Title: FY 1997 Victims of Crime Act Crime Victims Compensation Grant Application Kit U.S. Department of Justice Office of Justice Programs Office for Victims of Crime Office for Victims of Crime Victims of Crime Act Crime Victims Compensation Grant Application Kit Fiscal Year 1997 To receive your Compensation Grant all you need to do is: * Complete the Application for Federal Assistance (SF 424) found in Attachment B. (Application instructions and an example of a completed SF 424 can also be found in Attachment B.) Please ensure that your application is signed. * Read and sign the Assurances found in Attachment B. * Read and sign the Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements found in Attachment C. * Complete and sign, if applicable, the Disclosure of Lobbying Activities and Continuation Sheet found in Attachment D. * Complete Crime Victims Compensation Eligible State Payments Certification Form (FY 1996 payout) found in Attachment E. * Complete, if necessary, the ACH Vendor/Miscellaneous Payment Enrollment Form found in Attachment G. * Provide information on Civil Rights Requirements, Single Audit Act, Use of Administrative Funds, and Eligibility Requirements as described in Attachment H. Please send your completed original application and one copy to: Office for Victims of Crime Office of Justice Programs 633 Indiana Avenue, NW. Washington, D.C. 20531-0001 (202) 307-5983 Applications must be received by Close of Business November 25, 1996. TABLE OF CONTENTS Program Instruction for Fiscal Year 1997 1 Fiscal Year 1997 Application Kit 3 I. Grant Application Information 3 II. Eligibility Requirements for State Grantees 5 III. Funding Allocation and State Certification 7 IV. Use of Administrative Funds . . . . . . . . . . . . . . . . . . . . . 8 V. Program Requirements 11 VI. V. Financial Requirements 12 VII. VI. Fund Suspension or Termination 15 VIII. VII. Monitoring and Technical Assistance 15 Attachments Attachment A Crime Victims Fund Compensation Allocation Table Attachment B Application for Federal Assistance, Assurances, Sample Completed Application, and Instructions Attachment C Certification Regarding Lobbying Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements Attachment D Disclosure of Lobbying Activities Attachment E Crime Victims Compensation Eligible State Payments Certification Form and Instructions Attachment F Sample Administrative Cost Provision Budget Attachment G ACH Vendor/Miscellaneous Payment Enrollment Form Attachment H Application Kit Checklist Program Instruction VOCA Crime Victim Compensation Fiscal Year 1997 Grant Program Introduction This Application Kit and Program Instruction provide the necessary information and guidance for the preparation and submission of an application for a Victims of Crime Act (VOCA) crime victim compensation grant. The Office for Victims of Crime (OVC) has prepared this Application Kit and Program Instruction to assist State agencies, as designated by the Governor, in applying for grants. The Kit should be used in conjunction with VOCA; the victim compensation Program Guidelines; and the Office of Justice Programs (OJP) Financial Guide. The crime victim compensation grant program is authorized by 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 allocation of dollars for crime victim compensation grants to States in FY 1997 comes from monies deposited in the Crime Victims Fund (Fund) during FY 1996. The first $6,200,000 deposited in the Fund in each of the fiscal years 1992 through 1995 and the first $3,000,000 in each fiscal year thereafter shall be available to the Administrative Office of United States Courts for administrative costs [Section 1402(d)(1)]; the next $10 million shall be available for the Children's Justice and Assistance Act grants [Section 1402(d)(2)]. The remaining Fund deposits are distributed as follows: 48.5 percent is available for victim compensation grants, 48.5 percent is available for victim assistance grants, and 3 percent is available for support of services to federal crime victims and for demonstration, training, and technical assistance services to eligible crime victim assistance programs. [Section 1402(d)(3).} Section 1403(a)(1) of VOCA provides that "the Director shall make an annual grant from the Fund to an eligible crime victim compensation program of 40 percent of the amounts awarded during the preceding fiscal year, other than amounts awarded for property damage." The VOCA Victim Compensation Allocation Table for Fiscal Year 1997, (Attachment A) lists the distribution of funds to States from the Fiscal Year 1996 Fund. The amount listed on this table is the amount for which states may apply in their application for Federal Assistance. Based on the total States certified payments in FY 1995, the amount needed to award each eligible State 40% of the States' payout is $74,241,000. All unused funds allocated for the VOCA compensation grant program will be made available for VOCA victim assistance grants. In September 1996, Congress passed legislation extending the grant period from year of award plus two to year of award plus three. In Fiscal Year 1995, States were given the option of using up to five percent of their VOCA crime victim compensation grant funds for administering the state crime victim compensation grant program. States that elect to use administrative funds under the VOCA compensation grant must