[Federal Register Volume 60, Number 172 (Wednesday, September 6, 1995)]
[Notices]
[Pages 46283-46287]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-22054]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration on Aging
[Program Announcement 13655.911]


Grants to Indian Tribal Organizations for Supportive and 
Nutritional Services for Older Indians

AGENCY: Administration on Aging (AoA), OS, HHS.

ACTION: Announcement of availability of funds and opportunity to apply 
under the Older Americans Act, Title VI, Grants for Native Americans, 
Part A-Indian Program.

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SUMMARY: The Administration on Aging will accept applications for 
funding in Fiscal Year 1996 under the Older Americans Act, title VI, 
Grants for Native Americans, part A-Indian Program, from all current 
title VI, part A grantees, current grantees who wish to leave a 
consortium and apply as a new grantee, and eligible federally 
recognized Indian tribal organizations that are not now participating 
in title VI. Successful applications from new grantees will be funded 
if funds permit.

DATES: December 5, 1995.

ADDRESSES: See Appendix A.

FOR FURTHER INFORMATION CONTACT:
M. Yvonne Jackson, Ph.D., Office for American Indian, Alaskan Native, 
and Native Hawaiian Programs, Administration on Aging, Department of 
Health and Human Services, Wilbur J. Cohen Federal Building, Room 4257, 
330 Independence Avenue, SW, Washington, DC 20201, telephone (202) 619-
2713.

SUPPLEMENTARY INFORMATION:

1. Background and Program Purpose

    The Administration on Aging (AoA) is responsible for administering 
title VI, part A of the Older Americans Act, which provides for grants 
to Indian tribal organizations representing federally recognized Tribes 
for the provision of nutritional and supportive services to Indian 
elders.
    The 1978 Amendments to the Older Americans Act created title VI, 
Grants for Indian Tribal Organizations. The purpose of this title is to 
promote the delivery of supportive and nutritional services for Indian 
elders that are comparable to services provided under title III of the 
Older American Act. (Title III of the Older Americans Act, entitled 
``Grants for State and Community Programs on Aging'' is the nationwide 
program of supportive and nutritional services which serves persons 
over age 60 of all ethnic groups.)
    In the Older Americans Act Amendments of 1987, the name of title VI 
was changed to Grants for Native Americans, and part B--Native Hawaiian 
Programs--was added.
    Nutritional services and information and assistance services are 
required by the Act. Nutritional services include congregate meals and 
home-delivered meals. Supportive services include information and 
assistance, transportation, chore services, and other supportive 
services which contribute to the welfare of older Native Americans.

2. Eligibility of an Indian Tribal Organization or Indian Tribe To 
Receive a Grant

    To be eligible to receive a grant, a tribal organization or Indian 
tribe must meet the application requirements contained in sections 
612(a) and 612(b) of the Act, which are: ``(1) the tribal organization 
represents at least 50 individuals who are 60 years of age or older; 
and (2) the tribal organization demonstrates the ability to deliver 
supportive services, including nutritional services.'' For purposes of 
title VI, part A, the terms ``Indian tribe'' and ``tribal 
organization'' have the same meaning as in section 4 of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 450b).
    This announcement concerns all federally recognized Indian tribal 
organizations, those currently participating in title VI, part A 
individually or as members of a consortium and those that are not 
currently participating in title VI, part A.

3. Available Funds

    Distribution of funds among tribal organizations is subject to the 
availability of appropriations to carry out title VI, part A. As stated 
in section 614A(b) of the Act the amount of the grant made under this 
part to a tribal organization for fiscal year 1992 and for each 
subsequent fiscal year shall be not less than the amount of the grant 
made under this part to the tribal organization for fiscal year 1991 as 
stated under section 614A(a) of the Act. If the funds appropriated to 
carry out this part in a fiscal year subsequent to fiscal year 1991 
exceed the funds appropriated to carry out this part in fiscal year 
1991, then the amount of the grant (if any) made under this part to a 
tribal organization for the subsequent fiscal year shall be: (1) 
Increased by such amount as the Assistant Secretary considers to be 
appropriate, in addition to the amount of any increase required by 
subsection (a), so that the grant equals or more closely approaches the 
amount of the grant made under this part to the tribal organization for 
fiscal year 1980; or (2) an amount the Assistant Secretary considers to 
be sufficient if the tribal organization did not receive a grant under 
this part for either fiscal year 1980 or fiscal year 1991.
    Applications from current grantees who are a part of a consortium 
and wish to leave the consortium will be treated as new grant 
applications. Successful new grant applications for both current 
grantees who are leaving a consortium and tribal organizations who are 
not current grantees will be funded pending availability of additional 
funds.
    Information on typical grant levels in Fiscal Year 1994 is given 
below as a guide to POSSIBLE funding levels for Tribes representing the 
following documented numbers of Indian elders over age 60:

