VOCA 2006 Application Kit

VICTIMS OF CRIME ASSISTANCE (VOCA)

CONTINUATION APPLICATION KIT

LOUISIANA COMMISSION ON LAW ENFORCEMENT AND ADMINISTRATION OF CRIMINAL JUSTICE 1885 WOODDALE BLVD., ROOM 1230 BATON ROUGE, LA 70806-1511 (225) 925-1757

www.lcle.la.gov

Bobby Jindal Judy Dupuy Governor Executive Director Office of The Governor Louisiana Commission on Law Enforcement and Administration of Criminal Justice

To reduce the burden of applying for continuation funding, the Louisiana Commission on Law Enforcement has developed a condensed version of the VOCA application. Subgrantees may submit the standard forms and an updated budget detail and narrative. Subgrantees must meet the following criteria to submit a condensed continuation application.

The application submitted must be a continuation application. Enter continuation subgrant number - - .

The Goals and Objectives the application submitted must be consistent with those of the prior grant.

Certified Assurances must be signed and submitted.

The Lobbying and Debarment forms must be signed and submitted.

Subgrant Award Report

Submit only the standard forms of the application (see list below) and the updated budget detail and narrative.

Standard Forms: Cover Sheet, page 1 Checklist and Project Budget Summary, page 2

CVA - 2 Revised August 2008 THE VICTIMS OF CRIME ACT OF 1984

The Victims of Crime Act was passed by Congress and signed into law by the President on October 12, 1984. The Children's Justice and Assistance Act of 1986, the Anti-Drug Abuse Act of 1988 and again in 1992, and most recently by the Antiterrorism and Effective Death Penalty Act of 1996 amended the 1984 Victims of Crime Act. It is referred to as the Victims of Crime Act (VOCA) of 1984, as amended, Public Law 98-473, Title II, Chapter XIV (codified at 42 U.S.C. 10601, et seq.) The original Act was one of the results of recommendations made by the President's Task Force on Victims of Crime. The task force concluded that only the Federal, state and local governments, along with the private sector, sharing the responsibility of providing victims assistance, could adequately meet the needs of crime victims. The Victims of Crime Act is a response to the call for action by victims and victims' service providers who appealed to the task force for help. In 1984, VOCA established, within the U.S. Treasury, a separate account known as the Crime Victims Fund. The Fund receives deposits of fines and penalties levied against criminals convicted of Federal crimes. The Fund provides the source of funding for carrying out all of the activities authorized by VOCA. After certain designated amounts are distributed, of the remaining amount deposited in the fund in a fiscal year, 48.5% is available for victim assistance grants to the states. The Louisiana Commission on Law Enforcement (LCLE) has been designated by the Governor as the administrator of this program, known in Louisiana as the Crime Victim Assistance (CVA) Program. The Office of Victims of Crime makes annual VOCA crime victim assistance grants from the Fund to states. The primary purpose of these grants is to support the provision of services to victims of crime throughout the Nation. For the purpose of these Program Guidelines, services are defined as those efforts that: 1. Respond to the emotional and physical needs of crime victims. 2. Assist primary and secondary victims of crime to stabilize their lives after victimization. 3. Assist victims to understand and participate in the criminal justice system. 4. Provide victims of crime with a measure of safety and security such as boarding-up broken windows and replacing or repairing locks. In addition to the program eligibility requirements stated in the Act, the U.S. Department of Justice has issued guidelines and rules to implement the grant provisions of the Victims of Crime Act. In the following sections, those Federal guidelines have been harmonized with administrative guidelines adopted by the Louisiana Commission on Law Enforcement, Crime Victim Assistance Section. Eligible victim service providers should review this information carefully in order to assure program compliance.

CVA - 3 Revised August 2008 PREPARATION OF APPLICATION

The application for Crime Victims Assistance (CVA) Funds contained in this packet is the official document to be used in applying for CVA funds through the Louisiana Commission on Law Enforcement (LCLE). The following sections are designed to assist applicants in completing the application. For assistance in completing the programmatic portion of the application, governmental agencies should call their District Program Director. Nonprofit, non-governmental agencies and all, including the aforementioned, may call the VOCA Program Manager, LCLE, at (225) 925-1757 for assistance in completing the application.

A. GENERAL. 1. To be eligible for funding consideration, applications should be typewritten, complete, submitted on time, and in accordance with the criteria stated in previous sections of this guide. 2. Round "Budget Category Totals" up or down to the nearest dollar. The totals should always reflect whole dollar amounts. 3. A single signed original of the complete application must be submitted. This should be assembled and fastened by a single staple in the upper left-hand corner. 4. Unrequested material, such as individual letters of support, articles of incorporation, etc., received after or apart from the application will be added to or considered with the application. 5. The most current standard LCLE contract form must be used. A word-processed duplication is acceptable. 6. Contracts for professional services should not be executed until an award is made and a subgrant number issued. 7. The subgrant number must be on all contracts, future correspondence, and documents regarding this project. 8. Pre-award Costs: Pre-award costs are those costs which are considered necessary to the project but occur prior to the date of award. Awards issued after the start date are automatically given pre-award costs back to the start date. Prior approval is required for other pre- award costs and is to be requested in Section 10 on Page 1 of the Application. 9. Completed applications from local government units or private nonprofit agencies should be submitted to the cognizant Law Enforcement Planning Council who will forward the application with its comments and recommendations to LCLE. 10. Applications from statewide organizations should be submitted directly to LCLE. B. COVER SHEET. 1. Short Title of Project Leave blank. 2. Continuation of Subgrant Number If this is a continuation project, put prior subgrant number. 3. Project Duration Show the length, in months, of the total project. Also enter the desired Start Date and End Date for this subgrant. Use only the first day of a month as a beginning date. Projects are limited to no more than 12 months. 4. Project Funds Fill in the Federal and Match amounts provided by LCLE or the district. 5. Applicant Agency a. Authorized Official This is the individual authorized to enter into binding commitments on behalf of the Applicant Agency or Institution. This will normally be the chief officer of the agency, institution, or governmental unit involved (For Example: Mayor Earl Smith; Sheriff Walter Jones; President of Police Jury, Ms. Nora Green; YWCA (Nonprofit Agency Head), Mrs. Margaret LeBlanc.) b. Agency Enter the official name, mailing address, telephone and FAX numbers, and the Federal Employer TAX ID number of the agency or institution applying for funds. (For Example: City of Baton Rouge, East Carroll Sheriff's Office, and YWCA.) 6. Implementing Agency a. Agency Head This is the person in charge of the agency in which the applicant program is located. (For Example: Chief of Police Couvillion; Ms. Nora Green, YWCA (Nonprofit Agency Head); Sheriff Walter Jones.) b. Agency The name, address, telephone and FAX numbers of the agency implementing or benefiting from the project. In most cases, this will be the same as the Applicant Agency. (For Example: Applicant Agency, YWCA; Implementing Agency, YWCA.) However, in some cases it will be different. (For Example: City of Baton Rouge, Applicant Agency; the Baton Rouge Police Department, Implementing Agency.) 7. Project Director This is the individual who will be in direct charge of the project. He or she should be a person who combines substantial knowledge and experience in the project area with proven ability in administration and supervision of personnel and will be expected to devote a major portion of his or her time to the project. The Project Director must be an employee of the Applicant Agency and the official business address should be used. 8. Financial Officer This is the individual who will be responsible for fiscal matters relating to the project and in ultimate charge of agency accounting, management of funds, verification of expenditures, and subgrant financial reports (normally someone other than Project Director). The official business address should be used. NOTE: It is possible that a different person will fill each of the four positions, the Authorized Official, Agency Head, Project Director, and Financial Officer. It is also possible that the same person may serve in more than one capacity. However, there must be at least two (2) different people in any combination in these positions. The Financial Officer and the Project Director must be different individuals.

CVA - 4 Revised August 2008 9. Congressional Districts Served Check Congressional District(s) to be served by the project. Enter the population to be served by this project. It is possible that you will serve more than one population. If unknown, leave blank. Examples of population served: (a) Survivors of homicide. (b) Adult and child sexual assault victims. (c) Domestic violence victims. 10. Brief Project Description Enter a brief description of the project stressing project goals. This summary description should be limited to the space provided. Request pre-award costs here. C. CHECKLIST AND PROJECT BUDGET SUMMARY. (Please complete this section last.) 1. Checklist Answer the questions and enter the name and telephone number of the individual completing the budget section. 2. Budget Section General Information a. The budget must be completed in detail in the space provided. b. Use only whole dollar amounts. c. All items included in the budget will be reviewed to ensure budgetary reasonableness and allowable costs. 3. Computation of Twenty Percent (20%) Match a. Divide Federal funds by .80. This will give you the total cost of the VOCA project. b. Subtract Federal funds from the total cost of the VOCA project amount to get match. Example Calculation: $ 20,000 (Federal Funds) = $ 25,000 (Total Cost of VOCA Project) .80 20,000 Federal Funds $ 5,000 Match Amount 4. Match Requirements a. A twenty percent (20%) Non-Federal Match is required by ALL applicants, with the following exception, new or continuing Native American tribes/organizations located on reservations are required to provide a five percent (5%) match. b. Funds designated as match are restricted to the same uses as the CVA Program funds. c. Funds designated as match must be expended during the grant period. d. Match may be in the form of either Hard-Cash Match or In-Kind Match Contributions. (1) Hard-Cash Match Hard cash match represents an applicant's cash outlay and includes money contributed by public agencies and institutions, private organizations, and individuals. It may not include Federal funds from any source. (2) In-Kind Match In-kind match is the value of something that you can attach a dollar amount to, not something you expend dollars, such as but not limited to: (a) Personnel or Salaries The value placed on donated services must be consistent with the rate of compensation paid for similar work in the applicant's organization. If the required skills are found in the applicant's organization, the rate of compensation must be consistent with the labor market. In either case, fringe benefits may be included in the valuation. (b) Expendable Equipment The value on loaned or donated equipment may not exceed its fair market value. (c) Office Supplies (d) Workshop or Classroom Materials (e) Work Space The value of donated space may not exceed the fair rental value of comparable space as established by an independent appraisal of comparable space and facilities in privately owned buildings in the same locality. (f) Volunteers The monetary value of time contributed by professional and technical personnel and other skilled and unskilled labor if the services they provide are an integral and necessary part of a funded project. 1) Volunteers' duties must directly relate to the focus of the program. 2) The value of volunteer hours used as match is limited to $10.00 an hour. 3) In certain professionals such as licensed or certified therapists, attorneys, doctors, or law enforcement officers, the value of donated time can be counted at a rate consistent with their usual and customary charges for like services, not to exceed $100 per hour, as long as the service is allowed by Federal regulation. 4) Documentation must be kept on file listing the following: ● Name of volunteer, ● Number of hours contributed, ● Date worked, and ● Value of volunteer hours. e. The basis for determining the value of personal services, materials, equipment, and space must be documented and available for review or audit. f. Third party in-kind contributions may count toward satisfying match requirements provided the third party receiving the contribution expends them as allowable costs. g. Match must be dedicated to the project being funded. h. Match is restricted to allowable program items. i. Match may not be included as contribution for any other Federal funds. j. Match must be verifiable from the applicant's records.

