[Federal Register Volume 78, Number 66 (Friday, April 5, 2013)]
[Notices]
[Pages 20648-20658]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-08027]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

[C.F.D.A. Number: 93.591]


Standing Funding Opportunity Announcement for Family Violence 
Prevention and Services/Grants to State Domestic Violence Coalitions

AGENCY: Family and Youth Services Bureau (FYSB), Administration on 
Children, Youth, and Families (ACYF), ACF.

ACTION: This notice was originally published as Funding Opportunity 
Number HHS-2013-ACF-ACYF-SDVC-0562 on March 5, 2013 at http://www.acf.hhs.gov/grants/open/foa/view/HHS-2013-ACF-ACYF-SDVC-0562.

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SUMMARY: This notice for family violence prevention and services grants 
to Coalitions serves four purposes: To confirm a Federal commitment to 
reducing family violence, domestic violence, and dating violence; to 
provide for Coalitions to collaborate and coordinate with States, 
tribes, localities, cities, and the private sector to be involved in 
State and local planning towards an integrated service delivery 
approach that meets the needs of all victims, including those in 
underserved communities and racial and ethnic minorities; to provide 
training and technical assistance to domestic violence programs and 
providers of direct services; and to increase public awareness about 
and prevention of family violence, domestic violence, and dating 
violence, and increase the quality and availability of immediate 
shelter and supportive services for victims of family violence, 
domestic violence, and dating violence, and their dependents.
    Statutory Authority: This announcement governs the proposed award 
of formula grants under the Family Violence Prevention and Services Act 
(FVPSA) to private, non-profit State Domestic Violence Coalitions 
(Coalitions). The purpose of these grants is to further the 
intervention and prevention of family violence, domestic violence, and 
dating violence (42 U.S.C. 10401, et seq.).

SUPPLEMENTARY INFORMATION:

I. Funding Opportunity Description

Description

Background
    The FVPSA authorizes the Department of Health and Human Services 
(HHS) Secretary to award grants to statewide, private, non-
governmental, 501(c)(3) non-profit Coalitions to conduct activities to 
promote domestic violence intervention and prevention.

Ensuring the Well-Being of Vulnerable Children and Families

    The Administration on Children, Youth and Families (ACYF) is 
committed to facilitating healing and recovery and promoting the social 
and emotional well-being of children, youth,

[[Page 20649]]

and families who have experienced maltreatment, exposure to violence, 
and/or trauma. This funding opportunity announcement (FOA) and other 
discretionary spending this fiscal year are designed to ensure that 
effective interventions are in place to build skills and capacities 
that contribute to the healthy, positive, and productive functioning of 
families.
    Children, youth, and families who have experienced maltreatment, 
exposure to violence, and/or trauma are impacted along several domains, 
each of which must be addressed in order to foster social and emotional 
well-being and promote healthy, positive functioning:
     Understanding Experiences: A fundamental aspect of the 
human experience is the development of a world view through which one's 
experiences are understood. Whether that perspective is generally 
positive or negative impacts how experiences are interpreted and 
integrated. For example, one is more likely to approach a challenge as 
a surmountable, temporary obstacle if his or her frame includes a sense 
that ``things will turn out alright.'' On the contrary, negative 
experiences can color how future experiences are understood. Ongoing 
exposure to family violence might lead children, youth, and adults to 
believe that relationships are generally hostile in nature and affect 
their ability to enter into and stay engaged in safe and healthy 
relationships. Interventions should seek to address how children, 
youth, and adults frame what has happened to them in the past and shape 
their beliefs about the future.
     Developmental Tasks: People grow physically and 
psychosocially along a fairly predictable course, encountering normal 
challenges and establishing competencies as they pass from one 
developmental stage to another. However, adverse events have a marked 
effect on the trajectory of normal social and emotional development, 
delaying the growth of certain capacities, and, in many cases, 
accelerating the maturation of others. Intervention strategies must be 
attuned to the developmental impact of negative experiences and address 
related strengths and deficits to ensure children, youth, and families 
develop along a healthy trajectory.
     Coping Strategies: The methods that children, youth, and 
families develop to manage challenges both large and small are learned 
in childhood, honed in adolescence, and practiced in adulthood. Those 
who have been presented with healthy stressors and opportunities to 
overcome them with appropriate encouragement and support are more 
likely to have an array of positive, productive coping strategies 
available to them as they go through life. For children, youth, and 
families who grew up in or currently live in unsafe, unpredictable 
environments, the coping strategies that may have been protective in 
the unsafe environments may not be appropriate for safer, more 
regulated situations. Interventions should help children, youth, and 
families transform maladaptive coping methods into healthier, more 
productive strategies.
     Protective Factors: A wealth of research has demonstrated 
that the presence of certain contextual factors (e.g., supportive 
relatives, involvement in after-school activities) and characteristics 
(e.g., self-esteem, relationship skills) can moderate the impacts of 
past and future negative experiences. These protective factors are 
fundamental to resilience; building them is integral to successful 
intervention with children, youth, and families.
    The skills and capacities in these areas support children, youth, 
and families as challenges, risks, and opportunities arise. In 
particular, each domain impacts the capacity of children, youth, and 
families to establish and maintain positive relationships with caring 
adults and supportive peers. The necessity of these relationships to 
social and emotional well-being and lifelong success in school, 
community, and at home cannot be overstated and should be central to 
all interventions with vulnerable children, youth, and families.
    An important component of promoting social and emotional well-being 
includes addressing the impact of trauma, which can have a profound 
effect on the overall functioning of children, youth, adults, and 
families. ACYF promotes a trauma-informed approach, which involves 
understanding and responding to the symptoms of chronic interpersonal 
trauma and traumatic stress across the domains outlined above, as well 
as the behavioral and mental health sequelae of trauma.
    ACYF anticipates a continued focus on social and emotional well-
being as a critical component of its overall mission to ensure positive 
outcomes for all children, youth, adults, and families.

Annual State Domestic Violence Coalition Grantee Meeting

    Coalitions must send up to two representatives to the annual 
grantee meeting. Subsequent correspondence will advise Coalitions of 
the date, time, and location of their grantee meeting.