------------------------------------------------------------------------
                                                                Amounts 
Population range (No. of older Indians age 60 years and over,  of awards
           represented by the tribal organization)               in FY  
                                                                  1994  
------------------------------------------------------------------------
50 to 100....................................................    $49,000
101 to 200...................................................     56,000
201 to 300...................................................     64,500
301 to 400...................................................     73,000
401 to 500...................................................     81,600
501 to 1500..................................................     95,000
1501+........................................................    125,000
------------------------------------------------------------------------

4. Application Process

    Applicants should submit applications, describing their proposed 
plans for nutritional and supportive services for older Indians for 
project period April 1, 1996-March 31,1999, as described in section 5 
below, ``Content of the Application.''
    A three year project period was chosen in order to reduce the 
paperwork burden on the grantees. It is the intent of this agency to 
conduct on site monitoring at least once during the three year project 
period.
    The Program Performance and Financial Status reports, due on a 
semi-annual basis, will be reviewed for compliance with the program 
regulations. Failure to submit the required reports during the project 
period may result in loss of future funds and possibly termination of 
the grant within the project period.
    Thirty days prior to the end of each budget period within the three 
year project period grantees shall notify AoA 

[[Page 46284]]
as to their desire to continue as a grantee. Failure to submit this 
documentation within the required timeframe may result in loss of grant 
funding. At the beginning of each budget period within the three year 
project period grantees will be notified of the funding level for the 
subsequent year.
    One original application, signed by the principal official of the 
Tribe, and two copies of the complete application including all 
attachments must be submitted to the Administration on Aging, Grants 
Management Division, Margaret Tolson, Director, 330 Independence 
Avenue, SW., Washington, DC 20201. Incomplete applications will not be 
considered for funding.

5. Content of the Application

    The application must meet the criteria in sections 614(a) and (b) 
of the Act, and title 45 of the Code of Federal Regulations, 
Sec. 1326.19. The application may be presented in any format selected 
by the tribal organization. Contact the AoA Regional Office in your 
geographic area if you have questions concerning the content of the 
application. The application must include the following information:

A. Objectives and Need for Assistance
    This section must include objectives, expressed in measurable 
terms, which are related to the current supportive and nutrition 
service needs of the elders to be represented by the Tribal 
Organization. This section must also include a discussion of how the 
needs were evaluated.

B. Results or Benefits Expected

    The application should describe the results or benefits expected 
from each service proposed.