CVA - 5 Revised August 2008 k. Match must be necessary and reasonable for proper and efficient accomplishment of the project's objectives. l. Match must be accountable for grant period. m. Match must be provided for in the approved budget. n. Indirect costs, or any costs not directly related to providing services to victims of crime, are not allowable match. 5. Overmatch Applicants should be mindful that any funds designated as matching funds for VOCA dollars are restricted to the uses outlined in the application. Therefore, it is suggested that subgrantees only provide match at the levels required by the Guidelines [i.e., twenty-five percent (25%)]. In this way, there are no Federal restrictions on the non-Federal dollars not used by the applicant as project match. 6. Records for Match a. All subgrantees must maintain records which clearly show the source, the amount, and the timing of all matching contributions. b. If a program or project has included within its approved budget, contributions which exceed the required matching portion, the subgrantee must maintain records of them in the same manner as it does the grantor agency funds and required matching shares. D. SECTION 100. PERSONNEL - PAGES 3 AND 4. 1. Personnel. List only the position(s) and individual name(s) for each position being funded through this grant. a. For direct service providers, only that percentage of time project personnel provide direct services to victims can be charged to the project. Note: For example, if personnel spend seventy percent (70%) of time providing a direct service to victims and thirty percent (30%) on fund raising, only seventy percent (70%) of the salary may be charged to the project. b. If the agency has annual salary increases for all employees, the increase for project personnel should be budgeted in this section. Show such as a separate line item. Example Calculations: Annual Salary for a Full-Time Employee: 30 Weeks at $ 8.00/Hour X 40 Hours = $ 9,600 Annual Salary Increase of Five Percent (5%): 22 Weeks at $ 8.40/Hour X 40 Hours = $ 7,392 c. Explain salary increases in narrative on Page 4. d. Salary rates are to be comparable with salaries of similar jobs in the region served by the project. e. Retroactive pay increases are unallowable. The agency should have policy to provide for merit raises applicable to both grant and non-grant personnel. Raises should be estimated in budget if possible. f. No dual compensation is permitted. g. Time and attendance records must be maintained on a regular basis. h. Supervision of direct providers is allowable not to exceed ten percent (10%) of the supervisor's salary only to the extent that documentation is provided to show that such supervision is necessary and essential to providing direct services to victims of crime. i. With justification as to need, pro-rated administrative time to complete VOCA required time and attendance sheets and programmatic documentation reports, and statistics and administrative time to maintain crime victims' records is allowable not to exceed ten percent (10%) of grant funds. 2. Job Descriptions a. Must be provided for each position given. b. Provide a description of work expected to be done. c. List level of education and work experience required for hire. d. Must include salary ranges. 3. Resumes a. Must be submitted with the application if position is already filled. b. Must be submitted with progress reports for positions filled later. c. Must be resubmitted for grant continuation applications. d. Must list qualifications, i.e., education and work experience. 4. Qualifications a. Must meet those established for the particular position and/or be comparable to existing positions in funded grants. b. Are to be at a minimum level to perform duties described and in line with salary rates established. c. Unless a waiver is granted by LCLE, based on verifiable work experience, the following education requirements must be met: (1) Counselors: Must have at least a Bachelor's Degree in a Social Science or related field. (2) Therapists: Must have at least a Master's Degree in either Social Work, Psychology, Counseling, or related field. 5. Volunteers (Complete only if using volunteers as In-Kind Match.) a. Each program must utilize volunteers in some capacity. b. Time and attendance records must be maintained annually. c. Documentation required: (1) Name of volunteer. (2) Duties and functions performed. (3) Number of volunteer hours per duty/function. (4) Value of volunteer hours if used as match. E. SECTION 200. FRINGE BENEFITS. 1. Apply only to the employer's share of benefits for those salaries funded. 2. Are limited to no more than thirty percent (30%) of the total salary. 3. The percentage rate or cost used for calculating fringe benefits must be provided for each type budgeted. 4. Types of Fringe Benefits: a. Social Security (FICA): 6.2% b. Medicare: 1.45%

CVA - 6 Revised August 2008 c. Health/Life Insurance d. Workman's Compensation e. Unemployment f. Public/Private Retirement g. Liability Insurance/Malpractice Insurance (if part of an employee benefit package for all employees.) h. Only Social Security OR one bona fide retirement plan is eligible – NOT BOTH. 5. If personnel costs are budgeted and fringe benefits are not included in the budget, an explanation regarding fringe benefit omission must be explained at the top of the page. 6. If fringe benefits are being funded through another source or no benefits are being requested, please state who will be responsible for paying fringe benefits at the top of the page. F. SECTION 300. TRAVEL. 1. The agency should have an established travel policy. In the absence of such policy, the agency must follow Louisiana State Travel Guidelines. The stricter policy prevails. 2. Travel expenditures are restricted to only the personnel listed in the Personnel Section (100). (Training is exempted and explained later in Section M, Part 8.) 3. Travel is a reimbursable expenditure for actual travel, not a flat allowance. 4. Amount of funds budgeted for travel is to be in line with project duration, scope of travel required, etc. 5. Travel reimbursement for mileage is not allowable in a public vehicle when gas and operating expenses are provided by the agency. 6. For current Louisiana State Travel Guidelines, visit the State Travel Office online at the Email address: www.doa.Louisiana.gov/osp/travel 7. Travel for Training: a. All travel must be related to direct services provided to victims. b. Travel expense must be cost-effective. c. Prior approval from LCLE is required for in-state and out-of-state travel using grant funds. d. A training program agenda with descriptions and/or brochure must accompany all requests submitted to LCLE for prior approval. e. Approved in-state travel will be reimbursed at one hundred percent (100%.) Approved out-of-state travel will be reimbursed at fifty percent (50%) of total travel costs. This is inclusive only to the 48 states. Hawaii and Alaska are considered international travel. International travel is not allowed. f. Out-of-state travel for training using grant funds is limited to personnel paid with grant funds and volunteers who provide direct service hours listed in the application. g. Contractors may travel using grant funds only if the contractor is providing the training and travel is included in the contract. Louisiana State Travel Guidelines must be followed. Refer below to "Contractual Services" at VII.J.3.C. h. Administrators may travel using grant funds if a significant part of their job is providing direct services and the travel is for direct service training. i. Expenses relating to statewide organization meetings whose primary purpose is not to provide direct services or to train direct service providers are not eligible expenses. G. SECTION 400. EQUIPMENT.. 1. Distinguish between equipment and supplies. An equipment item is any item, regardless of costs, that has a life expectancy of two or more years and is not consumable. 2. Records maintained for equipment are to be evidenced by signed and a dated invoice. 3. Competitive procurement must be used, i.e., the agency must obtain three bids or quotes in writing and maintain such on file. 4. Equipment and cost of equipment will be reviewed as to project needs and justification. 5. The following equipment items cannot be purchased or leased with VOCA grant funds: a. Vehicles b. Police Automobile Radios 6. Office furniture may be purchased for each position funded and is limited to $ 3,500. Continuation programs may replace furniture with prior justification and documentation to LCLE of condition and purchase or an acquisition date. 7. Telephones purchased with these funds shall be limited to standard models unless justification for enhanced models is approved. 8. Audiovisual equipment is limited to $ 3,500 per program unless justification for additional funds is approved. 9. All equipment must be tagged and proper inventory controls established. 10. No equipment may be disposed of (sold, destroyed, given away) without LCLE approval. 11. Other equipment will be considered on a case-by-case basis according to most recent VOCA regulations, OJP Financial Guide, and LCLE policies. H. COMPUTER QUESTIONNAIRE. If purchasing any computer hardware or software, please complete this form. I. SECTION 500. SUPPLIES. 1. Distinguish between supplies and equipment. Supply items are those that by nature are used up or are consumable or have a life expectancy less than two years. 2. Supplies are to be related to and necessary for function of the project. 3. Uniforms are not eligible for funding. 4. Types of supplies: a. Office Supplies

