[Federal Register Volume 60, Number 122 (Monday, June 26, 1995)]
[Notices]
[Pages 32964-32982]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-15585]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families


Changing the Culture of Welfare Demonstration

AGENCY: Administration for Children and Families, Department of Health 
and Human Services.

ACTION: Announcement of the availability of funds and request for 
applications to create and test various cultural change models for 
adoption by welfare offices throughout the nation.

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SUMMARY: The Administration for Children and Families (ACF) announces 
the availability of Federal funding to participate in intensive joint 
planning and development activities that would reinforce the concept of 
the temporary nature of welfare, and promote self-sufficiency and 
employment. Funding under this announcement is authorized by section 
1110 of the Social Security Act governing Social Services Research and 
Demonstration activities.

DATES: The closing date for submission of applications is August 25, 
1995.

ADDRESSES: Application receipt point: Department of Health and Human 
Services, Administration for Children and Families, Division of 
Discretionary Grants, 370 L'Enfant Promenade, S.W., 6th Floor, Mailstop 
6C-462 Washington, DC 20447, William McCarron, Grants Officer.
    Hand delivered applications are accepted during the normal working 
hours of 8:00 a.m. to 4:30 p.m., Monday through Friday, on or prior to 
the established closing date at: Administration for Children and 
Families, Division of Discretionary Grants, 6th Floor, ACF Guard 
Station, 901 D Street S.W., Washington DC 20447.

FOR FURTHER INFORMATION CONTACT: Yvonne C. Howard, Project Officer, 
Administration for Children and Families, Office of Family Assistance, 
370 L'Enfant Promenade, S.W., 5th Floor, Washington, DC 20447. 
Telephone (202) 401-4619.

[[Page 32965]] SUPPLEMENTARY INFORMATION: The Administration for 
Children and Families (ACF) announces that competing applications are 
being accepted for Federal financial assistance to participate in 
intensive joint planning and development activities that would 
reinforce the concept of the temporary nature of welfare, and promote 
self-sufficiency and employment. An initial financial award for 12 
months, for up to 8 sites will be made under this announcement. The 
Department will fund up to four (4) grantees who will be selected on a 
competitive basis to receive second year continuation grants for 
implementation of cultural change models. The recipients will be 
expected to enter into a cooperative agreement with ACF.
    This program announcement consists of four parts. Part I provides 
background information about the Changing the Culture of Welfare (CCW) 
demonstration. Part II describes the activities supported by this 
announcement and application requirements. Part III describes the 
application review process. Part IV provides information and 
instructions for the development and submission of applications. The 
forms to be used for submitting an application follow Part IV.

Part I--Introduction

    Current welfare reform proposals emphasize work, responsibility and 
the temporary nature of welfare. The focus of the Aid to Families with 
Dependent Children (AFDC) program is changing from providing benefits 
to preventing welfare dependency. There is growing consensus that AFDC 
benefits should be transitional, time-limited assistance, requiring a 
goal-oriented partnership between the welfare agency and the AFDC 
client. Such a partnership should be designed to help the client 
recognize the value of work and construct a plan to enter the job 
market and/or training to quickly achieve economic self-sufficiency.
    Welfare reform initiatives in the 1980s and 1990s exemplify States' 
efforts to seek alternative methods of reducing welfare dependency. 
Reform has primarily been sought through waivers of statutory 
provisions, seen as barriers to achieving economic independence. In the 
welfare debate, another emerging issue has been the need for a radical 
culture change in the welfare system and the methods of assistance 
provided to the AFDC families.

Part II--Project Design

Purpose

    The purpose of the demonstration project is to provide an 
opportunity for State/local IV-A agencies who: (1) want to design and 
implement cultural change strategies or (2) are already implementing 
cultural change strategies successfully but want to further expand 
their initiatives, to focus more strongly on work, and make the system 
more supportive of self-sufficiency efforts.
    State and local welfare agencies are on the front line of the 
needed culture change since change must begin where the client meets 
the worker. In focusing on what the client needs to become self-
sufficient, workers, supervisors, and administrators must view their 
jobs in a broader context. Workers must be empowered to participate in 
changing the culture of the welfare office and helping clients move 
from dependence to independence.
    This culture change may be achieved by a variety of different 
approaches, including changes in management style, staff training, 
performance measurement and changes to the AFDC and JOBS rules which 
are perceived to impede the transition from welfare dependency to 
economic self-sufficiency.
    Sites will need to create and test cultural change models and look 
at the impacts, costs, and benefits of their models. They will need to 
demonstrate how the model can be expanded and provide up-front delivery 
of services to promote employment opportunities and portray welfare as 
a transitional program.
    They will need to also demonstrate how the job of the AFDC worker 
has changed, or will change, from one of determining eligibility and 
payment accuracy to one of financial consultant/customer service agent. 
This role includes working with the client to explore options and 
alternatives to public assistance, resources available in the community 
to meet immediate client needs, demonstrating the financial benefits of 
employment vs. receipt of welfare, and marketing (employment 
opportunities to the client, and clients to potential employers) etc.