C. Approach

(1) Description and Method of Delivery of Each Service
    (a) Nutrition. Nutrition services are required. There should be a 
description of the methods, facilities, and staff to be used in 
preparing, serving, and delivering meals, and the estimated number of 
persons to be served. The nutrition services provided, either directly 
or by way of a grant or contract, must be substantially in compliance 
with the provisions of part C, title III, which include:
    1. Provide at least one hot or other appropriate meal a day, 5 or 
more days a week in a congregate setting, and any additional meals 
which the recipient of a grant may elect to provide. A ``meal'', as 
used in section 307(a)(13), 308(b)(7), 311(a)(4), 331(1), 336, 
338(a)(1), and 339, 339A of the Act and Sec. 1321.17, Sec. 1321.59 and 
Sec. 1321.64, is a planned event in a day at which a variety of 
prepared foods are provided to an individual. These foods shall comply 
with the U.S. Dietary Guidelines for Americans published by the 
Secretary of the Department of Health and the Secretary of the 
Department of Agriculture and provide the nutrients specified in the 
current, daily Recommend Dietary Allowances, as established by the Food 
and Nutrition Board of the National Research Council of the National 
Academy of Sciences as specified in Section 339(2) unless the meal is a 
special meal provided to meet the health, religious, or ethnic 
considerations of eligible individuals. Snacks, partial meals, and 
second helpings are not considered meals.
    2. Provide at least one home delivered hot, cold, frozen, dried, 
canned, or supplemental food (with a satisfactory storage life) meal 
per day, 5 or more days a week, and any additional meals which the 
recipient of a grant may elect to provide. The above definition of a 
meal also applies here. Thus, neither individual grocery items nor food 
vouchers may not be used in lieu of home delivered meals.
    If no title VI, part A funds are to be used for nutrition services, 
the application must state how such services are provided in other 
ways, and how they are financed.
    (b) Information and Assistance. Information and assistance services 
are required. They must be available for older Indians living in the 
title VI part A service area and there should be a description of what 
information and assistance services will be provided and how they will 
be provided. The estimated number of individuals to be served should be 
stated. If no title VI, part A funds are to be used for information and 
assistance services, the application must state how such services are 
provided in other ways, and how they are financed.
    (C) Other Supportive Services. The application must describe any 
other supportive services to be provided wholly or partly by title VI, 
part A funds. The description should include what supportive services 
will be provided and how they will be provided. The approximate number 
of persons to be served by each service should be stated.
    Legal assistance and ombudsman services may be provided, but are 
not required. However, if provided, they should be reported as 
``Supportive Services.''
    If a tribal organization elects to provide legal services, it must 
substantially comply with the requirements in title 45 of the Code of 
Federal Regulations Sec. 1321.71, and all legal assistance providers 
must comply fully with the requirements in Sec. 1321.71(d) through 
Sec. 1321.71(k).
    Transportation of persons to nutrition sites or other places is to 
be considered as a ``Supportive Service.''
    (D) Coordination with title III. The application should provide a 
description of how title VI and title III resources are to be 
coordinated within the title VI service area, including information and 
assistance service.
(2) Evaluation Criteria
    The application must discuss the criteria to be used to evaluate 
the results and successes of the program, based on the objective 
indicated in Item A above. It will also explain the methodology that 
will be used to determine if the needs identified and discussed are 
being met and if the results and benefits identified in Item B above 
are being achieved.

D. Geographic Location

    The application must include both a narrative description of the 
title VI, part A service area, and a map with the service area 
identified. The area to be served by title VI, part A must have clear 
geographic boundaries. If the geographic area overlaps with another 
current title VI, part A grantee or new applicant then coordination of 
services without duplication must be developed between the two 
applicants and clearly outlined in the application. This agreement must 
be signed by the principal official of both tribal organizations. A 
``Consortium Agreement'' is included in the attachments of this Federal 
Register announcement. There is no prohibition, however, on its 
overlapping with areas served by title III.

E. Additional Information

(1) Older Indians in the Title VI, Part A Service Area
    The law requires that a tribal organization must represent at least 
50 persons aged 60 years or over in order to be eligible for title VI 
funding. Therefore, the number of persons aged 60 or over living in the 
proposed title VI service area must be stated in the application. The 
tribal organization may use Bureau of Statistics population figures, or 
may develop its own population statistics, but they must be certified 
from the Bureau of Indian Affairs in order to establish eligibility. 
The amount of the grant is based on this 