Role of State Coalitions

    FVPSA directs Coalitions to work with family violence, domestic 
violence, and dating violence service programs and providers of direct 
services to encourage appropriate and comprehensive responses to family 
violence, domestic violence, and dating violence against adults or 
youth within the State involved, specifically including training and 
technical assistance and conducting State needs assessments (section 
10411(d)(1)). Coalitions are required to coordinate and collaborate 
with the State FVPSA Administrators, community-based programs, and 
culturally specific organizations, including those serving racial and 
ethnic minorities, to plan and conduct State needs assessments and 
participate in State planning processes. These assessments are 
particularly important, not just, to identify and assess service gaps, 
but to include a diversity of stakeholders in the planning and 
decision-making process for needs assessments and to inform State 
planning. Coalitions must also participate in the planning and 
monitoring of the distribution of FVPSA subgrants and contracts and the 
administration of the grant programs and projects awarded by the States 
to eligible entities (section 10411(d)(2)). Coalitions thus play an 
important role in helping programs develop and continue practices 
consistent with FVPSA guidance, including the promotion of trauma-
informed services that help facilitate the social and emotional well-
being of both victims and their children. Coalitions must include 
activities to ensure that programs maintain confidentiality and provide 
widely accessible services consistent with best practices in the field 
and applicable Federal, State, tribal, and local requirements, as well 
as helping programs comply with the FVPSA data collection and outcome 
measurement requirements. Each of these issues is described below:
a. Client Confidentiality
    Coalitions have an important role in helping programs develop and 
continue practices consistent with FVPSA guidance. Programs funded by 
FVPSA must establish and implement policies and protocols for 
maintaining the safety, privacy, and confidentiality of adult, youth, 
and child victims of family violence, domestic violence, and dating 
violence, and their families (section 10406(c)(5)). Because it is 
required that the confidentiality of individuals receiving FVPSA 
services be protected, Coalitions must include activities to

[[Page 20650]]

ensure that local programs maintain confidentiality consistent with 
best practices in the field and applicable Federal, State, tribal, and 
local requirements. It is also highly recommended that the Coalition 
coordinate and collaborate with the State involving activities to 
assist programs in maintaining confidentiality requirements pursuant to 
section 10406(c)(5).
    The FVPSA nondisclosure of confidential and private information 
provisions also mean that domestic violence programs must maintain 
confidentiality of records pertaining to any individual provided 
domestic violence services. As a result, individual identifiers in 
client records may not be disclosed when providing statistical data on 
program activities and program services. In the annual grantee 
Performance Progress Report (SF-PPR), States, tribes, and their 
subgrantees must collect unduplicated data for each program rather than 
unduplicated data across programs or statewide. No client-level data 
should be shared with a third party, regardless of encryption, hashing 
or other data security measures, without a written, time-limited 
release as described in section 10406(c)(5)(B)(ii).
b. Coordinated and Accessible Services
    It is essential that community service providers, including those 
serving or representing underserved communities, are involved in the 
design and improvements of intervention and prevention activities to 
ensure that services are welcoming and accessible. Coordination and 
collaboration among victim services providers; community-based, 
culturally specific, and faith-based services providers; housing and 
homeless services providers: and, Federal, State, tribal, and local 
public officials and agencies is needed to provide more responsive and 
effective services to victims of family violence, domestic violence, 
and dating violence, and their dependents. As coalitions undertake 
these activities, it is expected that the communities and populations 
noted above will be included in coalition boards, committees, and other 
activities to ensure they are part of the decision making to create and 
maintain fully coordinated and accessible services.
    To promote a more effective response to family violence, domestic 
violence, and dating violence, HHS requires the designated Coalitions 
receiving funds under this grant announcement to collaborate with 
tribes and tribal organizations, FVPSA-funded State grantees, service 
providers, and community-based organizations, to address the needs of 
family violence, domestic violence, and dating violence victims, and 
their dependents, who are members of racial and ethnic minority 
populations and underserved populations (section 10411(d)(3)); examples 
of such underserved populations include, but are not limited to, the 
Lesbian, Gay, Bisexual, and Transgender (LGBT) communities; 
adolescents; male victims; human trafficking victims; and immigrants. 
Coalition training and technical assistance priorities should focus on 
building the capacity of domestic violence programs within the State to 
provide inclusive and culturally relevant services for the underserved 
populations identified in their planning. All populations identified in 
planning should also be a part of determining the training and 
technical assistance priorities to improve the capacity of programs to 
serve such populations. ACYF/FYSB also strongly encourages Coalitions 
to consider the needs of LGBT youth and adults and how their 
programming and, therefore, the training and technical assistance 
provided member programs, will be inclusive and non-stigmatizing for 
program participants from these communities.
    To serve victims most in need and to comply with Federal law, 
services must be widely accessible. Services must not discriminate on 
the basis of age, disability, sex, race, color, national origin, or 
religion (section 10406(c)(2)). The HHS Office for Civil Rights 
provides guidance to grantees in complying with civil rights laws that 
prohibit discrimination on these bases. Please see www.hhs.gov/ocr/civilrights/understanding/index.html. HHS also provides guidance to 
recipients of Federal financial assistance on meeting the legal 
obligation to take reasonable steps to provide meaningful access to 
federally assisted programs by persons with limited English 
proficiency. Please see www.hhs.gov/ocr/civilrights/resources/laws/revisedlep.html. Additionally, HHS provides guidance regarding access 
to HHS-funded services for immigrant survivors of domestic violence. 
Please see www.hhs.gov/ocr/civilrights/resources/specialtopics/origin/domesticviolencefactsheet.html
    Services must also be provided on a voluntary basis; receipt of 
emergency shelter or housing must not be conditioned on participation 
in supportive services (section 10408(d) (2)).
c. Trauma-Informed Programming
    ACYF promotes a trauma-informed approach, which involves 
understanding and responding to the symptoms of chronic interpersonal 
trauma and traumatic stress across the lifespan. Coalitions are 
uniquely situated to provide support to domestic violence programs in 
order to ensure that trauma-informed interventions are at the core of 
working with victims and their children. As Coalitions plan their 
training and technical assistance priorities, they must include 
responses that help support trauma-informed services among their member 
programs to ensure positive outcomes for all service populations. 
Coalitions must also coordinate and collaborate with the Domestic 
Violence Resource Network (the FVPSA-funded National Resource, Special 
Issue Resource, and Culturally-Specific Resource Centers) to inform 
their knowledge and practices to promote trauma-informed interventions 
among their member programs.

II. Award Information

    Subject to the availability of Federal appropriations and as 
authorized by the FVPSA (section 10403), HHS will make available in FY 
2013, 2014, and 2015 grants to the designated, statewide, domestic 
violence Coalitions described in this announcement. Each year, one 
grant will be available for one Coalition in each of the 50 States, the 
Commonwealth of Puerto Rico, and the District of Columbia. One 
Coalition in each of the U.S. Territories (Guam, U.S. Virgin Islands, 
Northern Mariana Islands, and American Samoa) is also eligible for a 
grant award under this announcement.

Length of Project Periods

    Coalitions may apply for one grant annually with an accompanying 
12-month budget narrative and SF-424. The project period is 24 months 
under this FOA for each fiscal year. Coalitions must address their 
anticipated activities for a 2-year project period: (FY 2013) October 
1, 2012-September 30, 2014; (FY 2014) October 1, 2013-September 30, 
2015; (FY 2015) October 1, 2014-September 30, 2016. FVPSA will continue 
to disperse funds annually pursuant to annual applications and award 
processes.