Eligible Applicants

    Financial assistance under this announcement is limited to State 
and local IV-A agencies. An applications from a local IV-A agency must 
be approved by the State IV-A agency.
    ACF is interested in providing financial support to IV-A agencies 
with experience in, or a demonstrated commitment to changing the 
culture of welfare. Examples of cultural change include:
    1. Training management and staff, as part of a overall process 
redesign geared toward employment and self-sufficiency, including 
customer relations training.
    2. Improving and modifying technology to support the line worker's 
ability to service clients.
    3. Implementing performance standards for evaluating staff with an 
emphasis on job placement standards as an important criteria.
    4. Establishing new criteria and incentives to reward staff 
participating in and promoting cultural change activities.
    5. Implementing a competency-based case management system.
    6. Reclassifying personnel positions to upgrade eligibility 
determination staff.
    7. Co-locating administrative and client service delivery staff 
working on AFDC and JOBS. Combining income maintenance and JOBS 
responsibilities in one worker.
    8. Implementing more intensive interventions to accommodate harder-
to-serve populations which would include individuals with learning 
disabilities and/or developmental disabilities.
    9. Establishing with educational institutions such as community 
colleges, training institutions and local employers, short term 
competency-based training programs linked to actual jobs.

Minimum Requirements for Project Design.

    In order to compete successfully in response to this announcement, 
the applicant should develop a plan which:
     Includes an outline and discussion of current, or planned 
culture change activities at the proposed demonstration sites. This 
outline should include a description of the specific features/
components and services that are involved with, or impacted by culture 
change activities, relevant demographics of the demonstration site, and 
the level of agency commitment and community collaboration.
     Describes how the applicant proposes to expand existing 
culture change strategies and how these strategies will involve a 
coordinated, integrated approach among, at minimum, AFDC/JOBS staff.
     Demonstrates how this model will increase the 
experiential/research information we now have of what AFDC clients need 
to become self-sufficient.
     Demonstrates how the model (or parts thereof) can be 
replicated in other localities. [[Page 32966]] 
     Includes methods for measuring the effects of the 
demonstration on AFDC/JOBS participants, e.g. increased participation, 
employment/earnings; reduced welfare dependency.
     Describes how a cost/benefit analysis will compare the 
direct and indirect costs with the financial and non-financial benefits 
of the program from the point of view of the participants; the 
government (Federal, State, and local); and the taxpayer.
     Includes the applicant's approach for providing assistance 
and training to State and county demonstration project staff, as 
needed.
     Provides information about other (State, local, community) 
resources the site will use to support this effort, including financial 
support (if any) for the demonstration, in addition to Federal funding.
     Provides for travel to Washington, DC (2 times) and one 
site visit to another project for up to three people.
    In recognition of the scope of the initiative, the potential 
difficulty in successfully implementing and operationalizing agency 
culture change, and the significance of the initiative for public 
policy, ACF has determined that a close, cooperative working 
relationship between the ACF and the selected States will greatly 
further the public interest. Therefore, the awards made under this 
announcement will be cooperative agreements between ACF and the 
selected State IV-A agencies. It is anticipated that ACF will be 
involved in the performance of the initiative in the following manner:
     ACF, working in cooperation with the State, will review 
and comment on the agency's cultural change strategies to ensure that 
the project meets specified goals and objectives.
     ACF will conduct site visits, teleconferences, and 
meetings, as appropriate, to provide technical assistance.
     ACF will facilitate information sharing and discussions 
across sites.
    The above-cited areas of involvement are illustrative of the 
anticipated level of Federal involvement with the selected States in 
the initiative. The exact activities will be detailed in the 
Cooperative Agreement which will be developed with each selected State.

Project Duration

    The length of the project should not exceed two years (24 months). 
This announcement is soliciting applications for two-year projects. 
Awards, on a competitive basis, will be for an initial one-year budget 
period for the design and planning of the project. Up to eight 
recipients of this initial award will compete among themselves for the 
four (4) continuation awards. Four awards for project implementation, 
beyond the one-year budget period but within the two-year project 
period will be entertained, subject to availability of funds, 
satisfactory progress of the recipient, and a determination that 
continued funding would be in the best interest of the Government.