[[Page 46285]]
number of Indians or Alaskan Natives aged 60 years or over in the 
proposed service area. Thus, the application should include only the 
number of Indians and Alaskan Natives aged 60 years or over in the 
proposed service area and not the total population census of all tribal 
members, age 60 and above, if not all the tribal members live in the 
proposed service area. If there is overlap between two or more title 
VI, part A applicants, as stated under ``Geographic Location'', the 
eligible elders can only be counted once and included in one 
application. The applicants are responsible for determining how the 
eligible elders will be counted. The same elder may not be counted by 
both applicants. This must be stated clearly in the application and 
signed by the principal official of the tribal organization.
    As a separate matter, the regulations allow a Tribe to define, 
based on its own criteria, who the Tribe will consider to be an ``older 
Indian'' for purposes of eligibility to receive title VI services. If a 
Tribe selects a different definition of ``older Indian'' for service 
delivery, the application must state the age selected, and the number 
of Indians under age 60 eligible to be served. If more than one Tribe 
is included in the application, this information must be stated 
separately for each Tribe. All Tribes in a consortium must use the same 
age for ``older Indian.''
(2) Resolution
    The tribal organization representing a federally recognized Tribe 
must submit an original copy of the Tribal council resolution 
authorizing participation in title VI, part A. If the tribal 
organization represents a consortium of more than one Tribe, a 
resolution is required from each participating Tribe, specifically 
authorizing representation by the tribal organization for the purpose 
of title VI, part A of the Older Americans Act.
(3) Program Assurances
    Title VI, part A Program Assurances must be included in the 
application. The title VI, part A Program Assurances are those 
provisions identified in section 614(a) of the Older Americans Act, and 
in title 45 of the Code of Federal Regulations Sec. 1326.19(d), issued 
August 31, 1988 (see Appendix B). The tribal organization must state 
that it agrees to abide by all the provisions for the entire project 
period being applied for April 1, 1993-March 31, 1996.
    Copies of the title III and title VI current law and regulations, 
and of part 92, may be obtained from the Regional Program Director for 
the Administration on Aging. (See appendix A)
(4) Certification Forms
    Certifications are required of the applicant regarding (a) 
lobbying; (b) debarment, suspension, and other responsibility matters; 
and (c) drug-free workplace requirements. Please note that a duly 
authorized representative of the applicant organization must attest to 
the applicant's compliance with these certifications.
(5) Identifying Information
    Applications must identify both the principal official of the 
tribal organization, and the proposed title VI program director: Name, 
Title, Address including Zip Code, Telephone Number, and, if available, 
the FAX Number. The tribal organization's EIN (Employer Identification 
Number) must also be included.
    If the applicant tribal organization is a consortium, the applicant 
must list the federally recognized tribes which are included. A copy of 
each tribal resolution must be enclosed.

6. Closing Date for Application

    To be eligible for consideration, applications must be received or 
postmarked on or before December 5, 1995. (Applicants are cautioned to 
request a legibly dated U.S. Postal service postmark, or to obtain a 
legibly dated receipt from a commercial carrier or the U.S. Postal 
Service. Private metered postmarks are not acceptable as proof of 
timely mailing.)

7. Action on Applications

    Awards will be made by the Assistant Secretary on Aging Funding 
decisions will be announced as soon as possible.

    Catalog of Federal Domestic Assistance Program #93.655 Grants to 
Indian Tribes and Native Hawaiians. This Program Announcement is not 
subject to E.O. 12372.

    Dated: July 7, 1995.
Fernando M. Torres-Gil,
Assistant Secretary for Aging.
Appendix A

Regional Offices

Region 1 (CT, MA, ME, NH, RI, VT)

Thomas Hooker, Regional Administrator, John F. Kennedy Building, 
Room 2075, Boston, Massachusetts 02203, (617)565-1158, FAX (617)565-
4511

Region II (NY, NJ, PR, VI)

Judith Rackmill, Regional Administrator, 26 Federal Plaza, Room 38-
102, New York, New York 10278, (212)264-2976, FAX (212)264-0114

Region III (DC, MD, VA, DE, PA, WV)

Paul E. Ertel, Jr., Regional Administrator, 3535 Market Street, P.O. 
Box 13716-Stop 23, Philadelphia, Pennsylvania 19101, (215)596-6891, 
FAX (215)596-0614

Region IV (AL, FL, MS, SC, TN, NC, KY, GA)

Frank Nicholson, Regional Administrator, 101 Marietta Tower, Suite 
1702, Atlanta, Georgia 30323, (404)331-5900, FAX (404)331-2017

Region V (IL, IN, MI, MN, OH, WI)