CVA - 7 Revised August 2008 b. Training Supplies: ● Books ● Manuals ● Periodicals (Subscriptions must be prorated for the grant period.) ● Audio-Visual Aids ● Films c. Postage d. Other supplies as may be related to this project. 5. The amount budgeted for supplies will be reviewed in relation to total funds budgeted, i.e., in relation to cost effectiveness. 6. Office supplies will be considered in the context of the program requesting funding. J. SECTION 600. CONTRACTUAL SERVICES. 1. Consultants may not be used to perform services ordinarily accomplished by existing personnel. Consultant contracts and agreements must receive approval from the Victim Services Board and LCLE before release of funds. 2. Dual compensation is not allowed. If a consultant is providing services during their regular workday for which they are being paid by their employer, travel and subsistence expenses are only allowed but not compensation for services rendered. 3. Contracts. a. Current LCLE contract form must be used. b. Contractual agreement is to contain detailed description of work to be performed. This must also coincide with the brief explanation found in the application. c. Contract must state the hourly rate and include a statement, such as "not to exceed the maximum amount of $______," which would be the dollar amount, budgeted in the Contractual Section (600) in the budget summary of the application. If travel expenses are to be included, a breakdown of each cost is required and a "not to exceed the maximum dollar amount" statement added to the contractual budget summary of the application. 4. Contract Packet. Before release of funds, contractual agreement must be reviewed and approved by LCLE. The contract packet should include: a. Executed contract with current subgrant number, b. Contractor's resume which includes: (1) Educational background and (2) Relevant work history, c. Receipts as mentioned in J.4.B., if applicable, and d. References. 5. Consultant Rates. a. The rate of compensation must be reasonable and consistent with that paid for similar services and be in compliance with OMB cost principles. Written documentation may be necessary on a case-by-case basis. b. Where prior approval and justification of the rate are required, the program should include copies of contractor's paid receipts or invoices for prior comparable services from two other sources. c. Approval for sole source when more than $ 100,000 must be sent to Washington, D.C. for prior approval. $ 100,000 and below must have prior approval by LCLE. Obtain guidelines from LCLE. 6. Consultant Rates should be according to current OJP Financial Guide. a. Current rate maximum is $450 for 8-hour day ($ 56.25 per hour). (1) This rate excludes travel and subsistence costs but includes preparation, evaluation, and travel time. (2) Rates more than $450 per day will require prior approval from LCLE. b. The following apply to certain consultants: (1) Consultants Associated with Educational Institutes. (a) The maximum rate is the consultant's academic salary projected for 12 months, divided by 260. (2) Consultants Employed by State and Local Governments. (a) Compensation is only allowed when their employer will not provide these services without cost. (b) The rate is not to exceed the daily salary rate for the employee as paid by the employer. (c) If the employee is not representing their agency, the rate is based on the necessary and reasonable cost principles. (3) Consultants Employed by Commercial and Not-for-Profit Organizations. (a) These are subject to competitive bidding procedures. (b) They are not subject to the $450 per day maximum before requesting prior approval. (c) For an individual consulting without employer involvement, the rate is not to exceed the daily salary paid by the employer subject to the $450 limitation. (4) Independent Consultants. (a) The rate must be reasonable and consistent with that paid for similar services in the marketplace. (b) Compensation may include fringe benefits. (c) Competitive bidding is required. (d) Prior approval is not required. K. INDIRECT COSTS. Indirect costs are not allowable. L. SECTION 700. RENOVATIONS. Minor renovations are limited to ten percent (10%) of the total project costs only to have the program to meet the requirements of the Americans with Disabilities Act and the National Historic Preservation Act.

CVA - 8 Revised August 2008 M. SECTION 800. OTHER DIRECT COSTS. 1. Audits For any non-Federal entity, meaning state, local government, or nonprofit organization, the following apply: a. The entity must comply with the conditions of the Office of Management and Budget Circular A-133 current revision. b. Effective for fiscal years ending after December 31, 2003, entities that expend $500,000 or more in a year in Federal awards shall have a single audit conducted in accordance with §___.500 except when they elect to have a program-specific audit conducted in accordance with paragraph © of Section Subpart B – Audits of the OMB Circular A-133. c. Effective for fiscal years ending after December 31, 2003, entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in §___.215(a), but records must be available for review or audit by appropriate officials of the Federal agency, pass-through entity, and General Accounting Office (GAO). Audit costs CANNOT be charged to the subgrant if the entity is exempt. d. For an agency that is required to have an audit, the audit cost may be an allowable expense. Check with LCLE for guidance. NOTE: A copy of the audit must be submitted to LCLE. 2. Printing All printed material must bear a prominent statement to the effect that it was printed with Crime Victim Assistance Program funds obtained through a subgrant (include grant number) from the Louisiana Commission on Law Enforcement. 3. Meeting Room Rentals This is allowed only for training within program purpose areas. 4. Phone Service a. The cost must be prorated where applicable. b. Enhancements or upgrades must improve only victim services. c. Local and long distance costs must be separated. 5. Rent a. The agency may charge, or prorate, the reasonable cost of rent for a VOCA-funded project. b. The agency must certify in writing that the requested rental charge is consistent with the prevailing rate in the local area and shall maintain documentation in its file to support such a determination. c. The pro-rated share of maintenance and operation costs is allowable to the extent they are not otherwise included in rental or other charges for space. d. Space rental cannot be charged to the project if the building is owned by the applicant agency. However, the pro-rated share of overhead costs such as utilities, janitorial services, etc., are allowable. 6. Advertising a. Grant funds are limited to newspaper advertising. b. Grant funds are prohibited for TV, radio and billboards. Agencies are encouraged to use Public Service Announcements. c. The purpose must be to identify crime victims and provide referral to needed services. d. Cost is limited to two percent (2%) of grant funds or $ 500, whichever is less. e. Agency may choose to assist victims in seeking crime victim compensation by running a newspaper ad. The ad should reference the subgrantee, LCLE as funding source, the Sheriff, and provide the name and phone number of the Crime Victim Reparations Claim Investigator. f. In-kind matching funds, up to a value of $ 2,500, in the form of donated production services and/or airtime from broadcast media, as well as Public Service Announcements from the print media are allowable. 7. Service Contracts and Insurance Coverage Service contracts and insurance coverage may cover only expenditures during the grant period, i.e., a three (3) year service contract to be paid from a grant with a duration of only twelve (12) months is not eligible. 8. Training a. Any training must meet the standards and curriculum requirements of the Peace Officer Standards and Training Council (POST), as appropriate. b. Training is eligible for funding for those persons (salaried or volunteer staff) who provide direct services to crime victims. Funds may only be used for training programs that improve the skills of service providers in meeting the needs of crime victims. Management training aimed at persons who do not provide direct services is not eligible for support. c. In-Service Training. Travel and per diem for trainer will be reimbursed at one hundred percent (100%), in accordance with VII K 3 - 5 (Contractual Services) and VII H 6 (Travel for Training), provided training is direct service training to staff or volunteers. A copy of the training curriculum must be provided. d. CVA funds may not be used solely to support a training activity or program. (No subgrant will be granted solely for the purpose of supporting a trainer or training activity.) 9. Emergency Costs. Emergency costs may be covered by CVA funds for emergency services for victims such as victim transportation, emergency food, etc. N. CERTIFIED ASSURANCES. 1. Must be signed by the Authorized Official, not by the Project Director, on Page 18. 2. The “District Authorization”, Page 19, must be signed by the District Program Director, or Assistant Director. 3. The entire set of Certified Assurances, Pages 13 – 18, must be returned with the application. 4. Keep a copy of the assurances for your reference and records. O. CHECKLIST. Please check appropriate boxes reflecting the sections of the grant application submitted to LCLE. P. SUBGRANT AWARD REPORT. Please complete and submit the Subgrant Award Report included in the CVA/VOCA Application Kit. Please answer all sections of this form and refer to the attached instructions for each section of the Subgrant Award Report form, if necessary.

CVA - 9 Revised August 2008

DISTRICT USE ONLY CONTINUATION APPLICATION FOR SUBGRANT DISTRICT PROGRAM DIRECTOR INITIALS PAGE 1 DATE VICTIMS OF CRIME ACT PROJECT ID CFDA # 16.575

FISCAL YEAR GMIS REV. 08/2008

LOUISIANA COMMISSION ON LAW ENFORCEMENT AND ADMINISTRATION OF CRIMINAL JUSTICE

1. SHORT TITLE OF PROJECT 2. CONTINUATION OF SUBGRANT NUMBER - - 3. PROJECT DURATION 4. PROJECT FUNDS Total Length: Months (Not to exceed 12 Months) Federal Funds: Desired Starting Date: In-Kind &/Or Total Cash Match: Desired Completion Date: Total Project: 5. APPLICANT AGENCY 6. IMPLEMENTING AGENCY Authorized Official: Agency Head: Agency Name: Agency Name: Address: Address: City, State: City, State: Zip Code: - Zip Code: - Telephone: ( ) - FAX: ( ) - Telephone: ( ) - FAX: ( ) - Email Address: Email Address: Federal Employer Tax Id #: - 7. PROJECT DIRECTOR 8. FINANCIAL OFFICER Name: Name: Address: Address: City, State: City, State: Zip Code: - Zip Code: - Telephone: ( ) - FAX: ( ) - Telephone:( ) - FAX: ( ) - Email Address: Email Address: 9. IS THIS AGENCY A FAITH-BASED ORGANIZATION? YES NO 10. CONGRESSIONAL DISTRICTS SERVED: 1 2 3 4 5 6 7 POPULATION SERVED: 11. BRIEF PROJECT DESCRIPTION: (Please do not exceed space provided below.)

CVA - 1 Revised August 2008 CHECKLIST AND PROJECT BUDGET SUMMARY INSTRUCTIONS: Complete this page LAST. The Checklist is self-explanatory. Project Summary - insert applicable budget category totals from the Detailed Project Budget. Do not exceed space provided. CHECKLIST: YES: NO:

Are all budgeted items allowable per Program Guidelines? Were instructions followed to determine allowable personnel/contractual costs? Are all line item computations correct? Do line items add to category totals? Have category totals been rounded to nearest dollar? Each category amount listed in the table below must equal category totals shown on Pages 3 through 11. Name of Person Completing Budget Section: Phone No.: ( ) - Fax No.: ( ) - E-Mail Address:

PROJECT BUDGET SUMMARY Include Match in Appropriate Budget Category Federal PLUS Match*

100. PERSONNEL

200. FRINGE BENEFITS

300. TRAVEL

400. EQUIPMENT

500. SUPPLIES

600. CONTRACTUAL

700. RENOVATIONS

800. OTHER DIRECT COSTS TOTAL*: *Cash Match and/or In-Kind Match must be included. PROJECT FUND BREAKDOWN (Total in Project Fund Breakdown and Total in Project Budget Summary must agree.) Federal Funds:

In-Kind Match: (Note: The value of In-Kind Match must run concurrently with the subgrant project period.)