Expenditure Period

    The FVPSA funds may be used for expenditures on or after October 1 
of each fiscal year for which they are granted and will be available 
for expenditure through September 30 of the following fiscal year; 
i.e., FY 2013 funds may be used for expenditures from October 1, 2012, 
through September 30, 2014; (FY 2014) October

[[Page 20651]]

1, 2013-September 30, 2015; (FY 2015) October 1, 2014-September 30, 
2016.

III. Eligibility Information

    In accordance with sections 10402(11) and 10411(c)(1), to be 
eligible for grants under this FOA an organization must be designated 
as a statewide, private, 501(c)(3) nonprofit, non-governmental domestic 
violence coalition as of the date of this announcement. A list of the 
designated State domestic violence coalitions is found in Appendix D. 
Designated coalitions must continue to meet the following criteria:
    The membership of the Coalition includes a majority of the primary-
purpose domestic violence service providers in the State (a Coalition 
may include representatives of Indian tribes and tribal organizations 
as defined in the Indian Self-Determination and Education Assistance 
Act). A primary-purpose domestic violence service provider is one that 
operates a project of demonstrated effectiveness, carried out by a 
nonprofit, nongovernmental, private entity or a tribe or tribal 
organization, that has as its project's primary purpose the operation 
of shelters for victims of domestic violence and their dependents; or 
provides counseling, advocacy, or self-help services to victims of 
domestic violence;
    The board membership of the Coalition is representative of the 
primary-purpose domestic violence service providers in the State and 
may include representatives of the communities in which the services 
are being provided in the State; in order for statewide needs 
assessments and other organizational and State planning to be fully 
informed directly by stakeholders from diverse communities, it is 
expected that the Coalition board will reflect the cultural, racial, 
and ethnic populations that the Coalition serves throughout the State;
    The purpose of the Coalition is to provide education, support, and 
technical assistance to the primary-purpose domestic violence service 
providers and providers of direct services in the State in order to 
establish and maintain shelter and supportive services for victims of 
domestic violence and their dependents;
    The Coalition serves as an information clearinghouse, primary point 
of contact, and resource center on domestic violence for the State and 
supports the development of policies, protocols, and procedures to 
enhance domestic violence intervention and prevention in the State.

Additional Information on Eligibility

DUNS Number Requirement
    Data Universal Numbering System (DUNS) Number is the nine-digit, or 
thirteen-digit (DUNS + 4), number established and assigned by Dun and 
Bradstreet, Inc. (D&B) to uniquely identify business entities.
    All applicants and sub-recipients must have a DUNS number at the 
time of application in order to be considered for a grant or 
cooperative agreement. A DUNS number is required whether an applicant 
is submitting a paper application or using the Government-wide 
electronic portal, www.Grants.gov. A DUNS number is required for every 
application for a new award or renewal/continuation of an award, 
including applications or plans under formula, entitlement, and block 
grant programs. A DUNS number may be acquired at no cost online at 
http://fedgov.dnb.com/webform. To acquire a DUNS number by phone, 
contact the D&B Government Customer Response Center:

U.S. and U.S. Virgin Islands: 1-866-705-5711
Alaska and Puerto Rico: 1-800-234-3867 (Select Option 2, then Option 1)
Monday-Friday 7 a.m. to 8 p.m., CST

    The process to request a DUNS Number by telephone will take between 
5 and 10 minutes.

SAM Requirement (www.Sam.gov)

    The System for Award Management (SAM) at www.sam.gov is a new 
system that consolidates the capabilities of a number of systems that 
support Federal procurement and award processes. Phase 1 of SAM 
includes the capabilities previously provided via Central Contractor 
Registration (CCR)/Federal Agency Registration (FedReg), Online 
Representations and Certifications Application (ORCA), and the Excluded 
Parties List System (EPLS).
    SAM is the Federal registrant database and repository into which an 
entity must provide information required for the conduct of business as 
a recipient. The former CCR Web site is no longer be available. All 
information previously held in the Central Contractor Registration 
(CCR) system has been migrated to SAM.gov.
    Applicants may register at www.sam.gov or by phone at 1-866-606-
8220. Registration assistance is available through the ``Help'' tab at 
www.sam.gov or by phone at 1-866-606-8220.
    Applicants are strongly encouraged to register at SAM well in 
advance of the application due date. Registration at SAM.gov must be 
updated annually.

    Note: It can take 24 hours or more for updates to registrations 
at SAM.gov to take effect. An entity's registration will become 
active after 3-5 days. Therefore, check for active registration well 
before the application due date and deadline. An applicant can view 
their registration status by visiting http://www.bpn.gov/CCRSearch/Search.aspx and searching by their organization's DUNS number.

    See the SAM Quick Guide for Grantees at https://www.sam.gov/sam/transcript/SAM_Quick_Guide_Grants_Registrations-v1.6.pdf.
    HHS requires all entities that plan to apply for, and ultimately 
receive, Federal grant funds from any HHS Agency, or receive subawards 
directly from recipients of those grant funds to:
     Be registered in at Sam.gov prior to submitting an 
application or plan;
     Maintain an active registration at www.sam.gov with 
current information at all times during which it has an active award or 
an application or plan under consideration by an HHS agency; and
     Provide its active DUNS number in each application or plan 
it submits to an HHS agency.
    ACF is prohibited from making an award to an applicant has not 
complied with these requirements. If, at the time an award is ready to 
be made, if the intended recipient has not complied with these 
requirements, ACF:
     May determine that the applicant is not qualified to 
receive an award; and
     May use that determination as a basis for making an award 
to another applicant.
    Additionally, all first-tier subaward recipients (i.e., direct 
subrecipients) must have an active DUNS number at the time the subaward 
is made.

IV. Application Requirements

    This section includes application requirements for FVPSA grants for 
Coalitions, as follows:

Content of Application Submission

    The Coalition application must be signed by the Executive Director 
of the Coalition or the official designated as responsible for the 
administration of the grant. The application must contain the following 
information:
    (1) A description of the process and anticipated outcomes 
(including timelines and specific activities that lead to desired 
outcomes) of utilizing these Federal funds to work with family 
violence, domestic violence, and dating violence service programs and 
providers of direct services to encourage appropriate and comprehensive 
responses to family violence, domestic violence, and dating violence 
against adults or youth within the State,

