[Federal Register Volume 60, Number 78 (Monday, April 24, 1995)]
[Notices]
[Pages 20096-20104]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-10029]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. 93630-95-1]


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

AGENCY: Administration on Developmental Disabilities (ADD), 
Administration for Children and Families (ACF), Department of Health 
and Human Services (DHHS).

ACTION: Announcement of the availability of funds for American Indian 
Consortiums to provide Protection and Advocacy (P&A) services for 
Fiscal Year 1995.

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SUMMARY: The Administration on Developmental Disabilities, 
Administration for Children and Families, announces the availability of 
fiscal year 1995 funding for two American Indian Consortiums. Financial 
funding provided by ADD to American Indian Consortiums is designed to 
provide P&A services to Native Americans with developmental 
disabilities.

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

ADDRESSES: Applications should be mailed to: Administration on 
Developmental Disabilities, Administration for Children and Families, 
Department of Health and Human Services, Room 329-D, HHH Building, 200 
Independence Avenue SW., Washington, DC 20201, Attn: 93.630-95-1 
American Indian Consortium.
    Hand delivered applications are accepted during the normal working 
hours of 8 a.m. to 4:30 p.m. Monday through Friday, on or prior to the 
established closing date at the above address.

FOR FURTHER INFORMATION CONTACT: Isadora Wills, Division of Program 
Operations, Administration on Developmental Disabilities, (202) 690-
5791.

SUPPLEMENTARY INFORMATION:

Part I. Program Purpose

    The Administration on Developmental Disabilities is the lead agency 
within ACF and DHHS responsible for planning and administering programs 
which promote the self-sufficiency and protect the rights of 
individuals with developmental disabilities.
    The 1994 Amendments (Pub. L. 103-230) to the Developmental 
Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6000 et seq.) 
(the Act) authorizes assistance to States and public and private 
nonprofit agencies and organizations to assure that individuals with 
developmental disabilities and their families participate in the design 
of and have access to culturally competent services, supports, and 
other assistance and opportunities that promote independence, 
productivity and integration and inclusion into the community.

Programs Funded Under the Act Are:

    <bullet> Federal assistance to State developmental disabilities 
councils;
    <bullet> State system for the protection and advocacy of individual 
rights;
    <bullet> Grants to university affiliated programs for 
interdisciplinary training, exemplary services, technical assistance, 
and information dissemination; and
    <bullet> Grants for Projects of National Significance.

Part II. General Information for P&A Consortium

    Based on section 142(b) of the Act (42 U.S.C. 6042(b)), an American 
Indian Consortium established to provide protection and advocacy 
services under Part C of the Act may submit an application to the 
Secretary to receive funding pursuant to section 142(c)(5). Such 
consortium shall coordinate activities with existing P&A systems.
    Currently, the States' have difficulties which prohibit the P&A 
systems from adequately serving large populations of American Indians 
who reside in isolated, expansive reservations. Despite their efforts, 
P&A systems in these States have not been able to overcome linguistic, 
geographic and cultural barriers in order to provide adequate 
protection and advocacy services to these populations. The American 
Indian Consortium will help alleviate this problem by allowing certain 
tribes to join together and apply to the Secretary for a Consortium 
award similar to those received by the territories. It is expected that 
the Consortium, when established, will work cooperatively with the 
existing P&A systems in the States where the Consortium operates and 
develop cooperative agreements on how to best serve Native Americans 
with developmental disabilities.
    For the purpose of this announcement an American Indian Consortium 
is ``any confederation of two or more recognized American Indian 
tribes, created through the official action of each participating 
tribe, that has a combined total resident population of 150,000 
enrolled tribal members and a contiguous territory of Indian lands in 
two or more States.'' (section 102(1) (42 U.S.C. 6001(1)).