Cash Match:

TOTAL*:

Provide Source of Cash Matching Funds:

Provide Source of In-Kind Match:

CVA - 1 Revised August 2008 DETAILED PROJECT BUDGET Federal Funds plus Cash Match (If Applicable) INSTRUCTIONS: Total estimated program costs should not exceed the federal funds allocated for the project, plus, the cash and/or in-kind matching share. Complete only those categories necessary for the successful operation of the project. Leave all others blank. The Budget Narrative sections are separate components and MUST be completed as instructed. DO NOT USE the term, “Refer To”. Do not exceed spaces provided. Attachments and copies will not be considered. ROUND ALL CATEGORY TOTALS TO THE NEAREST DOLLAR. 100. PERSONNEL Complete items below. If merit increases are a part of agency policy, list employee twice, once at current salary, then at salary to be received per merit increase. Please calculate salary on 4.33 weeks per month, 52 weeks per year. If pay is figured on an hourly basis, please use the “Hours Worked Weekly” column. If pay is figured on a monthly basis, use the “Monthly Salary” column. Only use one column. Also, hours worked weekly/monthly salary times the time devoted to project times the number of months will equal the total salary paid by the grant. (Example: $2,000 monthly X 50% x 12 months = $12,000.)

FULL-TIME, HOURS TIME POSITION TITLE NUMBER PART-TIME, WORKED MONTHLY DEVOTED TO TOTAL SALARY AND OF OR OVERTIME WEEKLY X SALARY PROJECT IN PAID BY GRANT EMPLOYEE NAME MONTHS EMPLOYEE PAY RATE PERCENTAGES

TITLE: %

SUBTOTAL AMOUNT OF PAID EMPLOYEES: VOLUNTEERS List ONLY volunteers used as In-Kind Match. Duties must directly relate to the focus of this project. Include their duties by service provided; e.g. answer hotline, drive victim to court, etc. Enter number of estimated volunteer hours to be donated for this project period. Multiply by rate of pay to get amount. Value is limited to $10/hour. In the case of certain professionals, such as licensed therapists, attorneys, and doctors, the value can be counted at a rate consistent with their usual and customary charges for like services, not to exceed $100/hour. Justification must be provided.

DUTIES OF VOLUNTEERS NO.OF HOURS VALUE RATE OF PAY AMOUNT

SUBTOTAL AMOUNT OF VOLUNTEERS:

CVA - 2 Revised August 2008 100. BRIEFLY EXPLAIN A) Need for each new position shown above; justify need for overtime:

B) The basis for determining the salary of each new position:

C) Project duties of each new position requested:

D) Indicate if personnel will be new or existing personnel; if existing, indicate if position has been backfilled. If this is a continuation application, indicate the personnel’s original status. (Existing personnel is an employee that currently works for the agency, but will now be working on grant activities. If so, the position the employee is moved from must be filled. If employee is the same from the previous grant, indicate if the employee was originally hired for that position.)

E) Attach a separate Job Description for each new grant position. Job Descriptions must include project duties, minimum education requirements, work experience levels, and salary range. Comments:

F) Resumes for each new position must be submitted. Comments:

100. PERSONNEL CATEGORY TOTAL: (Rounded)

CVA - 3 Revised August 2008 200. FRINGE BENEFITS (Employer’s Share of Employee Benefits) Project Personnel Only. In the table below, show calculations for Fringe Benefits by employee, if all employees on grant are not receiving identical benefits paid by grant. Fringe Benefit Addendum page is available on the website. Please refer to instructions on Page 10 for details. If Fringe Benefits are not included in the application budget, please explain how Fringe Benefits will be funded. Example: “The subgrantee will pay the benefits outside of the grant.” Provide Answer Here: EMPLOYEES’ NAMES AND TYPE OF FRINGE BENEFITS

SOCIAL SECURITY Rate = 6.2% (Rate times total salary = fringe total) RATE SALARY AMT % TIME TOTAL NAME .062 NAME .062 NAME .062 NAME .062 NAME .062 MEDICARE Rate = 1.45%(Rate times total salary = fringe total) RATE SALARY AMT % TIME TOTAL NAME .0145 NAME .0145 NAME .0145 NAME .0145 NAME .0145 HEALTH/LIFE INSURANCE Show monthly insurance rate amount for each employee. RATE MONTHS % TIME TOTAL NAME NAME NAME NAME NAME WORKMAN’S COMPENSATION Rate = (Please show percentage rate used.) RATE SALARY AMT % OF TOTAL TIME NAME NAME NAME NAME NAME UNEMPLOYMENT Rate = on the first $7,000 of each employee’s total salary. RATE UNEMPLOYMENT SALARY AMT % OF TOTAL TIME NAME INSURANCE TYPE NAME Please Check One: NAME FUTA NAME SUTA NAME PUBLIC/PRIVATE RETIREMENT Rate = (Please show percentage rate used.) RATE SALARY AMT % TIME TOTAL NAME NAME NAME NAME NAME OTHER Rate = SPECIFY: RATE SALARY AMT % TIME TOTAL NAME NAME NAME NAME NAME 200. FRINGE CATEGORY TOTAL: (Rounded)

CVA - 4 Revised August 2008 300. TRAVEL Itemize travel expenses of project personnel by purpose. Indicate who/which position will travel. Mileage is unallowable in agency owned vehicles. Charges are not to exceed agency travel rates, but in no case can this exceed current Louisiana Travel Guideline rates. Current guidelines allow only 50% of out-of-state travel reimbursement. LOCAL TRAVEL TOTAL COST OF THIS WHO/WHICH POSITION AND PURPOSE OF TRAVEL NO. OF MILES RATE USED TOTAL MILEAGE TRAVEL

TITLE:

PURPOSE:

TITLE:

PURPOSE:

TITLE:

PURPOSE:

SUBTOTAL FOR LOCAL TRAVEL NON-LOCAL IN-STATE TRAVEL/OUT-OF-STATE TRAVEL (Out-of-state travel requires prior approval from LCLE.) MILEAGE OR NO. OF WHO/WHICH POSITION AND PURPOSE OF TRAVEL FROM TO TOTAL COST AIRFARE COST MILES

TITLE:

PURPOSE:

TITLE:

PURPOSE:

TITLE:

PURPOSE:

SUBTOTAL MILEAGE/AIRFARE COST

LODGING CONFERENCE OTHER WHO/WHICH POSITION AND PURPOSE OF NO. OF NO. OF MEAL COST REGISTRATION TRAVEL TOTAL COSTS TRAVEL DAYS MEALS COSTS (Including Tax) & FEES COSTS

TITLE:

PURPOSE:

TITLE:

PURPOSE:

TITLE:

PURPOSE:

SUBTOTAL OF TRAVEL COSTS

300. TRAVEL CATEGORY TOTAL: (Rounded)

CVA - 5 Revised August 2008 400. EQUIPMENT List each type separately with Unit Cost, Tax and Shipping, and Total Cost. Please do not use Brand Names. Sole Source requires LCLE’s approval. Submit a Sole Source justification, if applicable, which is available from the District Program Director. EXAMPLE: TYPE QUANTITY UNIT PRICE TAX & SHIPPING COSTS TOTAL COST Chairs 2 $ 50.00 $25.50 $ 125.50

TAX AND TYPE OF EQUIPMENT QUANTITY UNIT PRICE TOTAL COST SHIPPING COSTS

SUBTOTAL OF EQUIPMENT DONATED EQUIPMENT (List Only Donated Equipment Used As In-Kind Match.)

TYPE OF DONATED EQUIPMENT VALUE QUANTITY METHOD OF DETERMINING VALUE TOTAL VALUE

SUBTOTAL OF DONATED EQUIPMENT

BRIEFLY EXPLAIN: A. Justify the need for each equipment item requested; [*NOTE: Computer equipment (hardware and/or software) requires a completed Computer Questionnaire (Page 8).]

B. Indicate procurement method; and

C. Its relationship to this project:

400. EQUIPMENT CATEGORY TOTAL: (Rounded)

CVA - 6 Revised August 2008 COMPUTER QUESTIONNAIRE

If a computer is requested, the following must be completed. Please do not exceed spaces provided.

1. How will the purchase of computer equipment and/or software enhance the program to be funded?

2. How will the computer(s) be integrated into and/or enhance your current system?

3. What is the cost of each of the following: A. Installation?

B. Staff training to use the computer equipment?

C. The on-going operational costs, such as maintenance agreements, supplies, etc.?

4. How will additional costs be supported?

5. Provide the following information for the proposed computer: A. MHz Processor: (Example: 533 MHz): B. Main Memory: (Example: 64 MB Main Memory): C. Disk Size: (Example: 6.2 GB Disk): D. Data Bus Width: (Example: 32 Bit):

CVA - 7 Revised August 2008 500. SUPPLIES List items within this category by major type; e.g., office supplies (pens, pencils, paper, etc.), postage, blank cassette tapes, CDs, DVDs, etc. Include tax and shipping costs in Unit Price, if applicable. List titles of publications and films. If office supplies average $50 per month or less, i.e., $600 for a 12-month grant period, do not itemize items. List as "Basic Supply Allowance" under "Type" and the dollar amount under "Total Cost".

TYPE OF SUPPLIES TITLE OF PUBLICATION(S)/FILM(S) QUANTITY UNIT PRICE TOTAL COST

SUBTOTAL OF SUPPLIES DONATED SUPPLIES (List only donated supplies used as In-Kind Match.)

TYPE OF DONATED SUPPLIES VALUE QUANTITY METHOD OF DETERMINING VALUE TOTAL VALUE

SUBTOTAL OF DONATED SUPPLIES BRIEFLY EXPLAIN: A) Need for and use of each major supply type requested:

B) Its relationship to this project.

500. SUPPLIES CATEGORY TOTAL: (Rounded)

CVA - 8 Revised August 2008 600. CONTRACTUAL/CONSULTANT (Include travel, lodging, and meal costs, if applicable.) Compensation for individual consultant services is to be reasonable and consistent with that paid for similar services in the market place. Travel, lodging, and meals, if applicable, should be figured in addition to compensation. All expenses must be included in the contract. (Available from District Program Director.)