[[Page 20652]]

including providing training and technical assistance and conducting 
statewide needs assessments (section 10411(d)(1)); include in the 
statewide needs assessment description a statement of how the needs 
assessment is undertaken in coordination and collaboration with the 
State's Plan for FVPSA formula grant funding and how representatives of 
underserved communities and racial and ethnic minority populations are 
included in the planning and decision-making;
    (2) A description of the process undertaken and procedures 
developed to participate in the planning and monitoring of the 
distribution of FVPSA State subgrants and subgrant funds (section 
10411(d)(2)), as well as the administration of FVPSA State-funded grant 
programs and projects;
    (3) A description of collaborations along with anticipated outcomes 
(including timelines and specific activities that lead to desired 
outcomes) with service providers and community-based organizations to 
address the needs of family violence, domestic violence, and dating 
violence victims, and their dependents, who are members of racial and 
ethnic minority populations and underserved populations (section 
10411(d)(3)); also include a description of the training or technical 
assistance or other activities provided to direct service providers to 
ensure programs are welcoming and accessible; examples of such 
underserved populations include, but are not limited to, the Lesbian, 
Gay, Bisexual, and Transgender (LGBT) communities; adolescents; men; 
immigrants; and human trafficking victims.
    (4) A description of collaborations and anticipated outcomes 
(including timelines and specific activities that lead to desired 
outcomes) for providing information to entities in such fields as 
housing, health care, mental health, social welfare, or business to 
support the development and implementation of effective policies, 
protocols, and programs that address the safety and support needs of 
adult and youth victims of family violence, domestic violence, or 
dating violence (section 10411(d)(4));
    (5) A description of work and anticipated outcomes (including 
timelines and specific activities that lead to desired outcomes) to 
encourage appropriate responses to cases of family violence, domestic 
violence, or dating violence against adults or youth, including by 
working with judicial and law enforcement officers (Section 
10411(d)(5)) unless the applicant coalition satisfies the exception 
described in paragraph (7) below;
    (6) A description of activities and anticipated outcomes (including 
timelines and specific activities that lead to desired outcomes) 
associated with working with family law judges, criminal court judges, 
child protective service agencies, and children's advocates to develop 
appropriate responses to child custody and visitation issues in cases 
of child exposure to family violence, domestic violence, or dating 
violence, and in cases in which family violence, domestic violence, or 
dating violence is present and child abuse is present (Section 
10411(d)(6)) unless the applicant coalition satisfies the exception 
described in paragraph (7) below.
    (7) If the applicant coalition uses funds received under the 
Violence Against Women Act for State domestic violence coalitions for 
the purposes described in paragraphs (5) and (6) above and is 
coordinating those activities with the State's STOP (Services, 
Training, Officers, Prosecutors) formula grant activities that address 
those purposes, the applicant Coalition shall not be required to 
undertake additional activities. If applicable, the applicant Coalition 
must provide a statement of assurance that funds for the referenced 
purposes are received from the Office on Violence Against Women (OVW), 
U.S. Department of Justice, and that the activities are coordinated 
with the State's STOP formula grant activities, (Section 10411(e)(1) 
and (2)); as part of the assurance the applicant coalition must also 
describe its activities in those OVW-funded areas including those in 
collaboration with the State STOP grant activities;
    (8) A description of work and anticipated outcomes (including 
timelines and specific activities that lead to desired outcomes) to 
provide information to the public about prevention of family violence, 
domestic violence, and dating violence, including information targeted 
to underserved communities; examples of such communities include, but 
are not limited to, LGBT communities, adolescents, male victims, 
immigrants, and human trafficking victims (section 10411(d)(7));
    (9) A description of collaborations (including timelines, specific 
activities, and outcomes) with Indian tribes and tribal organizations 
(and corresponding Native Hawaiian groups and communities) to address 
the needs of Native American (including Alaska Native) and Native 
Hawaiian victims of family violence, domestic violence, or dating 
violence, as applicable in the State (section 10411(d)(8)). Note: 
Tribes have special sovereign status and, as such, collaborations with 
them must include the opportunity for Coalition membership provided 
they meet general membership eligibility requirements that are not 
impediments to their special sovereign status; Coalitions are urged to 
seek technical assistance, if needed, from the National Indigenous 
Women's Resource Center for assistance in meeting this program 
requirement. Coalitions may include a description of the technical 
assistance received as well as plans to implement the technical 
assistance to support their applications;
    (10) A description of work and anticipated outcomes (including 
timelines and activities) associated with other activities to support 
the development of policies, protocols, and procedures to enhance 
domestic violence intervention and prevention in the State (section 
10402(11)); also include a description of the participation of 
underserved and culturally specific populations in the planning and 
decision-making regarding any additional work identified in this 
requirement;
    (11) To support ACYF priorities as described in Section 1. c. 
Trauma-Informed Programming, a description of work planned (including 
timelines and activities) to gauge the activities of domestic violence 
programs offering trauma-informed services that address lifetime 
exposure to violence, including trauma-focused intervention strategies. 
Such work shall also include a capacity assessment of all member 
programs to identify those needing additional training, technical 
assistance and support related to trauma-informed service provision;
    (12) A description of activities to describe the applicant 
Coalition's role as an information clearinghouse, primary point of 
contact, and resource center on domestic violence for the State; 
include the participation of underserved and culturally specific 
populations in identifying the kinds of resource information and other 
data needed to meet the unique needs of such populations.
    (13) The following documentation that certifies the status of the 
Coalition must be included in the grant application:
    (a) A copy of a currently valid 501(c)(3) certification letter from 
the IRS stating private, non-profit status; or a copy of the 
applicant's listing in the IRS' most recent list of tax-exempt 
organizations described in section 501(c)(3) of the IRS code;
    (b) To demonstrate compliance with section 10402(11):

[[Page 20653]]

    (i) A current list of the organizations operating programs for 
victims of domestic violence in the State; a list of the primary-
purpose domestic violence services providers in the State; and, the 
applicant Coalition's current membership list by organization, 
including a notation of culturally specific organizations represented 
in the membership structure (see Section III. Eligibility);
    (ii) A list of the applicant Coalition's current Board of 
Directors, with each individual's organizational affiliation and the 
Chairperson identified (see Section III. Eligibility);
    (14) A list of any Coalition or contractual positions to be 
supported by funds from this grant;
    (15) A budget narrative that clearly describes the planned 
expenditure of funds under this grant including a provision that sets 
aside funds for travel expenses for up to two staff to the Annual State 
Domestic Violence Coalition grantee meeting;
    (16) A description of the applicant's organizational policies and 
procedures to maintain victim confidentiality, as well as activities, 
training, and/or technical assistance to support member programs' 
confidentiality practices to support victim safety; and, a description 
of the activities undertaken with the FVPSA state administrator to 
ensure victim confidentiality in domestic violence programs.

Forms, Assurances, and Certifications

    Applicants seeking financial assistance under this announcement 
must submit the listed Standard Forms (SFs) and certifications. All 
required Standard Forms and certifications are available at the 
Grants.gov Forms Repository unless specified otherwise.

Additional Assurance and Policy

    Each application must provide a signed copy of the additional 
assurance and policy in Appendices A and E, respectively.