Part III. P&A Description and Requirements for Consortiums

    A. Under the Act categorical grants are made to States and American 
Indian Consortiums for the protection and advocacy of individual rights 
through P&A systems. Systems must advocate on behalf of, and provide 
services to, all persons who are or who may be eligible for treatment, 
services, or habilitation, or who are being considered for a change in 
living arrangements. The P&A systems have been expanding their efforts 
on behalf of institutionalized people, with special attention on behalf 
of minorities and other traditionally underserved populations. 
Typically, these systems provide direct services to clients during a 
fiscal year, and also provide information and referral services to 
others. Assistance is provided for education, habilitation services, 
financial entitlement, consent, architectural barriers removal, day 
care, employment, rights or privacy, abuse and neglect cases, 
sterilization, transportation, voting and zoning.

B. Statutory Authority

    The Developmental Disabilities Assistance and Bill of Rights Act, 
as amended, 42 U.S.C. 6000 et seq.

C. Funding Period

    In Fiscal Year 1995, ADD has set aside approximate $272,322 for 
funding two American Indian Consortiums. Each grant will be approximate 
$136,161. As specified in 45 CFR 1386.2 of the ADD regulations, Fiscal 
Year 1995 funds must be obligated by September 30, 1996. These funds 
must be liquidated by September 30, 1997, in accordance with 45 CFR 
1386.3 of the ADD regulations. Funding is authorized through Fiscal 
Year 1996. [[Page 20097]] 