include in the FY 1997 Crime Compensation Grant Application Kit a general description of how the administrative funds will be used. The description should include (1) what amount of the total grant will be used; (2) an itemization of the State's project expenditures for allowable administrative costs that also includes how the State grantee intends to use the funds and the types of activities that will be supported; and (3) how these activities will improve the administration of the VOCA program and/or improve services to crime victims. Application Elements An application for a VOCA crime victim compensation grant consists of a number of elements, each of which must be included as a part of the State's submission for a grant award. To ensure that all of the required elements are included in the submission, check off each item as completed and attach to the Application Kit Checklist provided in Attachment H. Applicants must provide a copy of their State's compensation statute and written assurance of compliance with each of the eligibility requirements (listed on pages 5-7) in a separate statement or in the cover letter transmitting the application. Each element of the application should be completed according to the instructions provided. States should not use forms from a previous year's application kit for FY 1997 funding. Particular care should be taken to ensure that the forms requiring a signature are signed by the "duly authorized official." This is the highest administrative official in the agency designated by the Governor to apply for and administer the Federal grant. The Governor's designee or highest administrative official in the State crime victims compensation program may serve as the certifying official for the purpose of submitting the required assurances and certification of eligible State compensation payments in FY 1996. Application Submission and Deadline An original and one copy of the signed Application for Federal Assistance, Standard Form 424, should be sent to the Office of Justice Programs, Office for Victims of Crime, 633 Indiana Avenue, N.W., Washington, D.C. 20531. Attention: State Compensation and Assistance Division. Applications may be submitted upon receipt of this Program Instruction, but no later than November 25, 1996. For Further Information Contact your State Program Specialist at the Office for Victims of Crime, State Compensation and Assistance Division, at telephone number (202) 307-5983. This program is not subject to the provisions of Executive Order 12372, Intergovernmental Review of Federal Programs. The collection of information requirements contained in Section IV, Reporting Requirements, has been submitted to the Office of Management and Budget (OMB) for review under the Paperwork Reduction Act, 44 U.S.C. 3504(h). Approval to use the specified reports to gather information on the use of VOCA victim compensation grant funds has been given by OMB. Effective Date: Upon issuance. Fiscal Year 1997 Application Kit I. Grant Application Information This Application Kit contains the necessary forms and detailed information required to make application for a Fiscal Year (FY) 1997 VOCA victim compensation grant. Please review the following instructions prior to completing the application. Applicants should contact their State Program Specialist at the State Compensation and Assistance Division within OVC for clarification of any requirements for this program. NOTE: Attachments must be signed by the highest administrative official in the agency designated by the Governor to apply for and administer the Federal grant. This grant Application Kit includes the following attachments: o Compensation Allocation Table (Attachment A) The Compensation Allocation Table provides information on the amount of monies allocated to each State for their crime victim compensation program. This is the amount each State should request in the application for VOCA compensation funding, at Items 15a and 15g of the Application for Federal Assistance. o Application For Federal Assistance, Standard Form 424, Assurances, Sample Completed Application (Attachment B) Standard Form 424 is the face sheet for the application. It should be followed by a signed copy of the Assurances. Instructions for completing the application form can be found in Attachment B, along with a sample completed form. o Certification Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-free Workplace Requirements (Attachment C) Any State agency that applies for a victim compensation grant, as authorized in Section 1403(a)(1) of VOCA, must provide the necessary certification. The form for the certification is titled, "Certification Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements (OJP Form 4061/6). The Governor's designee is required to sign and date the certification and include it with the State's application for a VOCA victim compensation award. Section 1: Lobbying This certification is a material representation of fact upon which reliance will be placed when considering the application. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. (31 U.S.C. 135 2) Section 2: Debarment, Suspension, and Other Responsibility State grantees should cross out this section, as it is not applicable. Section 3: Drug-Free Workplace Grantees of Federal agencies are required to certify that they will provide drug-free workplaces in compliance with the Drug-Free Workplace Act of 1988. o Disclosure of Lobbying Activities (Attachment D) Only those State grantees who receive over $100,000 and who have engaged in reportable Federal lobbying activities are required to complete and sign this form. Reportable Federal Lobbying activities include, but are not limited to payment of funds to an organization that lobbies' Federal government officials and/or Congress for grant monies for a specific project purpose; or the employment of an individual on a part-time basis whose sole purpose is to lobby on behalf of the organization for grant monies for a specific project purpose. This form is used to disclose lobbying activities pursuant to 31 U.S.C. 1352. o Crime Victims Compensation Eligible State Payments Certification Form and Instructions (Attachment E) The amount certified on this form will be used by OVC to determine the annual Federal grant award to each eligible State in FY 1998. Report all sources of State revenue available to the crime victim compensation program to award benefits to crime victims during the 1996 Fiscal Year, except for amounts paid for property losses or damage. o Sample Administrative Cost Provision Budget (Attachment F) This sample budget is provided as guidance for States electing to use administrative funds under the FY 1997 VOCA Crime Victims Compensation Grant. o ACH Vendor/Miscellaneous Payment Enrollment Form (Attachment G) If you are a new award recipient or if you previously received your funds in the form of a paper check from the U.S. Treasury, you must enroll in the Treasury Department's Automated Clearing House (ACH) Vendor Express program before you may request any federal funds. Please complete Block 2 (Payee/Company Information) and have your financial institution complete Block 3 (Financial Institution Information). Forward the original copy of the form to the address indicated in Block 1 (Agency Information). o Application Kit Checklist (Attachment H) This Checklist is provided to ensure that all elements of the application are completed. II. Eligibility Requirements for State Grantees Section 1403 (d)(4) of VOCA defines the term "State" to include all States, the District of Columbia and the following Territories: Commonwealth of Puerto Rico; the U.S. Virgin Islands; American Samoa; Northern Mariana Islands; and Guam. In order to be eligible for a crime victim compensation grant award under VOCA, each applicant must provide the necessary assurances that it meets the prescribed conditions and certain eligibility requirements described in Section 1403(b) of VOCA, codified at 42 U.S.C. 10602(b). State victim compensation programs applying for FY 1997 VOCA Crime Victim Compensation Grants must provide written assurance of compliance with each of the following eligibility requirements in a separate statement or in the cover letter transmitting the application. The Antiterrorism and Effective Death Penalty Act of 1996, signed into law on April 24, 1996, amends VOCA and changes victim compensation eligibility requirements as follows: states are required to provide victim compensation to victims of terrorism whether they are victimized within or outside the borders of the United States; if a crime victim applies for assistance from any federal, state or local government program that uses federal funds, the program may not include victim compensation benefits when determining income eligibility for an applicant, if the applicant needs such assistance (medical or otherwise), in full or in part, because of the commission of a crime against an applicant; and states are prohibited from awarding victim compensation benefits to any person convicted of a federal crime who is delinquent in paying a fine, monetary penalty, or restitution imposed for the offense. This provision, however, cannot be applied to deny compensation benefits until the U.S. Attorney General and the Director of the Administrative Office of the U.S. Courts issue a written determination that entities administering federal victim programs have access to an accurate and efficient criminal debt payment tracking system. These new provisions are highlighted in bold text in the section below. A State program is eligible for funding as provided in Section 1403(b) of VOCA if: such program is operated by a State and offers compensation to victims and survivors of victims of criminal violence, including drunk driving and domestic violence for-- medical expenses attributable to a physical injury resulting from compensable crime, including expenses for mental health counseling and care; loss of wages attributable to a physical injury resulting from a compensable crime; and funeral expenses attributable to a death resulting from a compensable crime; such program promotes victim cooperation with the reasonable requests of law enforcement authorities; such program certifies that grants received under this section will not be used to supplant State funds otherwise available to provide crime victim compensation; such program, as to compensable crimes occurring within the State, makes compensation awards to victims who are nonresidents of the State on the basis of the same criteria used to make awards to victims who are residents of such State; such program provides compensation to victims of Federal crimes occurring within the State on the same basis that such program provides compensation to