------------------------------------------------------------------------
    Forms/certifications           Description           Where Found
------------------------------------------------------------------------
Certification Regarding       Required of all       Available at
 Lobbying.                     applicants at the     www.acf.hhs.gov/
                               time of their         grants/grants_
                               application. If not   resources.html.
                               available with the
                               application, it
                               must be submitted
                               prior to the award
                               of the grant.
SF-LLL--Disclosure of         If any funds have     ``Disclosure Form to
 Lobbying Activities.          been paid or will     Report Lobbying''
                               be paid to any        is available at
                               person for            www.acf.hhs.gov/
                               influencing or        grants/grants_
                               attempting to         resources.html.
                               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
                               applicant shall
                               complete and submit
                               the SF-LLL,
                               ``Disclosure Form
                               to Report
                               Lobbying,'' in
                               accordance with its
                               instructions.
                               Applicants must
                               furnish an executed
                               copy of the
                               Certification
                               Regarding Lobbying
                               prior to award.
Survey on Ensuring Equal      Non-profit private    Available at
 Opportunity for Applicants.   organizations (not    www.acf.hhs.gov/
                               including private     grants/grants--
                               universities) are     resources.html.
                               encouraged to
                               submit the survey
                               with their
                               applications.
                               Submission of the
                               survey is
                               voluntary.
                               Applicants applying
                               electronically may
                               submit the survey
                               along with the
                               application as part
                               of an appendix or
                               as a separate
                               document. Hard copy
                               submissions should
                               include the survey
                               in a separate
                               envelope.
The needs of lesbian, gay,    See Appendix E for    See Appendix E for
 bisexual, transgender, and    submission            the complete policy
 questioning youth are taken   requirements.         description.
 into consideration in
 applicants program design.
------------------------------------------------------------------------

Paperwork Reduction Disclaimer

    The Project Description information collection is approved under 
OMB control number 0970-0280, which expires November 30, 2014.
    As required by the Paperwork Reduction Act, 44 U.S.C. 3501-3520, 
the public reporting burden for the project description is estimated to 
average 10 hours per response, including the time for reviewing 
instructions, gathering and maintaining the data needed, and reviewing 
the collection of information. The Project Description information 
collection is approved under OMB control number 0970-0280, which 
expires November 30, 2014. An agency may not conduct or sponsor, and a 
person is not required to respond to, a collection of information 
unless it displays a currently valid OMB control number.

Funding Restrictions

    The Consolidated Appropriations Act, 2012 (Pub. L. 112-74), enacted 
December 23, 2011, limits the salary amount that may be awarded and 
charged to ACF mandatory and discretionary grants. Award funds issued 
under this announcement may not be used to pay the salary, or any 
percentage of salary, to an individual at a rate in excess of Executive 
Level II. The Executive Level II salary of the Federal Executive Pay 
scale is $179,700 (/www.opm.gov/oca/12tables/html/ex.asp). This amount 
reflects an individual's base salary exclusive of fringe benefits and 
any income that an individual may be permitted to earn outside of the 
duties to the applicant organization. This salary limitation also 
applies to subawards/subcontracts under an ACF mandatory and 
discretionary grant.
    Costs of organized fund raising, including financial campaigns, 
endowment drives, solicitation of gifts and bequests, and similar 
expenses incurred solely to raise capital or obtain

[[Page 20654]]

contributions, are considered unallowable costs under grants awarded 
under this announcement.
    Construction is not an allowable activity or expenditure under this 
grant award.

Application Submission

    Applications should be sent or delivered to:

Administration for Children and Families,
Administration on Children, Youth and Families,
Family and Youth Services Bureau,
Division of Family Violence Prevention and Services,
ATTN: Kenneth E. Noyes, J.D., 1250 Maryland Avenue SW., Suite 8212, 
Washington, DC 20024

V. Award Administration Information

Administrative and National Policy Requirements

    Awards issued under this announcement are subject to the uniform 
administrative requirements and cost principles of 45 CFR Part 74 
(Awards and Subawards to Institutions of Higher Education, Hospitals, 
Other Nonprofit Organizations, and Commercial Organizations) or 45 CFR 
Part 92 (Grants and Cooperative Agreements to State, Local, and Tribal 
Governments). The Code of Federal Regulations (CFR) is available at 
www.gpo.gov.
    An application funded with the release of Federal funds through a 
grant award, does not constitute, or imply, compliance with Federal 
regulations. Funded organizations are responsible for ensuring that 
their activities comply with all applicable Federal regulations.

Equal Treatment for Faith-Based Organizations

    Grantees are also subject to the requirements of 45 CFR 87.1(c), 
Equal Treatment for Faith-Based Organizations, which says, 
``Organizations that receive direct financial assistance from the 
[Health and Human Services] Department under any Department program may 
not engage in inherently religious activities such as worship, 
religious instruction, or proselytization, as part of the programs or 
services funded with direct financial assistance from the Department.'' 
Therefore, organizations must take steps to completely separate the 
presentation of any program with religious content from the 
presentation of the Federally funded program by time or location in 
such a way that it is clear that the two programs are separate and 
distinct. If separating the two programs by time but presenting them in 
the same location, one program must completely end before the other 
program begins.
    A faith-based organization receiving HHS funds retains its 
independence from Federal, State, and local governments, and may 
continue to carry out its mission, including the definition, practice, 
and expression of its religious beliefs. For example, a faith-based 
organization may use space in its facilities to provide secular 
programs or services funded with Federal funds without removing 
religious art, icons, scriptures, or other religious symbols. In 
addition, a faith-based organization that receives Federal funds 
retains its authority over its internal governance, and it may retain 
religious terms in its organization's name, select its board members on 
a religious basis, and include religious references in its 
organization's mission statements and other governing documents in 
accordance with all program requirements, statutes, and other 
applicable requirements governing the conduct of HHS-funded activities.
    Regulations pertaining to the Equal Treatment for Faith-Based 
Organizations, which includes the prohibition against Federal funding 
of inherently religious activities, ``Understanding the Regulations 
Related to the Faith-Based and Neighborhood Partnerships Initiative'' 
are available at www.hhs.gov/partnerships/about/regulations/. 
Additional information, resources, and tools for faith-based 
organizations is available through The Center for Faith-based and 
Neighborhood Partnerships Web site at www.hhs.gov/partnerships/index.html and at the Administration for Children & Families: Toolkit 
for Faith-based and Community Organizations.

Requirements for Drug-Free Workplace

    The Drug-Free Workplace Act of 1988 (41 U.S.C. 8102 et seq.) 
requires that all organizations receiving grants from any Federal 
agency agree to maintain a drug-free workplace. By signing the 
application, the Authorizing Official agrees that the grantee will 
provide a drug-free workplace and will comply with the requirement to 
notify ACF if an employee is convicted of violating a criminal drug 
statute. Failure to comply with these requirements may be cause for 
debarment. Government-wide requirements for Drug-Free Workplace for 
Financial Assistance are found in 2 CFR part 182; HHS implementing 
regulations are set forth in 2 CFR 382.400. All recipients of ACF grant 
funds must comply with the requirements in Subpart B--Requirements for 
Recipients Other Than Individuals, 2 CFR 382.225. The rule is available 
at http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;sid=18b5801410be6af416dc258873ffb7ec;rgn=div2;view=text;node=
20091112%3A1.1;idno=49;cc=ecfr.