Marion Mengert, Acting Regional Administrator, 105 West Adams 
Street, 10th Floor, Chicago, Illinois 60603, (312)353-3141, FAX 
(312)886-8533

Region VI (AR, LA, OK, NM, TX)

John Diaz, Regional Administrator, 1200 Main Tower Building, Room 
1000, Dallas, Texas 75202, (214)767-2971, FAX (214)767-2951

Region VII (IA, KS, MO, NE)

Larry Brewster, Regional Administrator, 1150 Grand Avenue, suite 
600, Kansas City, Missouri 64106, (816)374-6015, FAX (816)374-6024

Region VIII (CO, MT, UT, WY, ND, SD)

Percy Devine, Regional Administrator, 1961 Stout Street, Room 308, 
Federal Office Building, Denver, Colorado 80294, (303)844-2951, FAX 
(303)844-2943

Region IX (CA, NV, AZ, HI, GU, TTPI, CNMI, AS)

Frank Cardenas, Regional Administrator, 50 United Nations Plaza, 
Room 480, San Francisco, California 94102, (415)556-6003, FAX 
(415)556-7393

Region X (AK, ID, OR, WA)

Chisato Kawabori, Regional Administrator, Blanchard Plaza, RX-33; 
Room 1202, 2201 Sixth Avenue, Seattle, Washington 98121, (206)615-
2298, FAX (206)615-2305
Appendix B

    Older Americans Act--Section 614(a)--No grant may be made under 
this part unless the eligible tribal organization submits an 
application to the Assistant Secretary which meets such criteria as 
the Assistant Secretary may by regulation prescribe. Each such 
application shall--
    (1) Provide that the eligible tribal organization will evaluate 
the need for supportive and nutrition services among older Indians 
to be represented by the tribal organizations;
    (2) Provide for the use of such methods of administration as are 
necessary for the proper and efficient administration of the program 
to be assisted;
    (3) Provide that the tribal organization will make such reports 
in such form and containing such information, as the Assistant 
Secretary may reasonably require, and comply with such requirements 
as the Assistant Secretary may impose to assure the correctness of 
such reports;
    (4) Provide for periodic evaluation of activities and projects 
carried out under the application;
    (5) Establish objectives consistent with the purposes of this 
part toward which activities under the application will be directed, 
identify obstacles to the attainment of such objectives, and 
indicate the manner in which the tribal organization proposes to 
overcome such obstacles;
    (6) Provide for establishing and maintaining information and 
assistance 

[[Page 46286]]
services to assure that older Indians to be served by the assistance 
made available under this part will have reasonably convenient 
access to such services;
    (7) Provide a preference for Indians aged 60 and older for full 
or part-time staff positions whenever feasible;
    (8) Provide assistance that either directly or by way of grant 
or contact with appropriate entities nutrition services will be 
delivered to older Indians represented by the tribal organization 
substantially in compliance with the provisions of part C of title 
III, except that in any case in which the need for nutritional 
services for older Indians represented by the tribal organization is 
already met from other sources, the tribal organization may use the 
funds otherwise required to be expended under this clause for 
supportive services;
    (9) Contain assurance that the provision of sections 
307(a)(14)(A) (i) and (iii), 307(a)(14)(B), and 307(a)(14)(C) will 
be complied with whenever the application contains provisions for 
the acquisition, alteration, or renovation of facilities to serve as 
multipurpose senior centers;
    (10) Provide that any legal or ombudsman services made available 
to older Indians represented by the tribal organization will be 
substantially in compliance with the provisions of title III 
relating to the furnishing of similar services; and
    (11) Provide satisfactory assurance that fiscal control and fund 
accounting procedures will be adopted as may be necessary to assure 
proper disbursement of, and accounting for, Federal funds paid under 
this part to the tribal organization, including any funds paid by 
the tribal organization to a recipient of a grant or contract.
    45 CFR 1326.19 * * * The application shall provide that:
    (d) Assurances as prescribed by the Assistant Secretary that:
    (1) A tribal organization represents at least 50 individuals who 
have attained 60 years of age or older;
    (2) A tribal organization shall comply with all applicable State 
and local license and safety requirements for the provision of those 
services;
    (3) If a substantial number of the older Indians residing in the 
service area are of limited English-speaking ability, the tribal 
organization shall utilize the services of workers who are fluent in 
the language spoken by a predominant number of older Indians;
    (4) Procedures to ensure that all services under this part are 
provided without use of any means tests;
    (5) A tribal organization shall comply with all requirements set 
forth in Sec. 1326.7 through Sec. 1326.17; and
    (6) The services provided under this part will be coordinated, 
where applicable, with services provided under title III of the Act.
Consortium Agreement