Federal Share of the Project

    The maximum Federal share of the Project is not to exceed $1.8 
million for the two-year project period, subject to the availability of 
funds. The maximum Federal share for the first year budget period will 
be $400,000 divided among up to eight recipients. The maximum Federal 
share for the second year continuation grants will be $1.4 million 
divided among four recipients.

Matching Requirement

    Applicants must provide at least five (5) percent of the total 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 $50,000 in Federal funds must include a 
match of at least $2,632 (i.e., 5 percent of the sum of the Federal and 
the non-Federal cost of the project). The successful applicant's match 
must be met by the completion of the project period.
    The recipient will be required to provide the agreed upon non-
Federal share, even if it exceeds the required match stated above. 
Therefore, applicants should ensure that any amount proposed as 
matching funds is committed to the project prior to inclusion in its 
budget.

Anticipated Number of Projects to be Funded

    Up to eight projects will be funded under this announcement.

Part III--The Review Process

A. Review Process and Funding Decisions

    Timely applications from eligible applicants will be reviewed and 
scored competitively. Reviewers will use the evaluation criteria listed 
below to review and score the application.
    In addition ACF may refer applications to other Federal or non-
Federal funding sources when it is determined to be in the best 
interest of the Federal Government or the applicant. It may also 
solicit comments from ACF Regional Office staff, other Federal 
agencies, interested foundations and national organizations. These 
comments along with those of the reviewers will be considered by ACF in 
making the funding decision.
    In making a funding decision, ACF may give preference to 
applications which reflect experience in working with the cultural 
change strategies since such experience on the part of a recipient has 
the potential to substantially improve the development of a culture 
change model.

B. Evaluation Criteria

    Using the evaluation criteria below, reviewers will review and 
score each application. Applicants should insure that they address each 
minimum requirement listed above.
    Reviewers will determine the strengths and weaknesses of each 
application in terms of the appropriate evaluation criteria listed 
below, provide comments, and assign numerical scores. The point value 
following each criterion heading indicates the maximum numerical weight 
that each criterion may be given in the review process.

Review Criteria

(1) Knowledge of Changing the Culture of Welfare (25 points)
    The applicant's proposal should demonstrate a good understanding of 
the project design and the tasks and objectives involved in the 
project. The application should provide: (a) evidence of organizational 
experience in changing the culture of welfare and/or (b) evidence of 
commitment to planning and implementing agency cultural change 
activities. The discussion should also reflect a clear understanding of 
``culture'' change and the current emphasis on work and responsibility 
and transitional benefits.
(2) Approach and Project Design (30 points)
    The application should include: (a) an outline of the project 
design which takes into account specific features the applicant wishes 
to address, the objectives, component(s) and services that will be 
impacted by the culture change strategies; (b) a description of how the 
applicant will involve agency staff (AFDC and JOBS) in the planning 
process, which staff (front-line worker/management etc.), and the level 
of staff involvement; and (c) the applicant's approach for providing 
assistance and training to agency staff to enable their full 
participation in the planning process. [[Page 32967]] 
(3) Public--Private Partnerships (15 points)
    In order to maximize the potential resources of the community to 
provide options and alternatives to the public welfare system, the 
applicant should provide evidence of coordination and commitments by 
public, private, non-profit, community organizations and businesses to 
support changing the culture of welfare.
(4) Methodology (5 points)
    The application should describe proposed methodology for measuring 
the effects of the planned demonstration on AFDC/JOBS participants and 
the extent to which the experiential/research knowledge will be 
increased.
(5) Staff Skills and Responsibilities (20 points)
    It has been our experience that in order for demonstrations of this 
scope to be successful, the support and commitment of the 
administrators at the highest levels of the agency are necessary. 
Demonstrations such as this are under tight time constraints and 
require innovation and flexibility. For example, it may be necessary 
from time to time to provide exceptions to normal administrative 
processes or to establish expedited processes. Thus the support and 
commitment of senior official to accomplish the many tasks involved is 
critical. The application should discuss this issue and indicate the 
level of commitment to the demonstration which is proposed. The 
application should list key individuals who will work on the project 
along with a short description of the nature of their contribution. 
Summarize the background and experience of the project director and key 
project staff.
(6) Budget Appropriateness (5 points)
    The application should demonstrate that the project's costs are 
reasonable in view of the anticipated results and benefits. Applicants 
may refer to the budget information presented in the Standard Forms 424 
and 424A.