Debarment and Suspension

    HHS regulations published in 2 CFR part 376 implement the 
government-wide debarment and suspension system guidance (2 CFR part 
180) for HHS' non-procurement programs and activities. ``Non-
procurement transactions'' include, among other things, grants, 
cooperative agreements, scholarships, fellowships, and loans. ACF 
implements the HHS Debarment and Suspension regulations as a term and 
condition of award. Grantees may decide the method and frequency by 
which this determination is made and may check the Excluded Parties 
List System (EPLS) located at www.sam.gov/, although checking the EPLS 
is not required. More information is available at www.acf.hhs.gov/grants/grants_resources.html.

Pro-Children Act

    The Pro-Children Act of 2001, 20 U.S.C. 7181 through 7184, imposes 
restrictions on smoking in facilities where federally funded children's 
services are provided. HHS grants are subject to these requirements 
only if they meet the Act's specified coverage. The Act specifies that 
smoking is prohibited in any indoor facility (owned, leased, or 
contracted for) used for the routine or regular provision of 
kindergarten, elementary, or secondary education or library services to 
children under the age of 18. In addition, smoking is prohibited in any 
indoor facility or portion of a facility (owned, leased, or contracted 
for) used for the routine or regular provision of federally funded 
health care, day care, or early childhood development, including Head 
Start services, to children under the age of 18. The statutory 
prohibition also applies if such facilities are constructed, operated, 
or maintained with Federal funds. The statute does not apply to 
children's services provided in private residences, facilities funded 
solely by Medicare or Medicaid funds, portions of facilities used for 
inpatient drug or alcohol treatment, or facilities where WIC coupons 
are redeemed. Failure to comply with the provisions of the law may 
result in the imposition of a civil monetary penalty of up to $1,000 
per violation and/or the imposition of an administrative compliance 
order on the responsible entity.

[[Page 20655]]

VI. Reporting Requirements

Performance Progress Reports (PPR)

    The Coalition grantee must submit an annual report of activities 
describing the coordination, training and technical assistance, needs 
assessment, and comprehensive planning activities carried out pursuant 
to its activities as delineated in its response to this announcement. 
Additionally, the Coalition must report on the public information and 
education services provided; the activities conducted in conjunction 
with judicial and law enforcement agencies notwithstanding that such 
activities may be conducted pursuant to a coalition grant from the 
Office on Violence Against Women, U.S. Department of Justice, in 
coordination with the applicable State's STOP formula grant activities 
as described in Section IV. Application Requirements, number 7; the 
actions conducted in conjunction with other agencies, such as the State 
child welfare agency, notwithstanding that such activities may be 
conducted pursuant to a coalition grant from the Office on Violence 
Against Women, U.S. Department of Justice, in coordination with the 
applicable State's STOP formula grant activities as described in 
Section IV. Application Requirements, number 7; activities conducted in 
conjunction with community-based, culturally specific service providers 
or organizations serving or representing underserved communities; and 
any other activities undertaken under this grant award. All activities 
should include both a narrative explanation and statistical data to 
support the activities reported. The annual report also must provide an 
assessment of the effectiveness of grant-supported activities. Further 
guidance regarding assessment requirements will be provided in 2013. 
Any evaluation activities conducted with FVPSA funds must also be 
reported including submission of final evaluation reports, if any. This 
form is found at www.acf.hhs.gov/programs/fysb/resource/ppr-fvpsa-coalitions.
    The annual report must be submitted using the Standard Form--
Performance Progress Report (SF-PPR) applicable to this program.
    The annual report is due 90 days after the end of the fiscal year 
in which the grant is awarded; i.e., December 29. Annual reports should 
be sent to:

Family Violence Prevention and Services Program,
Family and Youth Services Bureau,
Administration on Children, Youth and Families,
Administration for Children and Families,
Attention: Kenneth E. Noyes, J.D., 1250 Maryland Avenue SW., Room 8212,
    Washington, DC 20024.

    Please note that HHS may suspend funding for an approved 
application if any applicant fails to submit an annual performance 
report or if the funds are expended for purposes other than those set 
forth under this announcement.

Federal Financial Reports (FFR)

    Grantees must submit annual Financial Status Reports. The SF-425 is 
due December 29, 2013. The final SF-425 is due December 29, 2014. The 
SF-425 can be found at www.whitehouse.gov/omb/grants/grants_forms.html. Grantees have the option to submit their reports online 
through the Online Data Collection (OLDC) system at https://extranet.acf.hhs.gov/ssi.
    Failure to submit reports on time may be a basis for withholding 
grant funds, suspension, or termination of the grant. In addition, all 
funds reported after the obligation period will be recouped. Completed 
reports should be sent to:

Matthew McMahon, Program Specialist,
Office of Grants Management,
Office of Administration,
Administration for Children and Families,
370 L'Enfant Promenade, SW., 6th Floor, Washington, DC 20447.

    Fillable versions of the SF-425 form in Adobe PDF and MS-Excel 
formats, along with instructions, are available at www.whitehouse.gov/omb/grants_forms, www.forms.gov, and on the ACF Funding Opportunity 
Web site Forms page.
    Also note that a separate, quarterly financial report is required 
by the Division of Payment Management using the SF-425. The Division of 
Payment Management's online Payment Management System (PMS) is required 
for filing quarterly reports and is found at the following address: 
www.dpm.psc.gov. For further assistance, please call the HHS helpline 
at 877-614-5533.

VII. FFATA Subaward and Executive Compensation

    Awards issued as a result of this funding opportunity may be 
subject to the Transparency Act subaward and executive compensation 
reporting requirements of 2 CFR Part 170. See ACF's Award Term for 
Federal Financial Accountability and Transparency Act (FFATA) Subaward 
and Executive Compensation Reporting Requirement implementing this 
requirement and additional award applicability information.
    ACF has implemented the use of the SF-428 Tangible Property Report 
and the SF-429 Real Property Status Report for all grantees. Both 
standard forms are available at www.whitehouse.gov/omb/grants_forms/.

VIII. Agency Contact

Program Office Contact

    For Further Information Contact: Ken Noyes at (202) 205-7891 or 
email at: [email protected]mailto:.

Appendices

    Required Assurance, Certification and Policy:

A. Programmatic Assurances
B. Assurance of Compliance with Grant Requirements
C. Certification Regarding Lobbying
D. Designated State Domestic Violence Coalitions
E. LGBTQ Accessibility Policy
    Dates: The application due date is April 4, 2013.
    For Further Information Contact: Kenneth E. Noyes, J.D. at (202) 
205-7891 or email at: [email protected].

Bryan Samuels
Commissioner, Administration on Children, Youth and Families.