    It is agreed by all participating Principal Officials that 
coordination of services, without duplication within a specified 
geographic area, has been developed between the two or more Tribal 
Organizations applying for this grant. The application and map of 
service area reflect this understanding.

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Signature and Date

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Title

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Tribal Organization

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Signature and Date

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Title

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Tribal Organization

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Signature and Date

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Title

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Tribal Organization

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Signature and Date

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Title

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Tribal Organization

(Additional pages for signatures may be added if needed.)

U.S. Department of Health and Human Services Certification Regarding 
Drug-Free Workplace Requirements--Grantees Other Than Individuals

    By signing and/or submitting this application or grant 
agreement, the grantee is providing the certification set out below.
    This certification is required by regulations implementing the 
Drug-Free Workplace Act Of 1988, 45 CFR Part 76, Subpart F. The 
regulations, published in the May 25, 1990 Federal Register, require 
certification by grantees that they will maintain a drug-free 
workplace. The certification set out below is a material 
representation of fact upon which reliance will be placed when the 
Department of Health and Human Services (HHS) determines to award 
the grant. If it is later determined that the grantee knowingly 
rendered a false certification, or otherwise violates the 
requirements of the Drug-Free Workplace Act, HHS, in addition to any 
other remedies available to the Federal Government, may take action 
authorized under the Drug-Free Workplace Act. False certification or 
violation of the certification shall be grounds for suspension of 
payments, suspension or termination of grants, or government wide 
suspension or debarment.
    Workplaces under grants, for grantees other than individuals, 
need not be identified on the certification. If known, they may be 
identified in the grant application. If the grantee does not 
identify the workplaces at the time of application, or upon award, 
if there is no application, the grantee must keep the identity of 
the workplace(s) on file in its office and make the information 
available for Federal inspection. Failure to identify all known 
workplaces constitutes a violation of the grantee's drug-free 
workplace requirements.
    Workplace identifications must include the actual address of 
buildings (or parts of buildings) or other sites where work under 
the grant takes place. Categorical descriptions may be used (e.g., 
all vehicles of a mass transit authority or State highway department 
while in operation, State employees in each local unemployment 
office, performers in concert halls or radio studies.)
    If the workplace identified to HHS changes during the 
performance of the grant, the grantee shall inform the agency of the 
change(s), if it previously identified the workplaces in question 
(see above).
    Definitions of terms in the Nonprocurement Suspension and 
Debarment common rule and Drug-Free Workplace common rule apply to 
this certification. Grantees' attention is called, in particular, to 
the following definitions from these rules:
    ``Controlled substance'' means a controlled substance in 
Schedules I through V of the Controlled Substances Act (21 U.S.C. 
812) and as further defined by regulation (21 CFR 1308.11 through 
1308.15).
    ``Conviction'' means a finding of guilt (including a plea of 
nolo contendere) or imposition of sentence, or both, by any judicial 
body charged with the responsibility to determine violations of the 
Federal or State criminal drug statutes;
    ``Criminal drug statute'' means a Federal or non-Federal 
criminal statute involving the manufacture, distribution, 
dispensing, use, or possession of any controlled substance;
    ``Employee'' means the employee of a grantee directly engaged in 
the performance of work under a grant, including (i) All ``direct 
charge'' employees; (ii) all ``indirect charge'' employees unless 
their impact or involvement is insignificant to the performance of 
the grant; and, (iii) temporary personnel and consultants who are 
directly engaged in the performance of work under the grant and who 
are on the grantee's payroll. This definition does not include 
workers not on the payroll of the grantee (e.g., volunteers, even if 
used to meet a matching requirement; consultants or independent 
contractors not on the grantee's payroll or employees of 
subrecipients or subcontractors in covered workplaces).
    The grantee certifies that it will or will continue to provide a 
drug-free workplace by:
    (a) Publishing a statement notifying employees that the unlawful 
manufacture, distribution, dispensing, possession or use of a 
controlled substance is prohibited in the grantee's workplace and 
specifying the actions that will be taken against employees for 
violation of such prohibition;
    (b) Establishing an ongoing drug-free awareness program to 
inform employees about:
    (1) The dangers of drug abuse in the workplace; (2) The 
grantee's policy of maintaining a drug-free workplace; (3) Any 
available drug counseling, rehabilitation, and employee assistance 
programs, and, (4) The penalties that may be imposed upon employees 
for drug abuse violations occurring in the workplace;
    (c) Making it a requirement that each employee to be engaged in 
the performance of the grant be given a copy of the statement 
required by paragraph (a);
    (d) Notifying the employee in the statement required by 
paragraph (a) that, as a condition 

