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City of Everett
<br /> Certification of Compliance with the Statutory Eligibility Requirements of the Violence
<br /> Against Women Act as Amended, STOP Formula Grant Program
<br /> (Criminal Justice Applicants Only)
<br /> NOTE: If the applicant is a community-based victim service provider with criminal justice agencies in their
<br /> grant, one of the criminal justice agencies must complete this form to be submitted by the victim service
<br /> provider.
<br /> Applicants should refer to the laws cited below for further information regarding the certifications to which they are
<br /> required to attest. Signature on this form certifies that the Applicant is qualified to receive the STOP Formula Grant
<br /> Program funds and is in compliance with relevant requirements under 34 U.S.0§§10441,10446 through 10451 and 28
<br /> C.F.R.Part 90.
<br /> (1)Forensic Medical Examination Payment Requirement for Victims of Sexual Assault
<br /> (a)A state,Indian tribal government,or unit of local government shall not be entitled to funds underthe STOP Formula
<br /> Grant Program unless the state,Indian tribal government,unit of local government,or another governmental entity—
<br /> (1) incurs the full out-of-pocket cost of forensic medical exams for victims of sexual assault;and
<br /> (2)coordinates with health care providers in the region to notify victims of sexual assault of the availability of rape
<br /> exams at no cost to the victims.
<br /> (b)A state,Indian tribal government,or unit of local government shall be deemed to incur the full out-of-pocket cost of
<br /> forensic medical exams for victims of sexual assault if any government entity:
<br /> (1) provides such exams to victims free of charge to the victim;or
<br /> (2) arranges for victims to obtain such exams free of charge to the victims.
<br /> (c)A state or Indian tribal government may use STOP Formula Grant Program funds to pay for forensic medical exams
<br /> performed by trained examiners for victims of sexual assault,except that such funds may not be used to pay for forensic
<br /> medical exams by any state or Indian tribal government that requires victims of sexual assault to seek reimbursement for
<br /> such exams from their insurance carriers.
<br /> (d)(1)To be in compliance with this section,a state,Indian tribal government,or unit of local government shall comply with
<br /> - subsection(b)without regard to whetherthe victim participates in the criminal justice system or cooperates with law
<br /> enforcement.
<br /> (2)Filing Costs For Criminal Charges and Protection Orders
<br /> A state,Indian tribal government,or unit of local government will not be entitled to funds underthe STOP Formula Grant
<br /> Program unless it certifies that its laws,policies,and practices do not require,in connection with the prosecution of any
<br /> misdemeanor or felony sexual assault,domestic violence,dating violence,or stalking offense,or in connection with the
<br /> filing,issuance,registration,modification,enforcement,dismissal,withdrawal or service of a protection order,or a petition
<br /> for a protection order,to protect a victim of sexual assault,domestic violence,dating violence,or stalking,that the victim
<br /> bear the costs associated with the filing of criminal charges against the offender,or the costs associated with the filing,
<br /> issuance,registration,modification,enforcement,dismissal,withdrawal or service of a warrant,protection order,petition
<br /> for a protection order,or witness subpoena,whether issued inside or outside the State,tribal,or local jurisdiction.
<br /> Washington State STOP Formula Grant Program Renewal Application for FFY 2019 20
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