Part IV. Specific Responsibilities of the Applicant

    An applicant under this announcement must:
    A. Provide the resolutions from the participating tribes 
designating the applicant to operate the Protection and Advocacy 
system, to receive the federal funds available for this program, and to 
be responsible for reporting and accounting for such funds to ADD.
    B. Indicate that the System shall have the authority to:
    1. Pursue legal, administrative, and other appropriate remedies or 
approaches to ensure the protection of, and advocacy for, the rights of 
individuals with developmental disabilities within the exterior 
boundaries of the Tribes who are or who may be eligible for treatment, 
services, or habilitation, or who are being considered for a change in 
living arrangements, with particular attention to enrolled members of 
the Tribes (142(a)(2)(A)(i));
    2. Provide information on and referral to programs and services 
addressing the needs of persons with developmental disabilities 
(142(a)(2)(A)(ii));
    3. Investigate incidents of abuse and neglect of persons with 
developmental disabilities if the incidents are reported to the system 
or if there is probable cause to believe that the incidents occurred 
(142(a)(2)(B)); and
    4. Educate policymakers (142(a)(2)(K)).
    C. Specify that the system, on an annual basis:
    1. Develops a statement of objectives and priorities for the 
system's activities (142(a)(2)(C)); and
    2. Provide to the public including individuals with developmental 
disabilities attributable to either physical impairment, mental 
impairments, and their representatives, as appropriate, or a 
combination of physical or mental impairments, non-Tribal agency 
representatives, and non-State agency representatives of the State 
Developmental Disabilities Council, and the university affiliated 
program (if applicable within a State,) an opportunity to comment on--
    (a) The objectives and priorities established by the system and the 
rationale for the establishment of such objectives; and
    (b) The activities of the system, including the coordination with 
the advocacy programs under the Rehabilitation Act of 1973, the Older 
Americans Act of 1965, and the Protection and Advocacy for Mentally Ill 
Individual Act of 1986 and with other related programs, including the 
parent training and information centers, education ombudsman programs 
and assistive technology projects (142(a)(2)(D)).
    D. Demonstrate that the system:
    1. Has or will establish a grievance procedure for clients or 
prospective clients of the system to assure that persons with 
developmental disabilities have full access to services of the system 
(142(a)(2)(E));
    2. Is not being administered by the State Developmental 
Disabilities Council authorized under Part B (142(a)(2)(F));
    3. Is independent of any agency which provides treatment, services, 
or habilitation to individuals with developmental disabilities 
(142(a)(2)(G));
    4. Has access at reasonable times and locations to any resident who 
is an individual with a developmental disability in a facility that is 
providing services, supports, and other assistance to such a resident 
(142(a)(2)(H));
    5. Has access to all records of--
    (a) Any individual with developmental disabilities who is a client 
of the system if such individual, or the legal guardian, conservator, 
or other legal representative of such individual, has authorized the 
system to have such access (142(a)(2)(I)(i));
    (b) Any individual with developmental disabilities--
    (i) Who, by reason of such individual's mental or physical 
condition, is unable to authorize the system to have access 
(142(a)(2)(I)(ii)(I));
    (ii) Who does not have a legal guardian, conservator, or other 
legal representative, or for whom the legal guardian is the Tribe 
(142(a)(2)(I)(ii)(II)); and
    (iii) With respect to whom a complaint has been received by the 
system or with respect to whom as a result of monitoring or other 
activities there is probable cause to believe that such individual has 
been subject to abuse or neglect (142(a)(2)(I)(ii)(III)); and
    (c) Any individual with a developmental disability who has a legal 
guardian, conservator, or other legal representative with respect to 
whom a complaint has been received by the system or with respect to 
whom there is probable cause to believe the health or safety of the 
individual is in serious and immediate jeopardy whenever--
    (i) Such representative has been contacted by the system upon 
receipt of the name and address of such representative 
(142(a)(2)(I)(iii)(I));
    (ii) The system has offered assistance to such representative to 
resolve the situation (142(a)(2)(I)(iii)(II)); and
    (iii) Such representative have failed or refused to act on behalf 
of the individual (142(a)(2)(I)(iii)(III));
    6. Has hired and maintains sufficient numbers and types of staff, 
qualified by training and experience, to carry out such system's 
function except that such system shall not apply hiring freezes, 
reductions in force, or prohibitions on staff travel, or other 
policies, to the extent that such policies would impact staff or 
functions funded with Federal funds and would prevent the system from 
carrying out its functions under the Act (142(a)(2)(J));
    7. Will provide assurances to the Secretary that funds awarded to 
the consortium under this section will be used to supplement and 
increase the level of funds that would otherwise be made available for 
the purposes for which Federal funds are provided and not to supplant 
such non-Federal funds (142(a)(2)(L)); and
    8. Will submit to: Administration on Developmental Disabilities, 
Division of Program Operation, Room 329-D, HHH Building, 200 
Independence Avenue, SW, Washington, DC 20201 the following reports: 
Financial status reports (269s) bi-annually, Program Performance Report 
(PPRs) annually and the Statement of Objectives and Priorities (SOPs) 
annually.
    E. Describe how the system will assure that a multimember governing 
board is selected according to the policies and procedures of the 
system except that--
    1. The governing board shall be composed of members who broadly 
represent or are knowledgeable about the needs of the individuals 
served by the system and include individuals with developmental 
disabilities who are eligible for services, or have received or are 
receiving services, or parents, family member, guardians, advocates, or 
authorized representative of such individuals;
    2. Not more than \1/3\ of the membership of the governing board may 
be appointed by the chief executive officers of the tribes involved, in 
the case of any tribe in which such officer has the authority to 
appoint the membership of the board; and
    3. Any vacancy in the board shall be filled not later than 60 days 
after the date on which the vacancy occurs.

Part V. Intergovernmental Review of Federal Programs

    This program is covered by the State Plan Consolidation Section of 
E.O. 12372, but is excluded from intergovernmental consultation review. 
[[Page 20098]] 