[[Page 46287]]
of employment under the grant, the employee will:
    (1) Abide by the terms of the statement; and, (2) Notify the 
employer in writing of his or her conviction for a violation or a 
criminal drug statute occurring in the workplace no later than five 
calendar days after such conviction;
    (e) Notifying the agency in writing, within ten calendar days 
after receiving notice under subparagraph (d)(2) from an employee or 
otherwise receiving actual notice of such conviction. Employers of 
convicted employees must provide notice, including position title, 
of every grant officer or other designee on whose grant activity the 
convicted employee was working unless the Federal agency has 
designated a central point for the receipt of such notices. Notice 
shall include the identification number(s) of each affected grant;
    (f) Taking one of the following actions, within 30 calendar days 
of receiving notice under subparagraph (d)(2), with respect to any 
employee who is so convicted:
    (1) Taking appropriate personnel action against such an 
employee, up to and including termination, consistent with the 
requirements of the Rehabilitation Act of 1973, as amended; or, (2) 
Requiring such employee to participate satisfactorily in a drug 
abuse assistance or rehabilitation program approved for such 
purposes by a Federal, State, or local health, law enforcement, or 
other appropriate agency;
    (g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c), 
(d), (e) and (f).
    The grantee may insert in the space provided below the site(s) 
for the performance of work done in connection with the specific 
grant (Use attachments, if needed):

Place of Performance (Street address, City, County, State, ZIP Code)---
Check ______ if there are workplaces on file that are not identified 
here.
Sections 76.630 (c) and (d)(2) and 76.635 (a)(1) and (b) provide 
that a Federal agency may designate a central receipt point for 
STATE-WIDE AND STATE AGENCY-WIDE certifications, and for 
notification of criminal drug convictions. For the Department of 
Health and Human Services, the, central receipt point is: Division 
of Grants Management and Oversight, Office of Management and 
Acquisition, Department of Health and Human Services, Room 517-D, 
200 Independence Avenue, SW., Washington, DC 20201.

Signature--------------------------------------------------------------

Date-------------------------------------------------------------------

Title------------------------------------------------------------------

Organization-----------------------------------------------------------

DGMO Form #2 Revised May 1990
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 its 
principals involved:
    (a) are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded from covered 
transactions by any Federal department of agency;
    (b) have not within a 3-year period preceding this proposal been 
convicted of or had a civil judgement 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 government 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 for 
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 actions.

Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusions--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 participants 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 Exclusions--Lower Tier Covered Transactions'' without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Signature--------------------------------------------------------------

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Title------------------------------------------------------------------

Organization-----------------------------------------------------------

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 recipients 
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.

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Organization

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Authorized Signature  Title  Date

    Note: If Disclosure Forms are required, please contact: Mr. 
William Sexton, Deputy Director, Grants and Contracts Management 
Division, room 341F, HHH Building, 200 Independence Avenue, SW, 
Washington, D.C. 20201-0001.

[FR Doc. 95-22054 Filed 9-5-95; 8:45 am]
BILLING CODE 4130-01-M