500.

Guam

Frances Limitiaco Standing Soldier, Executive Director, Guam

Developmental Disabilities Council, 122 IT&E Plazza, Rm. 201, Harmon,

Guam 96911, (671) 646-9468, 9469, FAX # (671) 649-7672, TDD 671-649-

3911.

Northern Mariana Islands

Juanita S. Malone, Executive Director, Developmental Disabilities

Council, Department of Education, P. O. Box 2565, Saipan, CM 96950, W

(670) 322-3014, H (670) 322-1398.

[[Page 41910]]

Puerto Rico

Maria Luisa Mendia, Executive Director, Puerto Rico Developmental

Disabilities State Council, P.O. Box 9543, Santurce, Puerto Rico 00908,

(809) 722-0595 FAX # (809) 721-3622.

Virgin Islands

Mark Vinzant, Director, VI Developmental Disabilities Council, P.O.

Box 2671 Kings Hill, St. Croix, U.S. Virgin Islands 00850-9999, (809)

772-2133.

Western Carolina Islands (Trust Territories of the Pacific)

Minoru Ueki, MD, Trust Territory Health Council, MacDonald Memorial

Hospital KOROR, Palau. WCI 96940.

BILLING CODE 4184-01-P

[[Page 41911]]

[GRAPHIC] [TIFF OMITTED] TN12AU96.001

BILLING CODE 4184-01-C

[[Page 41912]]

Instructions for the SF 424

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.

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 disallowances, 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-M

[[Page 41913]]

[GRAPHIC] [TIFF OMITTED] TN12AU96.002

[[Page 41914]]

[GRAPHIC] [TIFF OMITTED] TN12AU96.003

BILLING CODE 4184-01-C

[[Page 41915]]

Instructions for the SF-424A

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 and 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 functions 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 on 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 Column (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 totals for all columns used.

Section B. Budget Categories

In the column heading (1) through (4), enter the titles of the same

programs, functions, and activities shown on 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 on Lines 6i and 6j. For all

applications for new grants and continuation grants the total mount 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 of 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) for 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.

[[Page 41916]]

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

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. Secs. 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 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 acquired 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-

[[Page 41917]]

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

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Date Submitted

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[[Page 41919]]

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BILLING CODE 4184-01-C

[[Page 41920]]

Attachment C

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 belief 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

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 indicated 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 Transactions'' provided below without modification in all

lower tier covered transactions and in all solicitations for lower tier

covered transactions.

Certification 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, and Voluntary

Exclusion--Lower Tier Covered Transactions'' without modification in

all lower tier covered transactions and in all solicitations for lower

tier covered transactions.

Attachment D

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, 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-M

[[Page 41921]]

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BILLING CODE 4184-01-C

[[Page 41922]]

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 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 children's services and that all subgrantees shall

certify accordingly.

[FR Doc. 96-20365 Filed 8-9-96; 8:45 am]

BILLING CODE 4184-01-M