victims of State crimes; such program provides compensation to residents of the State who are victims of crimes occurring outside the State if-- the crimes would be compensable crimes had they occurred inside that State; and are outside of the U.S. (if compensable crime is terrorism as defined in Section 2331 of title 18 of U.S. Code), or the places the crimes occurred in are States not having eligible crime victim compensation programs; such program does not, except pursuant to rules issued by the program to prevent unjust enrichment of the offender, deny compensation to any victim because of that victim's familial relationship to the offender, or because of the sharing of a residence by the victim and the offender; such program does not provide compensation to any person who has been convicted of an offense under Federal law with respect to any time period during which the person is delinquent in paying a fine, other monetary penalty, or restitution imposed for the offense (this provision, however, cannot be applied to deny benefits until the U.S. Attorney General and the Director of the Administrative Office of the U.S. Courts issue a written determination that the entities administering federal victim programs have access to an accurate and efficient criminal debt payment tracking system); and such program provides such other information and assurances related to the purposes of this section as the Director may reasonably require. Exclusion from income for purposes of means tests: Notwithstanding any other law, for the purpose of any maximum allowed income eligibility requirement in any Federal, State or local government program using Federal funds that provides medical or other assistance (or payment or reimbursement of the cost of such assistance) that becomes necessary to an applicant for such assistance in full or in part because of the commission of a crime against the applicant, as determined by the Director, any amount of crime victim compensation that the applicant receives through a crime victims compensation program under this section shall not be included in the income of the applicant until the total amount of assistance that the applicant receives from all such programs is sufficient to fully compensate the applicant for losses suffered as a result of the crime. III. Funding Allocation and State Certification A. Funding Allocation. Annual grant awards to eligible programs will equal 40 percent of the amounts awarded by the program from State sources of revenue two years prior to the grant year. For example, for FY 1997 a program's grant allocation is based on 40 percent of amounts awarded by the State program in FY 1995. B. State Certifications. In order to be eligible for a VOCA crime victims compensation award under Section 1403 of VOCA in FY 1998, a State must submit a FY 1996 Crime Victim Compensation Eligible State Payments Certification Form for the period (October 1, 1995 - September 30, 1996). This form is contained in this Application Kit (Attachment E). The amount certified on this Form will be used by OVC to determine the FY 1998 grant award to each eligible State. Instructions for completing the certification form are also contained in Attachment E. IV. Use of Administrative Funds Since Fiscal Year 1995, VOCA has allowed States to use up to five percent of the VOCA victim compensation grant funds for administering the state crime victim compensation grant program. The legislative intent is to advance program administration in all operational areas including claims processing, staff development and training, public outreach, and program funding by supporting those activities that will improve program effectiveness and service to crime victims. A. Maintenance of Effort and Supplantation States must certify that VOCA funds used for administrative purposes will not be used to supplant State or local funds, but will be used to increase the amount of State funds that would be available for administering the compensation program. For the purpose of establishing a baseline level of effort, States should maintain documentation as to the overall administrative commitment of the State prior to their use of VOCA administrative funds. The following examples illustrate how the maintenance of effort provision can be exercised and documented: Example 1: A State that has utilized VOCA administrative funds since Fiscal Year 1996: In Fiscal Year 1995, it cost a State $80,000 to administer the VOCA victim compensation grant program. These funds supported salary and benefits of two staff (a director and a claims investigator), prorated share of audit costs, and travel costs to attend training. In Fiscal Year 1996, the State received a VOCA grant in the amount of $700,000. The State used $35,000 of the VOCA grant (5%) to expand and improve services to crime victims by hiring an additional claims investigator and providing appropriate training to this individual. The State documented that a total of $115,000 ($80,000 + $35,000) was used to support administering the Fiscal Year 1996 VOCA compensation grant program. With the Fiscal Year 1997 grant program, the State will receive a VOCA grant in the amount of $800,000. The State elects to use $40,000 of the VOCA grant (5%) to expand and improve services to crime victims by purchasing computer equipment, hiring a clerk typist, and providing training to this individual. For