Part IV--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 as part of this announcement along with a checklist for 
assembling an application package.

A. Required Notification of the State Single Point of Contact

    This program announcement is covered under Executive Order 12372, 
Intergovernmental Review of Federal Programs, and 45 CFR Part 100, 
Intergovernmental Review of Department of Health and Human Services 
Program and Activities. Under the Order, States may design their own 
processes for reviewing and commenting on proposed Federal assistance 
under covered programs.
    All States and Territories except Alabama, Alaska, Colorado, 
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana, 
Nebraska, Oklahoma, Oregon, Virginia, Pennsylvania, South Dakota, 
Washington, American Samoa and Palau have elected to participate in the 
Executive Order process and have established Single Points of Contact 
(SPOCs), listed at the end of this announcement. Applicants from these 
nineteen jurisdictions need take no action regarding E.O. 12372. 
Applicants 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 any required material to the SPOCs 
as soon as possible so that the program office can obtain and review 
SPOC comments as part of the award process. It is imperative that the 
applicant submit all required materials, if any, to the SPOC and 
indicate the date of this submittal (or the date of contact if no 
submittal is required) on the Standard Form 424, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
deadline to comment on proposed new or competing continuation awards. 
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, 370 
L'Enfant Promenade, S.W., 6th Floor, Mailstop 6C-462, Washington, D.C. 
20447.
    Refer to the beginning of this announcement under the heading 
ADDRESSES, for hand delivered applications.

B. Deadline for Submittal of Applications

    The closing date for submittal of applications under this program 
announcement is found at the beginning of this announcement under the 
heading DATES. Applications shall be considered as meeting the 
announced deadline if they are either:
    1. Received on or before the deadline date at the receipt point 
specified in this program announcement, or
    2. Sent on or before the deadline date and received by ACF in time 
for the independent review. Applicants are cautioned to request a 
legibly dated receipt from a commercial carrier or U.S. Postal Service. 
Private metered postmarks shall not be acceptable as proof of timely 
mailing.
    Late Applications: Applications which do not meet the criteria in 1 
and 2 above are considered late applications. ACF 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 widespread disruption of mails. However, if ACF does not 
extend the deadline for all applicants, it will not extend the deadline 
for any applicants.

C. Instructions for Preparing the Application

    In order to assist applicants in completing the application, the 
Standard Forms 424 and 424A, required certifications, and a list of 
SPOCs have been included at the end of Part IV of this announcement. 
Please reproduce single-sided copies of these forms from the reprinted 
forms and type your information onto the copies.
    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.
    Item 1. Type of Submission--Non-Construction.
    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. 
[[Page 32968]] 
    Item 5. Applicant Information.
    Legal Name--Enter the legal name of applicant organization. For 
applications developed jointly, enter the name of the lead organization 
only. There must be a single applicant for each application.
    Organizational Unit--Enter the name of the primary unit within the 
applicant organization which will actually carry out the project 
activity. 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 and 
telephone number of a person who can respond to questions about the 
application. This person should be accessible at the address given.
    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--New.
    Item 9. Name of Federal Agency--DHHS/ACF.
    Item 10. Catalog of Federal Domestic Assistance Number--93.647.
    Item 11. Descriptive Title of Applicant's Project--Changing the 
Culture of Welfare.
    Item 12. Areas Affected by Project--Leave Blank.
    Item 13. Proposed Project--Enter the desired start date for the 
project and projected completion date. The project period must begin no 
later than September 30, 1995.
    Item 14. Congressional District of Applicant/Project--Enter the 
number of the Congressional district where the applicant's principal 
office is located.
    Items 15. Estimated Funding Levels--In completing 15a through 15f, 
the dollar amounts entered should reflect the total amount requested 
for the first 12-month budget period.
    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 available under this announcement for the first 12-month 
budget period.
    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.
    Item 15f. Enter the estimated amount of 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 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?--Check Yes if your State participates in the E.O. 12372 
process. Enter the date the application was made available to the State 
for review. 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.
    Item 16b. Is Application Subject to Review By State Executive Order 
12372 Process?--Check No if the program has not been selected by 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, and E are to be completed. Sections D and F do not 
need to be completed.
    Section A--Budget Summary. Line 1:

Column (a): Enter Changing the Culture of Welfare;
Column (b): Enter 93.647.
Columns (c) and (d): Leave blank.
Columns (e), (f) and (g): Enter the appropriate amounts needed to 
support the project for the first budget period.