Appendix A--Programmatic Assurances

    The grantee certifies that it will comply with the following 
assurances under the Family Violence Prevention and Services Act, 42 
U.S.C. 10401, et seq.
    (1) The applicant Coalition will use grant funds awarded under 
the Family Violence Prevention and Services Act (FVPSA) for 
administration and operations to further the purposes of family 
violence, domestic violence, and dating violence (as defined in 
section 10402(2), (3), and (4)).
    (2) The applicant Coalition will use grant funds to work with 
local family violence, domestic violence, and dating violence 
service programs and providers of direct services to encourage 
appropriate and comprehensive responses to family violence, domestic 
violence, and dating violence against adults or youth within the 
State (section 10411(d)(1)).
    (3) The applicant Coalition will undertake and develop 
procedures to participate in the planning and monitoring of the 
distribution of FVPSA State subgrants and subgrant funds (section 
10411(d)(2), as well as the administration of FVPSA State-funded 
grant programs and projects.
    (4) The applicant Coalition will use grant funds to work in 
collaboration with service providers and community-based 
organizations to address the needs of family violence, domestic 
violence, and dating violence victims, and their dependents, who are 
members of racial and ethnic minority

[[Page 20656]]

populations and underserved populations (section 10411(d)(3)).
    (5) The applicant Coalition will use grant funds to collaborate 
with and provide information to entities in such fields as housing, 
health care, mental health, social welfare, or business to support 
the development and implementation of effective policies, protocols, 
and programs that address the safety and support needs of adult and 
youth victims of family violence, domestic violence, or dating 
violence (section 10411(d)(4)).
    (6) The applicant Coalition will use grant funds to encourage 
appropriate responses to cases of family violence, domestic 
violence, or dating violence against adults or youth, including 
working with judicial and law enforcement agencies (section 
10411(d)(5)). However, the applicant Coalition receiving funds under 
the FVPSA is not required to use funds received under the FPVSA if 
the Coalition provides an annual assurance to the Division of Family 
Violence Prevention that the Coalition is: (1) Using funds received 
under the Violence Against Women Act for State Domestic Violence 
Coalitions for activities, collaboration, and coordination with 
judicial and law enforcement officers (section 2001(c)(1)) of the 
Omnibus Crime Control and Safe Streets Act of 1968, 42 U.S.C. 
3796gg(c)(1); and, (2) coordinating the activities carried out by 
the Coalition with the State's STOP (Services, Training, Officers, 
Prosecutors) activities pursuant to the Violence Against Women Act 
(part T of title I of the Omnibus Crime Control and Safe Streets Act 
of 1968, 42 U.S.C. 3796gg et seq.) that addresses those purposes 
(section 10411(e)).
    (7) The applicant Coalition will use grant funds to work with 
family law judges, criminal court judges, child protective service 
agencies, and children's advocates to develop appropriate responses 
to child custody and visitation issues in cases of child exposure to 
family violence, domestic violence, or dating violence in cases in 
which--(1) family violence, domestic violence, or dating violence is 
present; and, (2) child abuse is present (section 10411(d)(6)). 
However, the applicant Coalition receiving funds under the FVPSA is 
not required to use funds received under the FPVSA if the Coalition 
provides an annual assurance to the Division of Family Violence 
Prevention that the coalition is: (1) Using funds received under the 
Violence Against Women Act for State Domestic Violence Coalitions to 
address activities, training, and collaborations with family and 
court judges, child welfare agencies, and children's advocates, as 
well as responding to child custody and visitation issues when 
family violence, domestic violence, or dating violence are present 
and child abuse is present (section 2001(c)(1)) of the Omnibus Crime 
Control and Safe Streets Act of 1968, (42 U.S.C. 3796gg(c)(1)); and, 
(2) coordinating the activities carried out by the coalition with 
the State's STOP activities under part T of title I of the Omnibus 
Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796gg et 
seq.) that addresses those purposes (section 10411(e)).
    (8) The applicant Coalition will use grant funds to provide 
information to the public about prevention of family violence, 
domestic violence, and dating violence, including information 
targeted to underserved populations (section 10411(d)(7)).
    (9) The applicant Coalition will use grant funds to collaborate 
with Indian tribes and tribal organizations (and corresponding 
Native Hawaiian groups or communities) to address the needs of 
Indian (including Alaska Native) and Native Hawaiian victims of 
family violence, domestic violence, or dating violence, as 
applicable in the State (section 10411(d)(8)).
    (10) The applicant Coalition will prohibit discrimination on the 
basis of age, handicap, sex, race, color, national origin or 
religion, as described in section 10406(c)(2).
    (11) The applicant Coalition has established policies, 
procedures, and protocols to ensure compliance with the provisions 
of section 10406(c)(5) regarding non-disclosure of confidential or 
private information.
    (12) Pursuant to section 10406(c)(5) the applicant will comply 
with requirements imposed by that section, which include, but are 
not limited to: (1) The grantee will not disclose any personally 
identifying information collected in connection with services 
requested (including services utilized or denied), through the 
grantee's funded activities, or reveal personally identifying 
information without informed, written, reasonably time-limited 
consent by the person about whom information is sought, whether for 
the FVPSA-funded activities or any other Federal or State program 
and in accordance with Section 10406(c)(5)(B)(ii); (2) the grantee 
will not release information compelled by statutory or court order 
unless adhering to the requirements of section 10406(c)(5)(C); (3) 
the grantee may share non-personally identifying information in the 
aggregate for the purposes enunciated in section 10406(c)(5)(D)(i) 
as well as for other purposes found in section 10406(c)(5)(D)(ii) 
and (iii).
    (13) The applicant Coalition will not use grant funds, directly 
or indirectly, to influence the issuance, amendment, or revocation 
of any Executive Order or similar legal document by any Federal, 
State, or local agency, or to undertake to influence the passage or 
defeat of any legislation by the Congress, or any State or local 
legislative body, or State proposals by initiative petition, except 
where representatives of the Coalition are testifying or making 
other appropriate communications when formally requested to do so by 
a legislative body, a committee, or a member of such organization, 
or in connection with legislation or appropriations directly 
affecting the activities of the Coalition or any member of the 
Coalition (Section 10411(f)).
-----------------------------------------------------------------------
Name and Signature

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

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

Appendix B--Assurance of Compliance With Grant Requirements

    The undersigned certifies that:
    The applicant Coalition will not use grant funds, directly or 
indirectly, to influence the issuance, amendment, or revocation of 
any Executive Order or similar legal document by any Federal, State, 
or local agency, or to undertake to influence the passage or defeat 
of any legislation by Congress, or any State or local legislative 
body, or State proposals by initiative petition, except where 
representatives of the Coalition are testifying or making other 
appropriate communications, either when formally requested to do so 
by a legislative body, a committee, or a member of such 
organization, or in connection with legislation or appropriations 
directly affecting the activities of the Coalition (section 
10411(f)).
    The applicant Coalition will prohibit discrimination on the 
basis of age, disability, sex, race, color, national origin, or 
religion, as described in section 10406(c)(2).
-----------------------------------------------------------------------
Signature