the State to continue satisfying OVC's requirement of expanding, enhancing, and/or improving the State's previous level of effort, the State must be able to document a total of $120,000 ($80,000 + $40,000) was used to support administering the Fiscal Year 1997 VOCA compensation grant program. Example 2: A State electing to use VOCA administrative funds for the first time: In Fiscal Year 1996, it cost a State $70,000 to administer the VOCA victim compensation grant program. These funds supported salary and benefits of two staff (a director and a claims investigator). With the Fiscal Year 1997 grant program, the State will receive a VOCA grant in the amount of $700,000. The State will use $35,000 of the VOCA grant (5%) to expand and improve services to crime victims by hiring a restitution coordinator and providing training to this individual. For the State to satisfy OVC's requirement of expanding, enhancing, and/or improving the State's previous level of effort, the State must be able to document a total of $105,000 ($70,000 + $35,000) was used to support administering the Fiscal Year 1997 VOCA compensation grant program. B. Allowable Activities and Costs Allowable administrative costs include but are not limited to the following: program personnel, salary and benefits; travel costs for attendance at state, regional, and national compensation training conferences; computer equipment and support services; costs involved in the production and distribution of program brochures and posters, and other program outreach activities; professional fees for computer services and peer review; agency membership dues for victim compensation organizations; program enhancements such as toll free numbers; special equipment and materials to facilitate service to persons with disabilities, and other reasonable costs directly related to administering a compensation program. Staff supported by administrative funds under the VOCA compensation grant must work directly for the compensation program in the same proportion as their level of support from VOCA grant funds. If the VOCA supported staff have other functions, the proportion of time working on the compensation program must be documented using some reasonable method at regular intervals to provide a clear audit trail for the expenditure of grant funds. States who use VOCA grant funds to support staff salaries or benefits in whole or part must maintain time and attendance records on all funded staff which demonstrates that portion of staff time spent on compensation related activities. Only staff activities directly related to compensation functions can be funded with VOCA administrative funds. Similarly, any equipment purchases or other expenditures charged to the VOCA compensation grant should only be charged proportionate to the percentage of time utilized by the compensation program. Temporary or periodic personnel support, such as qualified peer reviewers for medical and mental health claims, and data processing support services are also allowable. These services may be obtained through contract using VOCA administrative funds. C. Application and Reporting Processes Those States that elect to use administrative funds under the VOCA compensation grant, shall include in the FY 1997 Crime Compensation Grant Application a general description of how the administrative funds will be used. The description should include (1) what amount of the total grant will be used; (2) an itemization of the State's project expenditures for allowable administrative costs that also includes how the State grantee intends to use the funds and the types of activities that will be supported; and (3) how these activities will improve the administration of the VOCA program and/or improve services to crime victims. (See Attachment F.) A State may modify projections set forth in their application by providing OVC a revised description of their planned use of administrative funds in writing, subsequent to submitting their annual application. Those States that choose to utilize administrative funds under the VOCA compensation grant, shall include a narrative description of the impact of the VOCA administrative funds with their annual performance report. State grantees will use the Financial Status Report, SF-269A, to record the actual expenditures of the administrative funds. VOCA victim compensation grantees are accustomed to drawing down all VOCA grant funds and submitting a Final Financial Report to close out the grant within one or two quarters. However, the procedures for compensation programs must be different, if administrative funds are used throughout the grant period. Compensation grants must remain open for as long as the State is using VOCA funds -- either to pay compensation benefits or for administrative costs. For example, if a compensation program is using administrative funds for salary and fringe benefits for the entire grant period, quarterly Financial Status Reports are required each quarter. In this example, line 10c (for recording Federal share of outlays) on the Financial Status Report would be used to show the amount of dollars that is used each quarter for salary and fringe benefits supported with VOCA administrative funds. A final Financial Status Report is due 120 days after the grant period ends. V. Program Requirements VOCA requires that each State grantee will certify that it meets the minimum