Part VI. The Application Process

A. Application Submission

    To be considered as an applicant for an allotment, interested 
Consortiums must submit an application to the Administration for 
Children and Families at the address specified in the Program 
Announcement. There is no application kit; the Consortium's 
applications may be in a format chosen by the applicant. It must, 
however contain resolutions from two or more tribes and be signed by an 
individual authorized to act for the applicant and to assume 
responsibility for the obligations imposed by the terms and conditions 
of the grant award and contain the following:
    1. The name and Employer Identification Number (EIN) of the agency 
designated by the Tribes to implement the Protection and Advocacy 
system.
    2. The name address, and telephone number of the director of the 
system or a contact person, if different from the director.
    3. Assurances that:
    a. One signed original and two copies of the application including 
all attachments, have been submitted on or before June 8, 1995 to: 
Administration on Developmental Disabilities, Administration for 
Children and Families, Department of Health and Human Services, Room 
329-D, HHH Building, 200 Independence Avenue SW., Washington, DC 20201, 
Attn: 93.630-95-1 American Indian Consortium.
    b. Not more than five percent of the total funds will be used for 
monitoring the administration of the system.
    4. Appropriate Certifications:
    a. Non-Profit Status. Any non-profit organization submitting an 
application must submit proof of its non-profit status in its 
application at the time of submission. The non-profit agency can 
accomplish this by providing a copy of the applicant's listing in the 
Internal Revenue Service's (IRS) most recent list of tax-exempt 
organizations described in section 501(c)(3) of the IRS code or by 
providing a copy of the currently valid IRS tax exemption certificate, 
or by providing a copy of the articles of incorporation bearing the 
seal of the State in which the corporation or association is domiciled.
    b. Applicants requesting financial assistance for a non-
construction project must file the Standard Form 424B, ``Assurances: 
Non-Construction Programs.'' Applicants must sign and return the 
Standard Form 424B with their applications.
    c. Lobbying. Prior to receiving an award in excess of $100,000, 
applicants shall furnish an executed copy of the lobbying 
certification. Applicants must sign and return the certification with 
their applications.
    d. Compliance with the Drug-Free Workplace Act of 1988. By signing 
and submitting the applications, applicants are providing the 
certification and need not mail back the certification with the 
applications.
    c. Debarment, suspension or otherwise ineligible for award. By 
signing and submitting the applications, applicants are providing the 
certification and need not mail back the certification with the 
applications. Copies of the certifications and assurance are located at 
the end of this announcement.
    d. Certification regarding environmental tobacco smoke. By signing 
and submitting this application the applicant/grantee certifies that it 
will comply with the requirements of the Act. The applicant/grantee 
further agrees that it will require the language of this certification 
be included in any subawards which contain provisions for children's 
services and that all subgrantees shall certify accordingly.

B. Application Consideration

    The Commissioner of the Administration on Developmental 
Disabilities determines the final action to be taken with respect to 
each application received under this announcement. The following points 
should be taken into consideration by all applicants:
    <bullet> Incomplete applications and applications that do not 
conform to this announcement will not be accepted for review. 
Applicants will be notified in writing of any such determinations by 
ADD.
    <bullet> The Commissioner's funding decision takes into account the 
analysis of the application, recommendation and comments of the Federal 
reviewing officials.
    <bullet> The Commissioner makes grant awards consistent with the 
purpose of the Act, all relevant statutory and regulatory requirements, 
this program announcement, and the availability of funds.

Part VII. Review Process and Criteria

    Applications submitted by the closing date and verified by the 
postmark under this program announcement will undergo a pre-review to 
determine:
    <bullet> That the applicant is eligible in accordance with the 
definition of an American Indian Consortium in Part II; and
    <bullet> That the application forms and materials submitted are 
adequate to allow an indepth evaluation (all required materials and 
forms are included in this announcement)
    Competing application from Consortiums will be reviewed and 
evaluated against the following criteria.

A. Objectives and Priorities (60 points)

    The applicant's description of objectives and priorities to be 
established. Information provided in response to the items under Part 
IV of this announcement ``Specific Responsibilities of the Applicant'' 
will be used to review and evaluate applications.

B. Approach (40 points)

    The applicants description of the system's operations/approach 
toward accomplishing the objectives and priorities. Evidence of the 
applicant's ability to manage a P&A System is well defined.