HOURS RATE PER INDIVIDUAL CONSULTANT TYPE OF SERVICE OR TASK TOTAL COST DEVOTED HOUR

SUBTOTAL OF CONTRACTUAL/CONSULTANT COSTS CONSULTANT/CONTRACTOR TRAVEL (IF APPLICABLE)

LODGING OTHER COSTS ORIGINATION/DESTINATION COST MEAL COST TOTAL COSTS COST (PLEASE IDENTIFY)

Origination:

Destination:

Origination:

Destination:

Origination:

Destination:

Origination:

Destination:

SUBTOTAL OF CONSULTANT/CONTRACTOR TRAVEL

BRIEFLY EXPLAIN: A) Purpose of each consultant or other contractual service requested:

B) Why the service requested is necessary and cost effective:

C) Method of procurement and basis for determining rate of pay:

600. CONTRACTUAL/CONSULTANT CATEGORY TOTAL: (Rounded)

CVA - 9 Revised August 2008 700. RENOVATION Note: Do not budget this category unless prior approval is received from LCLE. Is your building registered or does your building qualify with the National Historic Society? YES NO If yes, you must meet the requirements set forth by Section 106 of the National Historic Preservation Act (16. U.S.C. Section 470, et. seq., as amended. List planned renovations and itemized costs

PLANNED RENOVATIONS TOTAL COST

SUBTOTAL OF RENOVATION COSTS:

COMMENTS OR EXPLANATIONS:

700. RENOVATION CATEGORY TOTAL : (Rounded)

CVA - 10 Revised August 2008 800. OTHER DIRECT COSTS Itemize each type: e.g. audit, rent, (show square footage and cost per square foot), phone charges, utilities, printing, duplicating, etc. Pro-rate telephone and utility bills. Show method of determining cost.

TYPE OF OTHER DIRECT COST METHOD OF DETERMINING COST QUANTITY UNIT COST TOTAL COST

SUBTOTAL OF OTHER DIRECT COSTS DONATED OTHER DIRECT COSTS. (List donated other direct costs used as In-Kind Match.)

TYPE VALUE METHOD OF DETERMINING VALUE TOTAL

SUBTOTAL OF DONATED OTHER DIRECT COSTS BRIEFLY EXPLAIN: A) Need for each type listed; and

B) Relationship to project.

800. OTHER DIRECT COSTS CATEGORY TOTAL:

(Rounded)

CVA - 11 Revised August 2008 CERTIFIED ASSURANCES

The applicant understands, and agrees, that receipt of a subgrant as a result of this application subjects the applicant to the following assurances:

1. ALLOWABLE COSTS. The applicant certifies that any allowable costs incurred under any subgrant shall be determined in accordance with the general principles of allowable costs and standards for selected cost items set forth in Federal OMB Circular A-87 or A-122, as well as the current edition of the OJP Financial Guide, and LCLE Policies.

2. AUDIT REQUIREMENTS. The Applicant agrees to abide by the requirements of the OMB Circular A-133 entitled “Audits of States, Local Governments, and Non-Profit Organizations.” The effective date of the new OMB Circular A-133 is July 1, 1996, and shall apply to audits for fiscal years beginning after June 30, 1996. The audit reports for June 1997 are the first to come under this Circular. The threshold for the single audit requirement is as follows:

If you have expended $300,000 ($500,000 for fiscal years ending after December 31, 2003) or more in a year in Federal awards, you are required to have a single or program specific (if certain criteria are met) audit conducted for that year in accordance with the provisions of the OMB Circular A-133.

If an audit discloses findings or recommendations, then a corrective action plan must be submitted along with the audit report and it must include the following: a) The name and telephone number of the contact person responsible for the corrective action plan. b) Specific steps taken to comply with the recommendations. c) Timetable for performance and/or implementation dates for each recommendation. d) Descriptions of monitoring to be conducted to ensure implementation.

A copy of the resultant audit report, if applicable, management letter issued by the auditor, corrective action plan and any written responses to the aforementioned should be forwarded to the Louisiana Commission on Law Enforcement. The audit report with attachments should be sent within 30 days after the completion of the audit, but no later than 9 months after the end of the audited period.

3. COMMINGLING OF FUND. The applicant certifies and agrees there will be no commingling of funds on either a program-by-program basis or a project- by-project basis. Funds specifically budgeted and/or received for one project may not be used to support another.

4. COMPETITIVE PROCUREMENT. The applicant certifies that procurement of contract services and equipment shall be on a competitive basis in accordance with applicable federal, state, or local procurement regulations, and consistent with policies established by LCLE. Non-competitive procurement (sole source) must receive prior approval from LCLE. Contractors that develop or draft specifications, requirements, statements of work, and/or Request for Proposals (RFPs) for a proposed procurement shall be excluded from bidding or submitting a proposal to compete for the award of such procurement. An exemption to this regulation requires the prior approval of LCLE and is only given in unusual circumstances, such as when a non-profit organization is acting as the agent of the state or local unit of government. Any request for exemption must be submitted in writing to LCLE.

Any state agency or agency of a political subdivision of the state which is using appropriated federal funds must comply with Section 6002 of RCRA. Section 6002 requires that preference be given in procurement programs to the purchase of specific products containing recycled materials identified in guidelines developed by the Environmental Protection Agency (EPA).

5. COMPLIANCE WITH POLICY. The applicant certifies that this subgrant shall be subject to the policies and regulations established by the Office of Justice Programs (OJP), the Office for Victims of Crime (OVC), the Louisiana Commission on Law Enforcement (LCLE), and the Victim Services Advisory Board.

The applicant assures compliance with the applicable guidelines, provisions, policies and requirements authorized by the Victims of Crime Act (Public Law [P.L.] 98 - 473), as amended. Assurance of compliance to this Act is inclusive of any amendment or replacement of the Act through reauthorization or new legislation.

The applicant also assures compliance with the provisions of the Office of Management and Budget (OMB) Circular A-87, Cost Principles for State and Local Governments; OMB Circular A-122, Cost Principles for Nonprofit Organizations; 28 CFR (Code of Federal Regulations) Part 66, Uniform Administrative Requirements for Grants and Cooperative Agreements with State and Local Units of Governments (also known as the Grants Management Common Rule for State and Local Units of Government); the current edition of the OJP Financial Guide; and any other Federal requirements which may apply.

6. CONFIDENTIALITY AND PRIVACY RIGHTS. The applicant certifies that policies have been adopted that prohibit the disclosure of a victim’s name, address, telephone number, or any other identifying information without the prior voluntary written consent of the victim. These policies must be in compliance with the confidentiality and privacy rights and obligations created by any federal or state law, court rules, or rules of professional conduct applicable to the work performed by the applicant.

7. CONTRACTOR AUDITS. The applicant understands and agrees that every contract, agreement or understanding to make a study or prepare a report on behalf of a state agency official, by a private firm, consultant or individual who receives compensation thereof from state, federal, local or other public funds from whatever source, shall contain or be deemed to contain an authorization for the legislative auditor to audit the records of such firm, consultant or individual pertaining to such study or report.

8. COPYRIGHTS. The applicant assures that where activities supported by this subgrant produce original books, manuals, films, computer software, or other copyrightable material, the subgrantee may copyright such, but LCLE and OJP reserve a royalty-free, non-exclusive and irrevocable license to reproduce, publish, and use such materials, and to authorize others to do so.

CVA - 12 Revised August 2008 9. DEBARMENT. The applicant assures that neither he nor his principles are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. This assurance is required by regulations implementing Executive Order 12549, 28 CFR Part 67, Section 67.510, Participants' Responsibilities.

10. DISCRIMINATION FINDING. The applicant assures that in the event that any federal or state court or administrative agency makes a finding of discrimination after a due process hearing on the grounds of race, color, religion, national origin, sex, age, sexual orientation, or disability against a recipient of funds, the recipient will forward a copy of the findings to the Office of Civil Rights Compliance (OCRC), of the Office of Justice Programs.

11. DUAL COMPENSATION. The applicant assures that no contractor will receive dual compensation from his regular employer and the applicant for work performed during a single period of time and that adequate documentation will be maintained to verify such.

12. EQUAL EMPLOYMENT OPPORTUNITY PROGRAM. The applicant assures that if required to formulate an Equal Employment Opportunity Program (EEOP) in accordance with 28 CFR 42.301 et. seq., Subpart E, compliance to the requirement will follow, and a current EEOP will be maintained on file according to applicable requirements.

13. EQUAL TREATMENT REGULATION. The grantee agrees to comply with the applicable requirements of 28 C.F.R. Part 38, the Department of Justice regulation governing “Equal Treatment for Faith Based Organizations” (the “Equal Treatment Regulation”). The Equal Treatment Regulation provides in part that Department of Justice grant awards of direct funding may not be used to fund any inherently religious activities, such as worship, religious instruction, or proselytization. Recipients of direct grants may still engage in inherently religious activities, but such activities must be separate in time or place from the Department of Justice funded program, and participation in such activities by individuals receiving services from the grantee or a sub-grantee must be voluntary. The Equal Treatment Regulation also makes clear that organizations participating in programs directly funded by the Department of Justice are not permitted to discriminate in the provision of services on the basis of a beneficiary’s religion.

14. EQUIPMENT AND OTHER CAPITAL EXPENDITURES. The applicant certifies that: a) no other equipment owned by the subgrantee is available for the project; b) subgrant funds will not be used to provide reimbursement for the purchase price of equipment already owned by the subgrantee except through permissible depreciation or use allowance actually charged to the subgrantee; c) if equipment is for purposes other than this project, the appropriate proration of costs to each activity involved will be affected; d) the amount of Federal funds applicable to the purchase or rent of equipment shall be reduced by any amount received or credited toward the trade-in or sale of older existing equipment which is being replaced as a result of this subgrant; e) funds provided by this subgrant will not be used to replace items of equipment purchased with LCLE subgrant funds except as provided for in current CVA guidance.

15. EXPENSES NOT ALLOWABLE. The applicant certifies that subgrant funds will not be expended for: a) items not part of the approved budget or separately approved by LCLE; b) the purchase of land, construction of buildings, or payment of real estate mortgages or taxes, unless specifically provided for in the subgrant agreement; c) entertainment, amusements, or social activities, and incidental costs related thereto; d) bonuses or commissions; e) purchase of automobiles or other automotive vehicles unless provided for in the subgrant agreement; f) indirect costs, where the subgrantee does not have a current, approved Indirect Cost Rate Plan from their Federal Cognizant Agency; g) political purposes or activities; h) compensation for travel, salary payments, consulting fees, or other remuneration of full-time federal employee; i) military-type equipment; j) direct or indirect use of funds at federal, state, or local levels relating to lobbying activities; k) dues to organizations or federations.