eligibility criteria necessary to receive an award of VOCA crime victim compensation grant funds as outlined in the Act, the VOCA crime victim compensation Program Guidelines, and all applicable Federal law. A. Reporting Requirements Performance Report. Each State crime victim compensation program receiving funds under VOCA is required to submit an annual Performance Report. The State grantee will be responsible for compiling the information and submitting this Report. OVC uses the performance report data to report to Congress on the impact of Federal funds on the lives of crime victims throughout the nation. It is essential that your agency furnish each data element requested on this form and that statistical data is not consolidated into broad categories. This is a mandatory requirement of the VOCA crime victim compensation grant program and your full cooperation is required. The report will be provided by OVC in advance and is due December 30 of each year for the preceding FY (October 1 through September 30). B. Additional Requirements Confidentiality of Research Information. Except as otherwise provided by Federal law, no recipient of VOCA victim compensation funds shall use or reveal any research or statistical information furnished under VOCA by any person, and identifiable to any specific private person, for any purpose other than the purpose for which such information was obtained in accordance with VOCA. Such information, and any copy of such information, shall be immune from legal process and shall not, without the consent of the person furnishing such information, be admitted as evidence or used for any purpose in any action, suit, or other judicial, legislative, or administrative proceeding [Section 1407(d) of VOCA]. This provision does not override or repeal a State's laws governing the disclosure of information, such as a State's existing law pertaining to the mandatory reporting of a case of suspected child abuse. [See Pennhurst State School and Hospital v. Halderman, et al., 451 U.S. 1 (1981)]. VI. Financial Requirements Grantees receiving funds under the VOCA crime victim compensation grant program are to adhere to the financial and administrative provisions set forth in the OJP Financial Guide. The following financial requirements represent the core provisions under the VOCA crime victim compensation grant program. A. Award Document The award document constitutes the operative document obligating and reserving Federal funds for use by the grant recipient. Such obligation may be terminated without further cause if the grantee fails to affirm timely utilization of the grant by signing and returning the acceptance document to OJP and OVC WITHIN 45 DAYS from the date of award. Note: No Federal funds shall be disbursed to a grantee until the signed award document accepting the grant and the terms and conditions of the grant has been received by OJP and OVC. B. Payment of Grant Funds In accordance with the Debt Collection Improvement Act of 1996, the U.S. Treasury Department revised its regulations regarding federal payments. Effective July 26, 1996, all federal payments to VOCA victim compensation grantees must now be made via electronic funds transfer. States must enroll in the Treasury Department's Automated Clearing House (ACH) Vendor Express program before requesting any federal funds. Therefore, VOCA awardees can no longer receive drawdowns against their awards via paper check mailed from the Treasury. Grant recipients must enroll in ACH for Treasury to electronically transfer drawdowns directly to their banking institutions. For assistance in completing the ACH Vendor/Miscellaneous Payment Enrollment Form (see Attachment G), or for additional information on the ACH Vendor Express program, please call the Office of the Comptroller, Accounting Division, 633 Indiana Avenue, N.W., Washington, D.C. 20531, at telephone (202) 307-5909. C. Termination of Advance Funding If a State that receives cash advances demonstrates an unwillingness or inability to establish procedures that will minimize the time elapsing between cash advances and disbursement, the grantor agency may terminate advance funding and require the grantee organization to finance its operations with its own working capital. Payments to the grantee will then be made by the ACH Vendor Express method to reimburse the grantee for actual cash disbursements. It is essential that the grantee organization maintain a minimum amount of cash on hand and that drawdowns of cash are made only when necessary for disbursements. D. Obligation Period VOCA crime victim compensation funds may be obligated at any time during the balance of the FY in which the award was made, and the following three FYs. The FY 1997 grant period begins October 1, 1996, and ends on September 30, 2000. Although VOCA compensation awards are often not made until well after the October 1 FY start date, State crime victim compensation programs may pay claims prior to receiving the award, and charge the VOCA grant of funds retroactively from October 1. E. Financial Status Reports A Financial Status Report (269A) is required for all grant recipients. This report shall be submitted to the Office of the Comptroller (OC) by the grantee within 45 days after the end of the calendar quarter, (e.g., March 31, June 30, September 30, and December 31). Final Financial Status Reports are due 120 days