Part VII. Paperwork Reduction Act

    Under the Paperwork Reduction Act of 1980, Pub. L. 96-511, the 
Department is required to submit to the Office of Management and Budget 
(OMB) for review and approval any reporting and recordkeeping 
requirements in regulations including program announcements. This 
program announcement does not contain information collection 
requirement beyond those approved for ADD.

Part VIII. Receipt of Applications

    Applications shall be considered as meeting an announced deadline 
if they are either:
    1. Received on or before the deadline date at the Office specified 
in this announcement; or
    2. Sent on or before the deadline date and received by ACF in time 
for the review. (Applicants are cautioned to request a legibly dated 
U.S. Postal Service postmark or to obtain a legibly dated receipt from 
a commercial carrier of U.S. Postal Services. Private metered postmarks 
shall not be acceptable as proof of timely mailing).

A. Late Applications

     Applications which do not meet the criteria stated above are 
considered late applications. ACF/ADD shall notify each late applicant 
that its application will not be considered in the competition.

B. Extension of Deadlines

    ACF may extend the deadline for all applicants due to acts of God, 
such as floods, hurricanes or earthquakes; or [[Page 20099]] when there 
is a widespread disruption of the mails. However, if the granting 
agency does not extend the deadline for all applicants, it may not 
waive or extend the deadline for any applicant.

C. Effective Date

    We anticipate that successful applications shall be funded no later 
than June 30, 1995.

(Catalog of Federal Domestic Assistance Program Number 93.630 
Developmental Disabilities--Protection and Advocacy Program)

    Dated: April 17, 1995.
Bob Williams,
Commissioner, Administration on Developmental Disabilities.

Attachment A--Assurances--Non-Construction Programs

    Note: Certain of these assurances may not be applicable to your 
project or program. If you have questions, please contact the 
awarding agency. Further, certain Federal awarding agencies may 
require applicants to certify to additional assurances. If such is 
the case, you will be notified.

    As the duly authorized representative of the applicant I certify 
that the applicant:
    1. Has the legal authority to apply for Federal assistance, and 
the institutional, managerial and financial capability (including 
funds sufficient to pay the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standards or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a purpose that constitutes or presents the 
appearance of personal or organizational conflict of interest, or 
personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for 
merit systems for programs funded under one of the nineteen statutes 
or regulations specified in Appendix A of OPM's Standards for a 
Merit System of Personnel Administration (5 CFR 900, Subpart F).
    6. Will comply with all Federal statutes relating to 
nondiscrimination. These include but are not limited to: (a) Title 
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits 
discrimination on the basis of race, color or national origin; (b) 
Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on 
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, 
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on 
the basis of handicaps; (d) the Age Discrimination Act of 1975, as 
amended (42 U.S.C. Secs. 1601-6107), which prohibits discrimination 
on the basis of age; (e) the Drug Abuse Office and Treatment Act of 
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the 
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and 
Alcoholism Prevention. Treatment and Rehabilitation Act of 1970 
(P.L. 91-616), as amended, relating to nondiscrimination on the 
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the 
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), 
as amended, relating to confidentiality of alcohol and drug abuse 
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 
U.S.C. Sec. 3601 et seq.), as amended, relating to nondiscrimination 
in the sale, rental or financing of housing; (i) any other 
nondiscrimination provisions in the specific statute(s) under which 
application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statute(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the Uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property for project purposes regardless of Federal participation in 
purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
Secs. 1501-1508 and 7324-7328) which limit the political activities 
of employees whose principal employment activities are funded in 
whole or in part with Federal funds.
    9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 
U.S.C. Sec. 276c and 18 U.S.C. Secs. 874), and the Contract Work 
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding 
labor standards for federally assisted construction subagreements.
    10. Will comply, if applicable, with flood insurance purchase 
requirements of Section 102(a) of the Flood Disaster Protection Act 
of 1973 (P.L. 93-234) which requires recipients in a special flood 
hazard area to participate in the program and to purchase flood 
insurance if the total cost of insurable construction and 
acquisition is $10,000 or more.
    11. Will comply with environmental standards which may be 
prescribed pursuant to the following: (a) institution of 
environmental quality control measures under the National 
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order 
(EO) 11514; (b) notification of violating facilities pursuant to EO 
11738; (c) protection of wetlands pursuant to EO 11990; (d) 
evaluation of flood hazards in floodplains in accordance with EO 
11988; (e) assurance of project consistency with the approved State 
management program developed under the Coastal Zone Management Act 
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401 
et seq.); (g) protection of underground sources of drinking water 
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered 
Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C. Secs. 1271 et seq.) related to protecting components or 
potential components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 470), EO 11593 (identification and protection of 
historic properties), and the Archaeological and Historic 
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
    14. Will comply with P.L. 93-348 regarding the protection of 
human subjects involved in research, development, and related 
activities supported by this award of assistance.
    15. Will comply with the Laboratory Animal Welfare Act of 1966 
(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the 
care, handling, and treatment of warm blooded animals held for 
research, teaching, or other activities supported by this award of 
assistance.
    16. Will comply with the Lead-Based Paint Poisoning Prevention 
Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead 
based paint in construction or rehabilitation of residence 
structures.
    17. Will cause to be performed the required financial and 
compliance audits in accordance with the Single Audit Act of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.