16. INTEREST INCOME. Applicant assures that all interest earned on advances will be accountable. Interest Income is not considered Program Income. Subgrant agencies should only request federal funds for immediate needs. Interest earned on federal funds up to a maximum of $250 a year for all federal programs may be kept by the subgrantee. Amounts over $250 must be submitted annually to the United States Department of Health and Human Services, Division of Payment Management Services, P. O. Box 6021, Rockville, MD 20852. A copy of any pertinent correspondence must be submitted to LCLE. Interest on Program Income may be used as match with prior approval from LCLE.

17. FISCAL REGULATIONS. Applicant certifies and agrees that fiscal administration of subgrants shall be subject to such further rules, regulations, and policies concerning accounting and records, payment of funds, cost allowance, submittal of financial reports, and any other applicable required documentation which may be prescribed by the organizations and/or publications named in #1 and #3.

18. FUTURE SUPPORT. The applicant understands that the awarding of future funding is contingent upon the availability of future federal appropriations.

19. IMMIGRATION AND NATURALIZATION SERVICES EMPLOYMENT ELIGIBILITY VERIFICATION. The applicant agrees to comply with, and keep on file as appropriate, the Immigration and Naturalization Services Employment Eligibility Verification form (I-9). This form is to be used by recipients of federal funds to verify that persons are eligible to work in the United States.

20. INDIGENT DEFENDERS. The applicant certifies that no subgrant funds will be expended for any federal litigation by any indigent defender or any expenses including travel related thereto.

21. INSPECTION AND AUDIT. The applicant understands and agrees that OJP, OVC, LCLE, or any of their duly authorized representatives shall have access, for purposes of audit and examination, to any books, documents, papers, computer software, or records of the subgrantee, and to relevant books and records of contractors as provided under P. L. 98-473, as amended, and OMB Circular A-133, as applicable.

22. INVENTORY CONTROL OVER EQUIPMENT. The applicant certifies that any equipment purchased through the subgrant will be tagged, put in an inventory control system, and identified or distinguished as OJP purchased equipment. When equipment is willfully or negligently lost, stolen, damaged, or destroyed, the subgrantee is responsible for replacing or repairing the equipment. Stolen equipment must be reported to local police, and all resulting reports must be submitted to LCLE.

23. LANGUAGE PROFICIENCY. “Applicants must certify that Limited English Proficiency persons have meaningful access to the services under the program(s). National origin discrimination includes discrimination on the basis of limited English proficiency (LEP). To ensure compliance with Title VI and CVA - 13 Revised August 2008 the Safe Streets Act, recipients are required to take reasonable steps to ensure that LEP persons have meaningful access to their programs. Meaningful access may entail providing language assistance services, including oral and written translation when necessary. The U.S. Department of Justice has issued guidance for grantees to help them comply with Title VI requirements. The guidance document can be accessed on the Internet at www.lep.gov.”

24. LOBBYING. The applicant understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of the enactment, repeal, modification or adoption of any law, regulation or policy, at any level of government, without the express prior written approval of OJP, such as, for establishing, administering, contributing to, or paying for the expenses of a political party, campaign, political action committee, or other organization established for the purpose of influencing the outcome of elections; for attempting to influence federal or state legislation or appropriation by any means or in any manner whether before or after the introduction of any bill or resolution proposing such legislation or appropriation; for engaging in legislative liaison activities including attendance at legislative sessions or committee hearings, gathering information regarding legislation, and analyzing the effect of legislation, when such activities are carried out in support of or in knowing preparation for an effort to engage in unallowable lobbying; or for paying a publicity expert.

Applicant also assures they are aware that support of activities that are permissible under federal law and regulation does not make such costs allowable. The activity must also be within the scope of the purposes of the grant. If such objectives and activities have no direct applicability to the federal legislative process, then no costs related to federal congressional activity would be allowed.

25. MAINTENANCE OF RECORDS. The applicant certifies that all required records, with the exception of non-expendable property inventory records, shall be maintained in accordance with requirements set forth in 28 CFR Parts 66 and 70. All financial records, supporting documents, statistical records, and all other records pertinent to the award, shall be retained by each organization for AT LEAST THREE YEARS following closure of their most recent audit report. If any litigation claim, negotiation, audit, or other actions involving the records begin before the expiration of the three-year period, the records must be retained until completion of the action, or resolution of all issues which arise from it, or until the end of the regular three-year period, whichever is later. Non- expendable personal property inventory records must be maintained until final disposition of the property is authorized by OJP/LCLE.

26. MANDATORY REPORTING. The applicant assures compliance with the provisions of Article 609 of the Louisiana Children's Code, which, in part, states that all suspected, or known instances of child abuse and/or neglect shall be reported. Reports can be made to the Office of Community Services (OCS), the Child Abuse Hot Line, or local law enforcement.

27. MATCH. Applicant certifies that the required match is available and dedicated to this project and is not derived from other Federal funds. Current employee positions transferred to the subgrant shall be replaced or backfilled with new employees.

The applicant assures that funds required to pay the non-federal portion (cash match) of the cost of each project for which a subgrant is made shall be in addition to funds that would otherwise be made available for law enforcement, or other criminal justice efforts by the recipients of the grant funds. Recipients and their subrecipients must maintain records which clearly show the source, the amount, and the timing of all matching contribution.

28. NEW PROGRAM RESOURCES. The applicant, if it is a new program that has not yet demonstrated a record of providing services, certifies that at least 25% of its financial support is from non-federal sources.

29. NON-DISCRIMINATION. The applicant assures that he, and all his contractors, will comply with the non-discrimination requirements set forth in policies and regulations of the organizations and publications listed in # 1 and # 3; 42 USC (United States Code) 3789 (d) and 12131-12134; Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; Subtitle A, Title II of the Americans with Disabilities Act (ADA) of 1990; Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975; Department of Justice Non-Discrimination Regulation, 28 CFR Parts 35, 39, and 42, Subparts C, D, E, and G; and Title I of the Omnibus Crime Control and Safe Streets Act of 1968, Public Law 90-351, and 42 USC 3789 (d).

30. OBLIGATION OF SUBGRANT FUNDS. The applicant certifies that subgrant funds may not, without advance written approval by LCLE, be obligated prior to the effective date or subsequent to the termination date of the subgrant period. Obligations outstanding as of the termination date shall be liquidated within 75 days. Such obligation must be related to goods or services provided and utilized within the grant period. No additional obligations can be incurred after the end of the grant.

31. OTHER FEDERAL COMPLIANCE: A. FLOOD DISASTER PROTECTION ACT OF 1973. The applicant certifies that flood insurance will be purchased in communities where such insurance is available as a condition for the construction or acquisition purpose for use. {Flood Disaster Protection Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234, 87 Stat. 975, approved December 31, 1976)} B. NATIONAL HISTORIC PRESERVATION. The applicant will comply with the Federal regulations regarding any minor renovations or remodeling of a property or structure fifty years or older. {National Historic Preservation Act of 1966 as amended (16 USC 470), Executive Order 11593 and the Archeological and Historical Preservation Act of 1966 (16 USC 596a-1 et seq)} C. NATIONAL ENVIRONMENTAL POLICY ACT (NEPA). The applicant will comply with the Federal regulations in regards to the implementation of a new program involving the use of chemicals other than chemicals used in household, office, recreational, or educational environments.

32. OVERTIME. The applicant assures that executives, such as President or Executive Director of an organization, will not be reimbursed for overtime or compensatory time under the grant or a respective cooperative agreement.

33. PATENTS. The applicant assures that if any subgrant produces patents, patent rights, processes or inventions, a report will be made to LCLE from which a determination will be made as to whether protection of such invention or discovery is necessary in accordance with President's Memorandum of August 23, 1971 (36 P.R. 16889).

34. PEACE OFFICERS. The applicant certifies that all peace officers hired for, or assigned work associated with their subgrant, while in an official capacity, CVA - 14 Revised August 2008 will be POST certified or have been "grandfathered" in, as appropriate.

35. PERSONNEL. The applicant certifies that specific detailed time and attendance records, to include overtime, will be maintained on all grant personnel. Salaries and wages of employees chargeable to more than one grant program must be supported by appropriate time distribution records, which show equitable distribution of time and effort. The applicant further certifies that appropriate screening will be conducted, as well as background checks, for grant personnel who have contact with, or access to juveniles associated with the applicant's subgrant in accordance with the most current Louisiana Child Protection Act. 36. PRESS RELEASES. The applicant certifies that any statements or press releases describing projects, activities, or results shall name LCLE as the agency responsible for making federal funds available for such activity.

37. PROGRAM INCOME. The applicant certifies that all income earned as a direct result of grant-funded activity (sale of publications, registration fees, asset forfeitures, and/or any other activities that generate program income) will be accounted for and utilized only for allowable program costs and in accordance with the LCLE and OJP Program Income Guidelines. Program income must be reported on the Subgrant Expenditure Report.

38. PUBLIC AVAILABILITY OF INFORMATION. The applicant agrees to comply with all applicable federal regulations and state policies relating to the public availability of identifiable records or other documents that are pertinent to the receipt and expenditure of subgrant funds.

39. PUBLICATIONS. Applicants are encouraged to make the results and accomplishments of their activities available to the public. The applicant assures that where activities supported in whole, or in part, by this subgrant produce books, manuals, films, videos, plans or other publications, the applicant will comply with guidelines listed in Chapter 7 of the current OJP Financial Guide as follows: a) Inclusion of the statement, "The opinions, findings, and conclusions or recommendations expressed in this book/manual/film/video/plan/publication /program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice or LCLE"; b) An acknowledgment of support shall be made through use of the following, or comparable, footnote: "This project was supported by Subgrant Number awarded by the Louisiana Commission on Law Enforcement through the Office of Victims of Crime."; c) Submittal of a copy of any book/manual/film/video/plan/publication/computer software to LCLE, as well as a publication and distribution plan prior to publishing or distributing any of the aforementioned items developed under this subgrant.

40. RECORDING AND DOCUMENTATION OF RECEIPTS AND EXPENDITURES. The applicant certifies that accounting procedures will provide for accurate and timely recording of receipt of funds to include the source, expenditures made from such funds, and the unexpended balance. Controls must be established which are adequate to insure that expenditures charged to project activities are for allowable purposes and that documentation is readily available to verify that such charges are accurate.

41. RELIGIOUSLY AFFILIATED PROGRAMS. The applicant certifies that, if the agency is affiliated with a religious program, services will be offered to all victims without regard to religious affiliations and that receipt of services is not contingent upon participation in a religious activity or event.