    Section B--Budget Categories. This budget should include the 
Federal as well as non-Federal funding for the proposed project for the 
first 12-month budget period. The budget 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 items, as indicated below. The types of information to be 
included in the justification are indicated under each category. 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 staff, if known, specify. 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.
    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 grants governed by the administrative 
requirements of 45 CFR part 74, equipment means an article of 
[[Page 32969]] nonexpendable tangible personal property having an 
acquisition cost of $5000 or more per unit and a useful life of more 
than one year. For grants governed by the administrative requirements 
of 45 CFR part 92, equipment is tangible, nonexpendable personal 
property having a useful life of more than one year and an 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 procurement contracts (except those which belong on other 
lines such as equipment, supplies, etc.) and contracts with secondary 
recipient organizations. Also include any contracts with organizations 
for the provision of technical assistance. Do not include payments to 
individuals on this line.
    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. 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.
    Justification: Enclose a copy of the indirect cost rate agreement, 
if applicable.
    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. On 
lines 8-11, list estimates for each projected budget period within the 
total project period (if an additional line is needed, use line 23 and 
label it appropriately). Enter total amounts on line 12.
    In-kind contributions are defined in title 45 of the Code of 
Federal Regulations, Part 74.2., as the value of non-cash contributions 
provided by non-Federal third parties. Third party in-kind 
contributions may be in the form of real property, equipment, supplies 
and other expendable property, and the value of goods and services 
directly benefiting and specifically identifiable to the project or 
program.
    Justification: Describe third party in-kind contributions, if 
included.
    Section D--Forecasted Cash Needs. Not applicable.
    Section E--Budget Estimate of Federal Funds Needed For Balance of 
the Project. On lines 16-19, list estimates for Federal assistance 
required for future budget periods within the total project period. 
List estimated total amounts on line 20.
    Section F--Other Budget Information. Not applicable.
3. Program Narrative Statement
    The Program Narrative Statement should be clear, concise, and 
address the specific requirements mentioned under Part II. The 
narrative should also provide information concerning how the 
application meets the evaluation criteria using the following headings:
    (a) Knowledge of Changing the Culture of Welfare;
    (b) Approach and Project Design;
    (c) Public-Private Partnerships;
    (d) Methodology;
    (e) Staff Skills and Responsibilities;
    (f) Budget Appropriateness.
    The specific information to be included under each of these 
headings is described in section B of Part III--Evaluation Criteria.
    The narrative should be typed double-spaced. All pages of the 
narrative (including charts, references, footnotes, tables, maps, 
exhibits, etc.) must be sequentially numbered, beginning with 
Organizational Experience. The length of the application, including the 
application forms and all attachments, should not exceed 125 pages.
4. 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. In addition, 
applicants must certify their compliance with: (1) Drug-Free Workplace 
Requirements; and (2) Debarment and Other Responsibilities. These 
certifications are self-explanatory. Copies of these assurances and 
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 and certifications. A signature on the SF 424 
indicates compliance with Drug-Free Workplace and Debarment notices and 
Public Law 103-227, Part C--Environmental Tobacco Smoke, also known as 
the Pro-Children Act of 1994. [[Page 32970]] 

D. Checklist for a Complete Application

    The checklist below is for your use to ensure that your application 
package has been properly prepared.

--One original application, signed and dated, plus two copies.
--Complete application length should not exceed 125 pages.
--A complete application consists of the following items in this order:

     Application for Federal Assistance (SF 424);
     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);
     Budget Justification for SF 424A Section B--Budget 
Categories;
     Letter from the Internal Revenue Service to prove 
nonprofit status, if necessary;
     Copy of the applicant's approved indirect cost rate 
agreement, if appropriate;
     Program Narrative Statement (See Part III, Section C);
     Assurances--Non-construction programs (SF 424B); and
     Certification Regarding Lobbying.

E. Submitting the Application
    Each application package must include an original and two copies of 
the complete application. Each copy should be stapled securely. All 
pages of the narrative (including charts, tables, maps, exhibits, etc.) 
must be sequentially numbered. In order to facilitate handling, please 
do not use covers, binders, or tabs.
    Applicant should include a self-addressed, stamped acknowledgment 
card. All applicants will be notified automatically about the receipt 
of their application.

Catalog of Federal Domestic Assistance 93.647.

    Dated: May 22, 1995.
Lavinia Limon,
Director, Office of Family Assistance.

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BILLING CODE 4184-01-C
[[Page 32972]] 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.

Item and Entry:

    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State if 
applicable) and 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.)

