LIHEAP Performance Measures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 LIHEAP Performance Data	Form	New	Available
Form 1 LIHEAP Performance Data Form	Form	New	Available
Form 1 LIHEAP Perforrmance Data	Form	New	Available
Form 1 LIHEAP Performance Data	Form	New	Available
Form 1 Performance Data Form	Form	Removed	Available
Form 1 Performance Data Form	Form	Removed	Available
Form 1 Performance Data Form	Form	Removed	Available
Form 1 Performance Data	Form	Removed	Repair queued
Form 1 Performance Data Form	Form	Removed	Available
Form 1 Performance Data Form	Form	Removed	Available
LIHEAP Performance Data Form Supporting Statement 2017.docx	Supporting Statement A	Uploaded 2018-02-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
230203	Energy Vendors - Module 2	Form	New	LIHEAP Performance Data
230203	Energy Vendors - Module 2	Instruction	New
230202	Sup-Grantees Module 2	Form	New	LIHEAP Performance Data Form
230202	Sup-Grantees Module 2	Instruction	New
230201	State Grantee - Module 2	Form	New	LIHEAP Perforrmance Data
230201	State Grantee - Module 2	Instruction	New
230200	State Grantees Module 1	Form	New	LIHEAP Performance Data
230200	State Grantees Module 1	Instruction	New
211800	Small Energy Vendors	Form	Removed	Performance Data Form
211800	Small Energy Vendors	Instruction	Removed
211799	Sub Grantees (in states with sub grantee managed systems)- Part II	Form	Removed	Performance Data Form
211799	Sub Grantees (in states with sub grantee managed systems)- Part II	Form	Removed	Performance Data Form
211797	Large Energy Vendors - Part II	Form	Removed	Performance Data
211797	Large Energy Vendors - Part II	Instruction	Removed
211796	LIHEAP Performance Data Form - Part II Performance Measures	Form	Removed	Performance Data Form
211796	LIHEAP Performance Data Form - Part II Performance Measures	Instruction	Removed
211795	LIHEAP Performance Data Form-Part I	Form	Removed	Performance Data Form
211795	LIHEAP Performance Data Form-Part I	Instruction	Removed

ICR Details

OMB Control No: 0970-0449	ICR Reference No: 201802-0970-007
Status: Historical Active	Previous ICR Reference No: 201406-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: LIHEAP Performance Measures
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/27/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/22/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	12/04/2017
Responses	1,732	0	2,032
Time Burden (Hours)	22,220	0	84,479
Cost Burden (Dollars)	0	0	5,000,000

---

Abstract: One core purpose of LIHEAP is to ensure that low-income households have access to necessary home energy services. By preventing the loss of service to at risk clients, the program can eliminate the costs of service restoration (e.g., reconnection charges) and can minimize client health and safety risks. By restoring services to clients who do not currently have access to energy service, LIHEAP is eliminating a significant risk to the health and safety of clients. The prevention and restoration of home energy services measures are designed to be complimentary. As LIHEAP grantees are successful in increasing the number of households where loss of home energy is prevented, we hope to see a decrease in the number of households needing to have energy services restored. Based on the data collected from grantees, OCS will calculate the performance measures and report the results through the annual budget development process and in the annual LIHEAP Report to Congress. Once the data are published in the LIHEAP Report to Congress, grantees will be able to compare their own results to the results for other states, as well as to regional and national summaries through the LIHEAP Performance Measurement website.

---

Authorizing Statute(s): US Code: 42 USC 8621 Name of Law: Low-Income Energy Assistance
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 47211	10/11/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 4060	01/29/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Energy Vendors - Module 2	1	LIHEAP Performance Data
LIHEAP Performance Data Form - Part II Performance Measures	1	Performance Data Form
LIHEAP Performance Data Form-Part I	1	Performance Data Form
Large Energy Vendors - Part II	1	Performance Data
Small Energy Vendors	1	Performance Data Form
State Grantee - Module 2	1	LIHEAP Perforrmance Data
State Grantees Module 1	1	LIHEAP Performance Data
Sub Grantees (in states with sub grantee managed systems)- Part II	1, 1	Performance Data Form ,   Performance Data Form
Sup-Grantees Module 2	1	LIHEAP Performance Data Form

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,732	2,032	0	-300	0	0
Annual Time Burden (Hours)	22,220	84,479	0	-62,259	0	0
Annual Cost Burden (Dollars)	0	5,000,000	0	-5,000,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a reinstatement.

---

Annual Cost to Federal Government: $62,730

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/22/2018

---