42. RELOCATION ASSISTANCE. The applicant assures that it will comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970, 84 Stat. 1894, (P. L. 91-646) which provides for fair and equitable treatment of persons displaced as a result of federal or federally assisted programs.

43. RENT. The applicant certifies that: a) when rental charge is requested, the charge is consistent with the prevailing rate in the local area and documentation is maintained on file to support such a determination; b) the cost of space procured for program usage may not be charged to the program for periods of non- occupancy, without authorization from LCLE; c) rental cost of space cannot be paid if the building is owned by the subgrantee or if the subgrantee has a substantial financial interest in the property; d) depreciation or use allowance on idle or excess facilities is NOT ALLOWABLE, except when specifically authorized by LCLE; e) cost of utilities, insurance, security, janitorial services, elevator service, upkeep of grounds, normal repairs and alterations, and the like are allowable to the extent they are not otherwise included in rental or other charges for space.

44. REPORTS. The applicant assures that it shall submit, at such times and in such form as may be prescribed, such reports as LCLE may require, including monthly or quarterly fiscal reports, quarterly progress reports, quarterly program income reports, final fiscal reports, and annual performance reports.

45. SEATBELTS. The applicant assures that it will adopt and enforce a seatbelt policy for employees who operate any vehicle (company -owned, rental, or personally owned) while on the job. Such policy will require that, if available, safety restraints shall be used by the driver and passengers of vehicles.

46. SOFTWARE DEVELOPMENT. The applicant certifies that any computer software developed under this grant shall be placed in the public domain and made available to OJP, OJP Grantees, and LCLE for transfer to authorized users in the criminal justice system without cost other than that directly associated with the transfer. Systems will be documented in sufficient detail to enable a competent data processing staff to adapt the system, or portions thereof, to usage on a computer of similar size and configuration of any manufacturer.

47. SPECIAL CONDITIONS. The applicant certifies that it will abide by and incorporate any additional special conditions and requirements placed on the applicant agency as a result of a subgrant award or subgrant adjustment.

48. SUPPLANTING. The applicant assures that federal funds will not be used to supplant or replace state or local funds, but will be used to increase the amount of such funds that would otherwise, in the absence of federal funds, have been made available for the program funded.

49. TERMINATION OF AID. The applicant understands that the subgrant may be terminated, or fund payments discontinued by LCLE, if a substantial failure to comply with the provisions of the regulations and policies listed in #1 and #3 becomes known, or a failure to comply with the Subgrant Award Agreement is discovered.

CVA - 15 Revised August 2008 50. THIRD PARTY PARTICIPATION. The applicant certifies that no contract or agreement may be entered into by the subgrantee for execution of project activities or provision of services to a subgrant project (other than purchase of supplies or standard commercial or maintenance services) which is not incorporated into the approved proposal, or approved in advance by LCLE. Any such arrangement shall provide that the subgrantee will retain ultimate control and responsibility of the subgrant project and that the contractor shall be bound by applicable subgrant conditions and any other requirements applicable to the subgrantee in the conduct of the project.

51. TRAVEL. The applicant certifies that all travel will be in accordance with the current State Travel Regulations unless stricter regulations apply.

52. UTILIZATION AND PAYMENT OF FUNDS. The applicant assures that awarded funds are to be expended only for purposes and activities covered in the subgrantee's approved project plan and budget. Payments will be made on the basis of periodic requests or estimates of fund needs submitted by the subgrantee. Payments will be adjusted to correct previous overpayments, underpayment, or disallowances resulting from audit.

53. VICTIM COMPENSATION. The applicant certifies that it will refer victims to, provide brochures about, and assist victims with application to the Crime Victim Reparations Program.

54. VOLUNTEERS. The applicant certifies that it will incorporate the use of volunteers in its project. Volunteer services must be documented and, to the extent feasible, supported by the same methods used by the subgrantee for its employees.

55. WRITTEN APPROVAL OF CHANGES. The applicant certifies that all major project changes must have prior written approval from LCLE to include: a) changes of substance in project activities, designs, or research plans set forth in the approved application; b) changes in the project director or key professional personnel identified in the approved application; c) changes in the subgrant period; d) changes in the approved budget.

Requests for changes or extensions of the subgrant must be made in writing in advance of the subgrant expiration date. Expenditure of funds in excess of the submitted total cost estimated for any major budget category will be permitted only with LCLE's written approval. This will involve only those increases of more than 10 percent of the total category cost estimate.

CVA - 16 Revised August 2008 CRIMINAL PENALTIES

A. Whoever embezzles, willfully misapplies, steals, or obtains by fraud any funds, assets, or property which are the subject of a grant, contract or other form of assistance pursuant to this title, whether received directly or indirectly from the U.S. Department of Justice, shall be fined not more than $10,000 or imprisoned for not more than five years, or both.

B. Whoever knowingly and willfully falsifies, conceals, or covers up by trick, scheme, or device, any material fact in any application for assistance submitted pursuant to this title, or in any records required to be maintained pursuant to this title, shall be subject to prosecution under the provisions of Section 1001 of Title 18, United States Code.

C. Any law enforcement program or project underwritten, in whole or in part, by any grant, contract, or other form of assistance pursuant to this title, whether received directly or indirectly from the U.S. Department of Justice shall be subject to the provisions of Section 371 of Title 18, United States Code.

I have read and agree to comply with and abide by CERTIFIED ASSURANCES 1 through 55 and the CRIMINAL PENALTIES A, B, and C, and I have kept a copy of each for my reference.

SIGNATURE OF AUTHORIZED OFFICIAL

CVA - 17 Revised August 2008 LOCAL DISTRICT LEVEL PROGRAM DIRECTORS DISTRICT DIRECTOR OR ASSISTANT DIRECTOR MUST COMPLETE THE FOLLOWING SECTION:

SUBGRANTEE AGENCY:

PROJECT TITLE: FY:

I certify that this application was reviewed and approved by the Law Enforcement Planning Council/Criminal Justice Coordinating Council at their regularly scheduled open, public meeting held on . The minutes and ballots of this council meeting are maintained on file in the District Office.

I further certify that an announcement of the Council meeting at which this allocation and application was reviewed, was published in major newspapers for public notification in accordance with the provisions of the Sunshine Act and in accordance with Louisiana Commission on Law Enforcement Policy.

As District Program Director/Assistant Director, and on behalf of the District Law Enforcement Planning Council or Office of Criminal Justice Coordination, I have reviewed and approved this application, and certify that it is in accordance with applicable federal rules and regulations which govern this project, local and/or state requirements, and Commission/Victim Services Advisory Board policies.

SIGNATURE OF DISTRICT PROGRAM DIRECTOR OR ASSISTANT DIRECTOR

CVA - 18 Revised August 2008 CHECKLIST

THE FOLLOWING ITEMS MUST BE RETURNED AS PART OF THE GRANT APPLICATION AND PLACED IN THE ORDER BELOW:

APPLICATION FOR SUBGRANT – PAGE 1

CHECKLIST AND PROJECT BUDGET SUMMARY – PAGE 2

DETAILED PROJECT BUDGET – PAGES 1–12

COMPUTER QUESTIONNAIRE, IF COMPUTER HARDWARE AND/OR SOFTWARE IS TO BE PURCHASED – PAGE 8

CERTIFIED ASSURANCES ( MUST BE SIGNED BY AUTHORIZED OFFICIAL ) – PAGES 13 – 18

DISTRICT AUTHORIZATION ( MUST BE SIGNED BY DISTRICT PROGRAM DIRECTOR OR ASSISTANT DIRECTOR ) – PAGE 19

JOB DESCRIPTIONS FOR EACH NEW PERSONNEL POSITION REQUESTED ON PAGE 3.

RESUMES FOR NEW PROFESSIONAL-LEVEL PERSONNEL LISTED ON PAGE 3.

COOPERATIVE AGREEMENTS

SUBGRANT AWARD REPORT

CERTIFICATIONS REGARDING LOBBYING; DEBARMENT; SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS

CVA - 19 Revised August 2008 U.S. DEPARTMENT OF JUSTICE The purpose of this report is to collect basic information on subgrant recipients and their programs in a manner that is convenient to report and OFFICE OF JUSTICE PROGRAMS analyze. This report must be completed in full and submitted by the State agency (grantee) within ninety (90) days from the date of the award of a OFFICE FOR VICTIMS OF CRIME subgrant to a local victim assistance program. A Subgrant Award Report must be completed for each program receiving Victims of Crime Act SUBGRANT AWARD REPORT funding. Send the original and one (1) copy to: Office for Victims of Crime, 633 Indiana Avenue, N.W., Washington, D.C. 20531.