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BILLING CODE 4184-01-C
[[Page 32975]] 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 under Column (a) 
the catalog program title and the catalog number in Column (b).
    For applications pertaining to a single program requiring budget 
amounts by multiple 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 Columns (c) and (d) the estimated amounts of funds 
which will remain unobligated at the end of the grant funding period 
only if the Federal grantor agency instructions provide for this. 
Otherwise, leave these columns blank. Enter in columns (e) and (f) 
the amounts of funds needed for the upcoming period. The amount(s) 
in Column (g) should be the sum of amounts in Columns (e) and (f).
    For supplemental grants and changes to existing grants, do not 
use Columns (c) and (d). Enter in Column (e) the amount of the 
increase or decrease of Federal funds and enter in Column (f) the 
amount of the increase or decrease of non-Federal funds. In Column 
(g) enter the new total budgeted amount (Federal and non-Federal) 
which includes the total previous authorized budgeted amounts plus 
or minus, as appropriate, the amounts shown in Columns (e) and (f). 
The amounts(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 headings (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 amount 
in column (5), Line 6k, should be the same as the total amount shown 
in Section A, Column (g), Line 5. For supplemental grants and 
changes to grants, the total amount of the increase or decrease as 
shown in Columns (1)-(4), Line 6k should be the same as the sum of 
the amounts in Section A, Columns (e) and (f) on Line 5.
    Line 7--Enter the estimated amount of income, if any, expected 
to be generated from this project. Do not add or subtract this 
amount from the total project amount. Show under the program 
narrative statement the nature and source of income. The estimated 
amount of program income may be considered by the federal grantor 
agency in determining the total amount of the grant.

Section C. Non-Federal-Resources

    Lines 8-11--Enter amounts of non-Federal resources that will be 
used on the grant. If in-kind contributions are included provide a 
brief explanation on a separate sheet.

    Column (a)--Enter the program titles identical to Column (a), 
Section A. A breakdown by function or activity is not necessary.
    Column (b)--Enter the contribution to be made by the applicant.
    Column (c)--Enter the amount of the State's cash and in-kind 
contribution if the applicant is not a State or State agency. 
Applicants which are a State or State agencies should leave this 
column blank.
    Column (d)--Enter the amount of cash and in kind contributions 
to be made from all other sources.
    Column (e)--Enter totals 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

    Line 16-19--Enter in Column (a) the same grant program titles 
shown in Column (a), Section A. A breakdown by function or activity 
is not necessary. For new applications and continuation grant 
applications, enter in the proper columns amounts of Federal funds 
which will be needed to complete the program or project over the 
succeeding funding periods (usually in years). This section need not 
be completed for revisions (amendments, changes, or supplements) to 
funds for the current year of existing grants.
    If more than four lines are needed to list the program titles, 
submit additional schedules as necessary.
    Line 20--Enter the total for each of the Columns (b)-(e). When 
additional schedules are prepared for this Section, annotate 
accordingly and show the overall totals on this line.

Section F. Other Budget Information

    Line 21--Use this space to explain amounts for individual direct 
object-class cost categories that may appear to be out of the 
ordinary or to explain the details as required by the Federal 
grantor agency.
    Line 22--Enter the type of indirect rate (provisional, 
predetermined, final or fixed) that will be in effect during the 
funding period, the estimated amount of the base to which the rate 
is applied, and the total indirect expense.
    Line 23--Provide any other explanations or comments deemed 
necessary.

Assurances--Non-Construction Programs

    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 [[Page 32976]] accordance with 
generally accepted accounting standards or agency directive.
    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. 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 (2) U.S.C. 
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. 794), which prohibits discrimination on the basis 
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 
U.S.C. 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) 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. 3601 et seq.), 
as amended, relating to non-discrimination in the sale, rental or 
financing of housing; (i) any other nondiscrimination provisions in 
the specific statute(s) under which application for Federal 
assistance is being made; and (j) the requirements of any other 
nondiscrimination statute(s) which may apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the Uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
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. 276a to 276a-7), the Copeland Act (40 U.S.C. 
276c and 18 U.S.C. 874), and the Contract Work Hours and Safety 
Standards Act (40 U.S.C. 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 if $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 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. 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 Wild and Scenic Rivers Act of 1968 (16 
U.S.C. 1271 et seq.) related to protecting components or potential 
components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 470), EO 11593 (identification and protection of 
historic properties), and the Archaeological and Historic 
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
    14.Will comply with P.L. 93-348 regarding the protection of 
human subjects involved in research, development, and related 
activities supported by this award of assistance.
    15. Will comply with the Laboratory Animal Welfare Act of 1966 
(P.L. 89-544, as amended, 7 U.S.C 2131 et seq.) pertaining to the 
care, handling, and treatment of warm blooded animals held for 
research, teaching, or other activities supported by this award of 
assistance.
    16. Will comply with the Lead-Based Paint Poisoning Prevention 
Act (42 U.S.C. 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.
----------------------------------------------------------------------
Signature of Authorized Certifying Official