after the end of the grant period. Note: Failure to comply with this requirement may result in administrative action such as the withholding of payments, cancellation of a letter of credit, or non-certification of new or supplemental grant awards. In lieu of using the standard 269A Report, grantees may satisfy the financial reporting requirements by completing an 269A turnaround document. This document is a facsimile of the 269A extracted from the grantor agency's computer files and sent directly to each grantee. Pertinent information such as grantee's name and address, grant number, and the previously submitted financial information (if any) is printed on the form by the computer. F. Compensable Expenses The range of expenses for which States may award crime victims compensation varies nationwide, although all States must award compensation for those compensable expenses specifically identified in Section 1403(b) of VOCA. These expenses include: (1) Medical expenses attributable to a personal injury resulting from a compensable crime, including expenses for mental health counseling and care; (2) Loss of wages attributable to a personal injury resulting from a compensable crime; and (3) Funeral expenses attributable to a death resulting from a compensable crime. Compensable crime is defined as a crime the victims of which are eligible for compensation under the eligible crime victim compensation program, and includes, crimes involving terrorism, driving while intoxicated and domestic violence. Compensable expenses to be included in the annual certification must be authorized by State statute or rule, providing there is rule making authority in State law. States may include expenses, not specifically identified in VOCA, such as pain and suffering; crime scene clean up; replacement costs for clothing and bedding held as evidence; annuities for child victims for loss of support; medically-necessary building modification; medically necessary devices; and attorney fees related to a victim's claim for compensation. States may also include payments related to forensic sexual assault examinations, even if the victim did not report the crime to law enforcement if such payments are made from funds administered by the compensation program and are allowable under the state's statute or administrative rules. G. Unallowable Costs and Expenses States may not use VOCA funds to pay for or include in their annual certification of State payments the following costs and expenses: (1) Property Damage and Loss. Section 1403(a)(2) of VOCA specifically states amounts awarded for property damage may not be included in the annual certification. H. Audit Responsibilities States that expend $300,000 or more in federal financial assistance in their fiscal year must have an audit for that year in accordance with OMB Circular, A-133, as amended. VII. Fund Suspension or Termination If, after notice and opportunity for a hearing, the Office for Victims of Crime, Office of Justice Programs, finds that a State has failed to substantially comply with VOCA, the OJP Financial Guide, the Final Program Guidelines, or any other implementing regulation, the Director of OVC may suspend or terminate funding to the State, or take other appropriate action, as deemed necessary. 42 U.S.C. 1407 (f). See also, Hearing and Appeal Procedures at 28 CFR Part 18. VIII. Monitoring and Technical Assistance Section 1407(c) of VOCA provides access, for the purpose of audit and examination, to any books, documents, papers, and records of the State recipient of VOCA grant funds to the Director of OVC. As part of its oversight responsibilities, OVC and the Office of the Comptroller will conduct periodic on-site reviews of State grantee records pertaining to certified payments to crime victims from State funding sources, as well as all other financial and programmatic aspects of the State crime victim compensation program to determine compliance with VOCA, the Final Program Guidelines, the OJP Financial Guide, Civil Rights requirements, and all other applicable Federal law. Attachment A Crime Victims Compensation Allocation Table Attachment B Application for Federal Assistance, Assurances, Sample Competed Application, and Instructions Attachment C Certification Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-free Workplace Requirements Attachment D Disclosure of Lobbying Activities NOTE: Only those States grantees who received over $100,000 and who have engaged in reportable Federal lobbying activities are required to complete and sign this form. Attachment E Crime Victims Compensation Eligible State Payments Certification Form and Instructions Attachment F Sample Administrative Cost Provision Budget Attachment G ACH Vendor/Miscellaneous Payment Enrollment Form Attachment H Application Kit Checklist State Crime Victim Compensation Grant Program Application Kit Checklist To ensure that all elements of the application are completed, check off each item as completed and attach this checklist to your application. Application for Federal Assistance, Standard Form 424,- Attachment B Certified Assurances signed by an authorizing official - Attachment B Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements - Attachment C Disclosure of Lobbying Activities and Continuation Sheet - Attachment D Crime Victims Compensation Eligible State Payments Certification Form (FY 1996 payout) - Attachment