1. a. SUBGRANTEE AGENCY NAME AND ADDRESS (Including ZIP Code + 4): 2. FEDERAL GRANT NUMBER: LEAVE BLANK

3. PURPOSE OF VOCA SUBGRANT AWARD: (Check One)

a. START UP A NEW VICTIM SERVICES PROJECT

b. CONTINUE A VOCA FUNDED VICTIM PROJECT FUNDED IN A PREVIOUS YEAR c. EXPAND OR ENHANCE AN EXISTING PROJECT NOT FUNDED BY VOCA IN THE PREVIOUS YEAR b. AREA CODE AND TELEPHONE NUMBER: d. START UP A NEW NATIVE AMERICAN VICTIM SERVICES PROJECT c. CONGRESSIONAL DISTRICT: e. EXPAND OR ENHANCE AN EXISTING NATIVE AMERICAN PROJECT 4. a. CRIME VICTIM ASSISTANCE FUNDS AWARDED: LEAVE BLANK 5. SUBGRANT MATCH (Financial support from other sources): b. STATE AWARD NUMBER: a. VALUE OF IN-KIND MATCH: c. PROJECT BEGIN DATE: b. CASH MATCH: d. PROJECT END DATE: c. TOTAL MATCH:

6. THESE VOCA FUNDS WILL PRIMARILY BE USED TO: (Check one) 7. FOR THIS VICTIM SERVICES PROGRAM INDICATE: a. EXPAND SERVICES INTO A NEW GEOGRAPHIC AREA a. NUMBER OF PAID STAFF (Full-time equivalents) b. OFFER NEW TYPES OF SERVICES b. HAS THE VICTIM SERVICES PROGRAM RECEIVED A VOLUNTEER WAIVER? c. SERVICE ADDITIONAL VICTIM POPULATIONS 1. YES NO d. CONTINUE EXISTING SERVICES TO CRIME VICTIMS 2. IF NO WAIVER HAS BEEN GRANTED, INDICATE THE NUMBER OF VOLUNTEER STAFF: e. OTHER 8. IDENTIFY HOW MUCH OF THE VOCA GRANT THAT WILL BE USED TO MEET THE PRIORITY AND UNDERSERVED REQUIREMENTS. (FEDERAL FUNDS ONLY.) 9. TYPE OF IMPLEMENTING AGENCY (Check the appropriate boxes) a. CHILD ABUSE a. CRIMINAL JUSTICE – GOVERNMENT: b. DOMESTIC VIOLENCE 1. LAW ENFORCEMENT 4. COURT c. SEXUAL ASSAULT

d. UNDERSERVED 2. PROSECUTION 5. CORRECTIONS 1. DUI/DWI CRASHES 3. PROBATION 6. OTHER 2. SURVIVORS OF HOMICIDE VICTIMS

3. ASSAULT b. NON-CRIMINAL JUSTICE – GOVERNMENT: 4. ADULTS MOLESTED AS CHILDREN 1. SOCIAL SERVICES 4. HOSPITAL 5. ELDER ABUSE 6. ROBBERY 2. MENTAL HEALTH 5. OTHER 7. OTHER VIOLENT CRIMES 3. PUBLIC HOUSING 10. PLEASE PROVIDE THE TOTAL AMOUNTS OF FUNDING ALLOCATED TO VICTIM SERVICES BASED ON THE SUBGRANTEE'S CURRENT FISCAL YEAR BUDGET. c. PRIVATE NON-PROFIT: FUNDING SOURCES CURRENT YEAR 1. HOSPITAL 4. SHELTER a. FEDERAL (Excluding VOCA) b. VOCA FUNDS 2. RAPE CRISIS 5. MENTAL HEALTH

c. STATE AGENCY d. LOCAL 3. RELIGIOUS ORGANIZATION 6. OTHER e. OTHER

d. NATIVE AMERICAN TRIBE OR ORGANIZATION: 11. IDENTIFY THE VICTIM(S) TO BE SERVED THROUGH THE VOCA-FUNDED PROJECT (VOCA grant plus Match) BY CHECKING THE TYPE OF CRIME(S): a. CHILD PHYSICAL ABUSE h. ADULTS MOLESTED AS CHILDREN b. CHILD SEXUAL ABUSE i. SURVIVORS OF HOMICIDE VICTIMS c. DUI/DWI CRASHES l. ROBBERY d. DOMESTIC VIOLENCE k. ASSAULT f. ADULT SEXUAL ASSAULT l. OTHER VIOLENT CRIMES g ELDER ABUSE m. OTHER

12. CHECK THE SERVICES TO BE PROVIDED BY THIS VOCA-FUNDED PROJECT (VOCA grant plus Match) a. CRISIS COUNSELING h. CRIMINAL JUSTICE SUPPORT/ADVOCACY b. FOLLOW-UP CONTACT i. EMERGENCY FINANCIAL ASSISTANCE c. THERAPY j. EMERGENCY LEGAL ADVOCACY d. GROUP TREATMENT k. ASSISTANCE IN FILING COMPENSATION CLAIMS e. CRISIS HOTLINE COUNSELING l. PERSONAL ADVOCACY f. SHELTER/SAFE HOUSE m. TELEPHONE CONTACTS (Information and referral) g. INFORMATION AND REFERRAL (In-Person) n. OTHER SUBGRANT AWARD REPORT INSTRUCTIONS DEFINITIONS: 8. Indicate the amount of VOCA Federal funds that are allocated to the priority and underserved victims of crime. The following words are defined to provide consistency in completing the Subgrant Award Report Form. 9. Check the appropriate boxes that best describe the agency listed in Item 1.

Child: A person under the age of 18 or as otherwise defined by State law. 10. Report the total budget available to the victim services program, by source of funding. Do not report the entire agency budget, unless the entire budget is devoted to victim Elder Abuse: Abuse perpetrated by a caretaker upon an elderly individual who depends services. For example, if VOCA funds are awarded to support a victim advocate unite on others for support and assistance. in a prosecutor's office, then only report the budget for the victim advocate unit. Note: Do not include in-kind match. Do not report sums less than one dollar. Victim Services Program: All services and activities offered on behalf of victims of crime, including the VOCA grant and match. 11. Check the box(es) that best identify type(s) of victims the VOCA-funded project will serve. "Other" in this category refers to victims of non-violent crime, i.e. burglary, VOCA-Funded Project: VOCA funds plus match. white collar, etc. Please Specify.

INSTRUCTIONS: 12. Check the box(es) that best identify type(es) of services or activities that will be 1. a. Provide the name and a two-line address of the agency receiving the VOCA funds. provided by the VOCA-funded project, as described below. Note: Report only those This item refers to the agency providing the direct services to victims of crime, services actually provided by the VOCA-funded project. Do not report services not a pass-through or conduit agency. offered by another agency.

b. Provide the area code and telephone number. a. Crisis Counseling refers to in-person crisis intervention, emotional support and guidance and counseling provided by advocates, counselors, mental health c. List the Congressional District and any other District(s) affected by the VOCA- professionals, or peers. Such counseling may occur at the scene of a crime, funded program or project. immediately after a crime, or be provided on an on-going basis.

2. Provide the Federal grant award number from which this subgrant is made. This b. Follow-up Contact refers to in-person contacts, telephone contacts and written number can be found in "Item 4 of the OJP Award" document, Form 4000/2. Note: communications with victims to offer emotional support, provide empathetic listening, If funds are awarded from more than one Federal VOCA grant award to this victim check on a victim's progress, etc. agency, a Subgrant Award Report must be completed and submitted for each award. c. Therapy refers to intensive professional psychological and or psychiatric treatment for 3. Check the appropriate box. individuals, couples, and family members related to counseling to provide emotional support in crisis arising from the occurrence of crime. This includes the evaluation of 4. a. Provide the total dollar amount of VOCA Federal funds awarded. Do not mental health needs, as well as the actual delivery of psychotherapy. report Cash or In-kind matching funds nor sums less than one dollar. d. Group Treatment refers to the coordination and provision of supportive group b. Provide the State award number assigned to this VOCA award. Note: Each activities and includes self-help, peer, social support, etc. number must be different. e. Crisis Hotline Counseling typically refers t the operation of a 24-hour telephone c. Indicate the date the VOCA-funded project begins. service, 7 days a week, which provides counseling, guidance, emotional support information and referral, etc. d. Indicate the date the VOCA-funded project ends. f. Shelter/Safe House refers to offering short- and long-term housing and related support 5. a. Provide the value of in-kind match. services to victims and families following a victimization.

b. Provide the value of cash match. g. Information and Referral (In-Person) refers to in-person contacts with victims during which time services and available support are identified. c. Indicate the total match available to this VOCA-funded project. Note: Do not report sums less than one dollar. h. Criminal Justice Support/Advocacy refers to support, assistance, and advocacy provided to victims at any stage of the criminal justice process, to include post All VOCA awards must be matched (20 percent), either with in-kind or cash match, sentencing services and support. except for VOCA subgrants made in the Virgin Islands, Puerto Rico, American Samoa, Guam, Northern Marlanas and Palau. Match must run concurrently with the i. Emergency Financial Assistance refers to cash outlays for transportation, food, VOCA-funded project and must be designated exclusively for direct victim services clothing, emergency housing, etc. as determined by VOCA. No Federal funds may be used to match this VOCA subgrant. j. Emergency Legal Advocacy refers to the filing of temporary restraining orders injunctions and other protective orders, elder abuse petitions, and child abuse petitions This is computed by dividing the amount of the award from Item 4.(a.) by .80 and but does not include criminal prosecution or the employment of attorney for non- subtracting the amount of the award from the figure obtained. (For example, a emergency purposes, such as custody disputes, civil suits, etc. $30,000 award divided by .80 equals $37,500, less $30,000 award equals $7,500 match.) k. Assistance in Filing Compensation Claims includes making victims aware of the availability of crime victim compensation, assisting the victim in completing the Native American Tribe/Organization Match is 5% if the Tribe or Organization is required forms, gathering the needed documentation, etc. It may also include follow- located on a reservation. This is computed by dividing the amount of the award from up contact with the victim compensation agency on behalf of the victim. Item 4.(a.) by .95 and subtracting the amount of the award from the figure obtained. (For example, a $30,000 award divided by .95 equals $31,579, less $30,000 award l. Personal Advocacy refers to assisting victims in securing rights, remedies and services equals $1,579 match.) from other agencies; locating emergency financial assistance, intervening with employers, creditors and others on behalf of the victim; assisting the filing for losses 6. Check the box that indicates how the VOCA funds will, primarily, be used. If it will covered by public and private insurance programs including worker's compensation, be used equally for two or more items, select 6.(3.), "Other". unemployment benefits, etc.; accompanying the victim to the hospital; etc.

7.a.b. Within the victim services program, which includes the VOCA funds and match, m. Telephone Contacts refers to contacts with victims during which time services are indicate the number of paid staff (7.a.) And whether or not a volunteer waiver has available support are identified. been given (7.b.) If "No", indicate the number of volunteer staff. Use full-time equivalents when responding to these questions and round fractions to the nearest n. Other refers to other allowable VOCA services and activities not listed. whole number. These numbers may be estimated or prorated.

Public reporting burden for this collection of information is estimated to average 3 minutes per response, including the time for reviewing instructions and entering the date into the Subgrant Subdial System. Send comments regarding this burden estimate

or any other aspects of this collection of information, including suggestions for reducing this burden, the State Compensation and Assistance Division, Office for Victims of Crime, S. Department of Justice, 633 Indiana Avenue, N. W., Washington, D. C.

20531, and to the Public Use Reports Project, 1121-0142, Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D. C. 20503. OJP ADMIN FORM 7390/2A (REV. 11-95) PREVIOUS EDITIONS ARE OBSOLETE.