----------------------------------------------------------------------
Applicant Organization

----------------------------------------------------------------------
Title

----------------------------------------------------------------------
Date Submitted

Executive Order 12373--State Single Points of Contact

Arizona

Mrs. Janice Dunn, ATTN: Arizona State Clearinghouse, 3800 N. Central 
Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315

Arkansas

Tracie L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and 
Administration, P.O. Box 3278, Little Rock, Arkansas 72203, 
Telephone (501) 682-1074

California

Glenn Stober, Grants, Coordinator, Office of Planning and Research, 
1400 Tenth Street, Sacramento, California 95814, Telephone (916) 
323-7480

Delaware

Ms. Francine Booth, State Single Point of Contact, Executive 
Department, Thomas Collins Building, Dover, Delaware 19903, 
Telephone (302) 736-3326

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
Florida

Florida State Clearinghouse, Intergovernmental Affairs Policy Unit, 
Executive Office of the Governor, Office of Planning and Budgeting, 
The Capitol, Tallahassee, Florida 32399--0001, Telephone (904) 488-
8441

Georgia

Mr. Charles H. Badger, Administrator, Georgia State Clearinghouse, 
254 Washington Street, S.W., Atlanta, Georgia 30334, Telephone (404) 
656-3855

Illinois

Steve Klokkenga, State Single Point of Contact, Office of the 
Governor, 107 Stratton Building, Springfield, Illinois 62706, 
Telephone (217) 782-1671

Indiana

Jean S. Blackwell, Budget Director, State Budget Agency, 212 State 
House, Indianapolis, Indiana 46204, Telephone (317) 232-5610

Iowa

Mr. Steven R. McCann, Division of Community Progress, Iowa 
Department of Economic Development, 200 East Grand Avenue, Des 
Moines, Iowa 50309, Telephone (515) 281-3725 [[Page 32977]] 

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local 
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601, 
Telephone (502) 564-2382

Maine

Ms. Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone (207) 289-3261

Maryland

Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of 
State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
2365, Telephone (301) 225-4490

Massachusetts

Karen Arone, State Clearinghouse, Executive Office of Communities 
and Development, 100 Cambridge Street, Room 1803, Boston, 
Massachusetts 02202, Telephone (617) 727-7001

Michigan

Richard S. Pastula, Director, Michigan Department of Commerce, 
Lansing, Michigan 48909, Telephone (517) 373-7356

Mississippi

Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant 
Management and Reporting, 301 West Pearl Street, Jackson, 
Mississippi 39203, Telephone (601) 960-2174

Missouri

Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson 
City, Missouri 65102, Telephone (314) 751-4834

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron 
Sparks, Clearinghouse Coordinator

New Hampshire

Mr. 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

New Jersey

Gregory W. Adkins, Acting Director, Division of Community Resources, 
N.J. Department of Community Affairs, Trenton, New Jersey 08625-
0803, Telephone (609) 292-6613

    Please direct correspondence and questions to: Andrew J. 
Jaskolka, State Review Process, Division of Community Resources, CN 
814, Room 609, Trenton, New Jersey 08625-0803, Telephone (609) 292-
9025.
New Mexico

George Elliott, Deputy Director, State Budget Division, Room 190, 
Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone 
(505) 827-3640, FAX (505) 827-3006

New York

New York State Clearinghouse, Division of the Budget, State Capitol, 
Albany, New York 12224, Telephone (518) 474-1605

North Carolina

Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., 
N.C. State Clearinghouse, 116 W. Jones Street, Raleigh, North 
Carolina 27603-8003, Telephone (919) 733-7232

North Dakota

N.D. Single Point of Contact, Office of Intergovernmental 
Assistance, Office of Management and Budget, 600 East Boulevard 
Avenue, Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094

Ohio

Larry Weaver, State Single Point of Contact, State/Federal Funds 
Coordinator, State Clearinghouse, Office of Budget and Management, 
30 East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, 
Telephone (614) 466-0698

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
Department of Administration, Division of Planning, 265 Melrose 
Street, Providence, Rhode Island 02907, Telephone (401) 277-2656

    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

Tennessee

Mr. Charles Brown, State Single Point of Contact, State Planning 
Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville, 
Tennessee 37219, Telephone (615) 741-1676

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, P.O. Box 
12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, ATTN: 
Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, 
Telephone (801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy 
Research & Coordination, Pavilion Office Building, 109 State Street, 
Montpelier, Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West 
Virginia Development Office, Building #6, Room 553, Charleston, West 
Virginia 25305, Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department 
of Administration, 101 South Webster Street, P.O. Box 7864, Madison, 
Wisconsin 53707, Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building, 
4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-
7574
Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management 
Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96910, 
Telephone (671) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of 
the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning 
Board, Minillas Government Center, P.O. Box 41119, San Juan, Puerto 
Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41 
Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802.