E ACH Vendor/Miscellaneous Payment Enrollment Form - Attachment G The following information may be provided on a separate sheet of paper or in the cover letter transmitting the application: Civil Rights Information: Each State agency that applies for VOCA crime victim compensation grant funds must provide to OVC the name, address, and telephone number of the civil rights contact person who has lead responsibility in ensuring that all applicable civil rights requirements are met and who acts as the liaison in civil rights matters with the Office for Civil Rights for the Office of Justice Programs (OJP). Single Audit Act Information: As required by OMB Circular No. A-133, as amended, each State agency that applies for VOCA crime victim compensation grant funds must provide OVC with the name and address of the designated Cognizant Federal Agency, the Federal agency assigned by OMB, and the dates of the State fiscal year. Administrative Cost: States that elect to utilize administrative funds under the VOCA compensation grant, must include in the FY 1997 Crime Victim Compensation Grant Application Kit a general description of how the administrative funds will be used. (See Attachment F.) Eligibility Requirements: States must submit the following: a copy of their State's compensation statute; and a brief statement certifying that they are in compliance with Eligibility Requirements for State Grantees, as set forth in Section II of this application kit (pages 5-7). Instructions for Completion of the Application for Federal Assistance (SF 424) The Application for Federal Assistance is a standard form used by most Federal agencies for application for Federal assistance. This form contains 18 different items, all of which are to be completed before your application is reviewed. The Office of Justice Programs (OJP) cannot accept the application without a completed and signed SF 424. Item 1 Type of Submission: Check the "Non-Construction" box in the application section. Item 2 Date Submitted: Indicate the date you sent the application to OJP. The "Application Identifier" is the number assigned by your jurisdiction, if any, to track applications. If your jurisdiction does not assign an identifier number, leave this space blank. Item 3 Date Received by State: Leave blank. This block is completed by the State single point of contact, if applicable. Item 4 Date Received by Federal Agency: This item and the corresponding "Federal Identifier" will be completed by OJP. Item 5 Applicant Information: The "Legal Name" is the name of the Sate agency, designated by the Governor, to administer the VOCA victim compensation grant program. One person should be designated as the Contact for the proposed project, and that person's telephone number should also be included. It is not unusual for the name of the contact person to differ from the authorized representative of your agency in Item 18 below. Item 6 Employer Identification Number: Each employer receives an employer identification number from the Internal Revenue Service. Generally, this number can be easily obtained from your agency's accountant or comptroller. Item 7 Type of Applicant: Enter letter "A" in this space. Item 8 Type of Application: Check the box marked "New." Item 9 Name of Federal Agency: Enter "U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime." Item 10 Catalog of Federal Domestic Assistance Number: Enter"/16/./5/7/6/" and for "Title," enter "Crime Victims Compensation." This reflects the number assigned to the VOCA victim compensation grant program in the "Catalog of Federal Domestic Assistance." Item 11 Descriptive Title of Applicants Project: Type in the: (1) title of the program as the "Fiscal Year 1997, Victims of Crime Act victim compensation grant program"; (2) name of the cognizant federal agency, ex. U. S. Department of Education; and (3) applicant's fiscal year, i.e. twelve month audit period, ex: 10/1/96 - 9/30/97. Item 12 Areas Affected by Project: Enter "State of (insert State name)". Item 13 Proposed Project Dates: The proposed project start date is October 1, 1996, and the end date is September 30, 2000. Item 14 Congressional Districts: In line "a" enter the word "Statewide" and in line "b" enter "crime victim compensation." Item 15 Estimated Funding: In lines "a" and "g" enter the amount your State is requesting as indicated in the "Crime Victims Fund Compensation Allocation Chart" (Attachment A). Items "b" through "f" should be left blank. Item 16 State Executive Order 12372: Check box "b. No." VOCA victim compensation grant funds are not subject to Executive Order 12372, which assures inter-governmental review of Federal activities. Item 17 Delinquent Federal Debt: This question applies to the applicant organization. Categories of debt include delinquent audit disallowances, loans, and taxes. Item 18 Authorized Representative: Type the name, title and telephone number of the person legally authorized to apply for and administer the Federal VOCA victim compensation grant. This is the individual designated by the Governor or the highest administrative official in the agency designated by the Governor to apply for and administer this Federal grant. The signature on the original application must be signed in blue ink and/or stamped as "original" to help us distinguish the original from the photocopies. Also, indicate the date the application is signed.