Low Income Home Energy Assistance Program (LIHEAP) Household Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Household Report Short Form	Form	Modified	Available
Form 1 Household Report Long Form	Form	Modified	Available
COMM_OMB_SupportingStmt_HHR_FY22_020322_fnl.docx	Supporting Statement A	Uploaded 2022-02-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184199	LIHEAP Household Report–Short Format	Form	Modified	Household Report Short Form
184199	LIHEAP Household Report–Short Format	Instruction	Modified
184198	LIHEAP Household Report–Long Format	Form	Modified	Household Report Long Form
184198	LIHEAP Household Report–Long Format	Instruction	Modified

ICR Details

OMB Control No: 0970-0060	ICR Reference No: 202202-0970-011
Status: Historical Active	Previous ICR Reference No: 202008-0970-012
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Low Income Home Energy Assistance Program (LIHEAP) Household Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/11/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/28/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2025	36 Months From Approved	05/31/2022
Responses	207	0	204
Time Burden (Hours)	2,710	0	2,704
Cost Burden (Dollars)	0	0	0

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Abstract: The Low Income Home Energy Assistance Program (LIHEAP) block grant (42 U.S.C. 8621) was established under Title XXVI of the Omnibus Budget Reconciliation Act of 1981, P. L. 97-35. The Office of Community Services (OCS) within the Department of Health and Human Services' (DHHS) Administration for Children and Families (ACF) administers LIHEAP at the Federal level. The LIHEAP Household Report is an annual data collection effort conducted by OCS to collect information from LIHEAP grantees to meet statutory requirements and program objectives. The LIHEAP statute requires the collection of data on the number of households assisted, their income levels, and vulnerability group, by type of LIHEAP assistance, for inclusion in the Secretary’s annual LIHEAP Report to Congress. The data are collected through the LIHEAP Household Report, which consists of the following: (1) a Long Format for state grant recipients, the District of Columbia, and select territory grant recipients, and (2) a Short Format for tribal grant recipients and select territory grant recipients. OCS is requesting an extension with minor changes to the LIHEAP Household Report to meet statutory requirements related to American Rescue Plan (ARP) Act funding.

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Authorizing Statute(s): US Code: 42 USC 8629 Name of Law: Omnibus Reconciliation Act of 1981, LIHEAP
  

Citations for New Statutory Requirements: PL: Pub.L. 117 - 2 2911 Name of Law: American Rescue Plan Act (the ARP Act) of 2021

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 73293	12/27/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 11076	02/28/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
LIHEAP Household Report–Long Format	1	Household Report Long Form
LIHEAP Household Report–Short Format	1	Household Report Short Form

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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	207	204	0	3	0	0
Annual Time Burden (Hours)	2,710	2,704	0	6	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: No

Burden Reduction Due to:

Short Statement: ACF changed the LIHEAP Household Report form for FY 2022 This change requires grantees to report the number of households assisted by non- supplemental to funds separate from new households assisted by American Rescue Plan Act (the ARP Act) of 2021 (P. L. 117-2) from those provided by the other FY 2022 appropriations acts.

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Annual Cost to Federal Government: $56,559

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? Yes

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Common Form ICR:  No

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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: 02/28/2022

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