    Please direct correspondence to: Linda Clarke, Telephone (809) 
774-0750.

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BILLING CODE 4184-01-C
[[Page 32980]] Certification Regarding Debarment, Suspension, and Other 
Responsibility Matters--Primary Covered Transactions

    By signing and submitting this proposal, the applicant, defined 
as the primary participant in accordance with 45 CFR Part 76, 
certifies to the best of its knowledge and believe that it and its 
principals:
    (a) are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded from covered 
transactions by any Federal Department or agency;
    (b) have not within a 3-year period preceding this proposal been 
convicted of or had a civil judgment rendered against them for 
commission of fraud or a criminal offense in connection with 
obtaining, attempting to obtain, or performing a public (Federal, 
State, or local) transaction or contract under a public transaction; 
violation of Federal or State antitrust statutes or commission of 
embezzlement, theft, forgery, bribery, falsification or destruction 
of records, making false statements, or receiving stolen property;
    (c) are not presently indicted or otherwise criminally or 
civilly charged by a governmental entity (Federal, State or local) 
with commission of any of the offenses enumerated in paragraph 
(1)(b) of this certification; and
    (d) have not within a 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or 
local) terminated for cause or default.
    The inability of a person to provide the certification required 
above will not necessarily result in denial of participation in this 
covered transaction. If necessary, the prospective participant shall 
submit an explanation of why it cannot provide the certification. 
The certification or explanation will be considered in connection 
with the Department of Health and Human Services (HHS) determination 
whether to enter into this transaction. However, failure of the 
prospective primary participant to furnish a certification or an 
explanation shall disqualify such person from participation in this 
transaction.
    The prospective primary participant agrees that by submitting 
this proposal, it will include the clause entitled ``Certification 
Regarding Debarment, Suspension, Ineligibility, and Voluntary 
Exclusion--Lower Tier Covered Transaction.'' provided below without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.
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.

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.

Statement for Loan Guarantees and Loan Insurance

    The undersigned states, to the best of his or her knowledge and 
belief, that:
    If any funds have been paid or will be paid to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with this 
commitment providing for the United States to insure or guarantee a 
loan, the undersigned shall complete and submit Standard Form-LLL, 
``Disclosure Form to Report Lobbying,'' in accordance with its 
instructions.
    Submission of this statement is a prerequisite for making or 
entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the required statement shall 
be subject to a civil penalty of not less than $10,000 and not more 
than $100,000 for each such failure.
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Date

BILLING CODE 4184-01-P

[[Page 32981]]

[GRAPHIC][TIFF OMITTED]TN26JN95.004



BILLING CODE 4184-01-C
[[Page 32982]] Certification Regarding Environmental Tobacco Smoke

    Public Law 103-227, Part C--Environmental Tobacco Smoke, also 
known as the Pro-Children Act of 1994 (Act), requires that smoking 
not be permitted in any portion of any indoor routinely owned or 
leased or contracted for by an entity and used routinely or 
regularly for provision of health, day care, education, or library 
services to children under the age of 18, if the services are funded 
by Federal programs either directly or through State or local 
governments, by Federal grant, contract, loan, or loan guarantee. 
The law does not apply to children's services provided in private 
residences, facilities funded solely by Medicare or Medicaid funds, 
and portions of facilities used for inpatient drug or alcohol 
treatment. Failure to comply with the provisions of the law may 
result in the imposition of a civil monetary penalty of up to $1000 
per day and/or the imposition of an administrative compliance order 
on the responsible entity.
    By signing and submitting this application the applicant/grantee 
certifies that it will comply with the requirements of the Act. The 
applicant/grantee further agrees that it will require the language 
of this certification be included in any subawards which contain 
provisions for the children's services and that all subgrantees 
shall certify accordingly.

[FR Doc. 95-15585 Filed 6-23-95; 8:45 am]
BILLING CODE 4184-01-P