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

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

Appendix C--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:
    No Federal appropriated funds have been paid or will be paid, by 
or on behalf of the undersigned, to any person for influencing or 
attempting to influence an officer or employee of an agency, a 
Member of Congress, an officer or employee of Congress, or an 
employee of a Member of Congress in connection with the awarding of 
any Federal contract, the making of any Federal grant, the making of 
any Federal loan, the entering into of any cooperative agreement, 
and the extension, continuation, renewal, amendment, or modification 
of any Federal contract, grant, loan, or cooperative agreement.
    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.
    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

[[Page 20657]]

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.
-----------------------------------------------------------------------
Signature
-----------------------------------------------------------------------
Title
-----------------------------------------------------------------------
Organization

Appendix D

    State Domestic Violence Coalitions as Designated by the U.S. 
Department of Health and Human Services, Administration for Children 
and Families, Administration on Children, Youth and Families as of 
December 2011

------------------------------------------------------------------------
               Coalition name                       City          State
------------------------------------------------------------------------
Alabama Coalition Against Domestic Violence  Montgomery.......  AL
Alaska Network on Domestic Violence and      Juneau...........  AK
 Sexual Assault.
American Samoa Alliance Against Domestic     Pago Pago........  AS
 and Sexual Violence.
Arizona Coalition Against Domestic Violence  Phoenix..........  AZ
Arkansas Coalition Against Domestic          Little Rock......  AR
 Violence.
California Partnership to End Domestic       Sacramento.......  CA
 Violence.
Colorado Coalition Against Domestic          Denver...........  CO
 Violence.
Connecticut Coalition Against Domestic       E. Hartford......  CT
 Violence.
Delaware Coalition Against Domestic          Wilmington.......  DE
 Violence.
District of Columbia Coalition Against       Washington.......  DC
 Domestic Violence.
Florida Coalition Against Domestic Violence  Tallahassee......  FL
Georgia Coalition Against Domestic Violence  Decatur..........  GA
Guam Coalition Against Sexual Assault and    Hagatna..........  GU
 Family Violence.
Hawaii State Coalition Against Domestic      Honolulu.........  HI
 Violence.
Idaho Coalition Against Sexual & Domestic    Boise............  ID
 Violence.
Illinois Coalition Against Domestic          Springfield......  IL
 Violence.
Indiana Coalition Against Domestic Violence  Indianapolis.....  IN
Iowa Coalition Against Domestic Violence...  Des Moines.......  IA
Kansas Coalition Against Sexual & Domestic   Topeka...........  KS
 Violence.
Kentucky Domestic Violence Association.....  Frankfort........  KY
Louisiana Coalition Against Domestic         Baton Rouge......  LA
 Violence.
Maine Coalition to End Domestic Violence...  Augusta..........  ME
Maryland Network Against Domestic Violence.  Bowie............  MD
Jane Doe, Inc.--Massachusetts Coalition      Boston...........  MA
 Against Sexual Assault and Domestic
 Violence.
Michigan Coalition Against Domestic &        Okemos...........  MI
 Sexual Violence.
Minnesota Coalition for Battered Women.....  St. Paul.........  MN
Mississippi Coalition Against Domestic       Jackson..........  MS
 Violence.
Missouri Coalition Against Domestic &        Jefferson City...  MO
 Sexual Violence.
Montana Coalition Against Domestic & Sexual  Helena...........  MT
 Violence.
Nebraska Domestic Violence & Sexual Assault  Lincoln..........  NE
 Coalition.
Nevada Network Against Domestic Violence...  Reno.............  NV
New Hampshire Coalition Against Domestic &   Concord..........  NH
 Sexual Violence.
New Jersey Coalition for Battered Women....  Trenton..........  NJ
New Mexico Coalition Against Domestic        Albuquerque......  NM
 Violence.
New York State Coalition Against Domestic    Albany...........  NY
 Violence.
North Carolina Coalition Against Domestic    Durham...........  NC
 Violence.
Northern Marianas Coalition Against Sexual   Saipan...........  MP
 and Domestic Violence.
North Dakota Council on Abused Women's       Bismarck.........  ND
 Services.
Ohio Domestic Violence Network.............  Columbus.........  OH
Oklahoma Coalition Against Domestic          Oklahoma City....  OK
 Violence & Sexual Assault.
Oregon Coalition Against Domestic Violence   Portland.........  OR
 & Sexual Assault.
Pennsylvania Coalition Against Domestic      Harrisburg.......  PA
 Violence.
Coordinadora Paz para la Mujer, Inc.         San Juan.........  PR
 (Puerto Rico Coalition Against Domestic
 Violence).
Rhode Island Coalition on Domestic Violence  Warwick..........  RI
South Carolina Coalition Against Domestic    Columbia.........  SC
 Violence & Sexual Assault.
South Dakota Coalition Against Domestic      Pierre...........  SD
 Violence & Sexual Assault.
Tennessee Coalition Against Domestic &       Nashville........  TN
 Sexual Violence.
Texas Council on Family Violence...........  Austin...........  TX
Utah Domestic Violence Council.............  Salt Lake City...  UT
Vermont Network Against Domestic & Sexual    Montpelier.......  VT
 Violence.
Virginia Sexual & Domestic Violence Action   Richmond.........  VA
 Alliance.
Virgin Islands Domestic Violence and Sexual  Kingshill........  VI
 Assault Council.
Washington State Coalition Against Domestic  Seattle..........  WA
 Violence.
West Virginia Coalition Against Domestic     Elkview..........  WV
 Violence.
Wisconsin Coalition Against Domestic         Madison..........  WI
 Violence.
Wyoming Coalition Against Domestic Violence  Laramie..........  WY
 & Sexual Assault.
------------------------------------------------------------------------


[[Page 20658]]

Appendix E--LGBTQ Accessibility Policy

    As the Authorized Organizational Representative (AOR) signing 
this application on behalf of [Insert full, formal name of applicant 
organization]
    I hereby attest and certify that:
    The needs of lesbian, gay, bisexual, transgender, and 
questioning people are taken into consideration in applicant's 
programming. Applicant has considered how its programming will be 
inclusive of and non-stigmatizing toward such individuals. If not 
already in place, awardee must establish and publicize policies 
prohibiting harassment based on race, sexual orientation, gender, 
gender identity (or expression), religion, and national origin. The 
submission of an application for this funding opportunity 
constitutes an assurance that applicant has or will put such 
policies in place within 12 months of the award. Awardees should 
ensure that all staff members are trained to prevent and respond to 
harassment or bullying in all forms during the award period. Within 
12 months of the award awardee must be prepared to monitor claims, 
address them seriously, and document their corrective action(s) so 
all programming beneficiaries are assured that the applicant 
organization and its programming is safe, inclusive, and non-
stigmatizing by design and in operation.
    Insert Date of Signature:
    Print Name and Title of the AOR:
    Signature of AOR:

    [FR Doc. 2013-08027 Filed 04/04/2013 at 8:45 a.m.]
[FR Doc. 2013-08027 Filed 4-4-13; 8:45 am]
BILLING CODE 4184-32-P