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Signature of Authorized Certifying Official

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Title

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Applicant Organization

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

Attachment B--Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative 
Agreements

    The undersigned certifies, to the best of his or her knowledge 
and belief, that:
    (1) No Federal appropriated funds have been paid or will be 
paid, by or on behalf of the undersigned, to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with the awarding 
of any Federal contract, the making of any Federal grant, the making 
of any Federal loan, the entering into of any cooperative agreement, 
and the extension, continuation, [[Page 20100]] renewal, amendment, 
or modification of any Federal contract, grant, loan, or cooperative 
agreement.
    (2) If any funds other than Federal appropriated funds have been 
paid or will be paid to any person for influencing or attempting to 
influence an officer or employee of any agency, a Member of 
Congress, an officer or employee of Congress, or an employee of a 
Member of Congress in connection with this Federal contract, grant, 
loan or cooperative agreement, the undersigned shall complete and 
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
accordance with its instructions.
    (3) The undersigned shall require that the language of this 
certification be included in the award documents for all subawards 
at all tiers (including subcontracts, subgrants, and contracts under 
grants, loans, and cooperative agreements) and that all 
subrecipients shall certify and disclose accordingly.
    This certification is a material representation of fact upon 
which reliance was placed when this transaction was made or entered 
into. Submission of this certification is a prerequisite for making 
or entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the required certification 
shall be subject to a civil penalty of not less than $10,000 and not 
more than $100,000 for each such failure.

State for Loan Guarantee and Loan Insurance

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

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Signature

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Title

----------------------------------------------------------------------
Organization

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

Attachment D--Certification Regarding Debarment, Suspension, and Other 
Responsibility Matters-Primary Covered Transactions

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

Certificaiton Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion-Lower Tier Covered Transactions (To Be Supplied to 
Lower Tier Participants)

    By signing and submitting this lower tier proposal, the 
prospective lower tier participant, as defined in 45 CFR Part 76, 
certifies to the best of its knowledge and belief that it and its 
principals:
    (a) are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded from 
participation in this transaction by any federal department or 
agency.
    (b) where the prospective lower tier participant is unable to 
certify to any of the above, such prospective participant shall 
attach an explanation to this proposal.
    The prospective lower tier participant further agrees by 
submitting this proposal that it will include this clause entitled 
``certification Regarding Debarment, Suspension, Ineligibility, 
Voluntary Exclusion-Lower Tier Covered Transactions. ``without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Attachment E--Certification Regarding Environmental Tobacco Smoke

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

[FR Doc. 95-10029 Filed 4-21-95; 8:45 am]
BILLING CODE 4184-01-P