Instructions for Completing the *LIHEAP Household Report for FFY 2007*

## Division of Energy Assistance/OCS/ACF

Drafted September 2006

## 

**The Paperwork Reduction Act of 1995**

This information collection is conducted in accordance with the Low
Income Home Energy Assistance Program (LIHEAP) statute (Public Law
97-35, as amended), and 45 CFR 96.82. Information received from this
collection provides data to Congress in its oversight of grantees\'
performance in administering the LIHEAP program.

Public reporting burden for this collection of information is estimated
as follows: (1) an average burden of 25 hours per respondent for the
**Recommended Long Format for LIHEAP Assisted Households**, (2) an
average burden of 13 hours per respondent for the **Recommended Format
for LIHEAP Applicant Households**, and (3) an average burden of 1 hour
per respondent for the **Recommended Short Format for LIHEAP Assisted
Households**. The estimates include the time for reviewing instructions,
and gathering, editing, maintaining, and reporting the data.

The responses to this collection are required, except where \"requested
data\" are indicated, in order to obtain LIHEAP funding in accordance
with Section 2605(c)(1)(G) of the LIHEAP statute.

This information is not considered confidential; therefore, no
additional safeguards are considered necessary beyond that customarily
applied to routine government information.

An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently
valid OMB control number.

**Introduction**

Section 309 of the Human Services Amendments of 1994, Public Law
103-252, amended section 2605(c)(1)(G) of the LIHEAP statute to require
grantees, as part of their annual LIHEAP grant application, to report
certain data on households which apply for LIHEAP assistance and on
households which receive LIHEAP assistance **through Federal LIHEAP
funds** (including oil overcharge or Petroleum Violation Escrow funds
designated for LIHEAP). Grant awards will not be made until the required
data are received for the prior fiscal year. In addition, House and
Senate Committee reports on the predecessor bills to Public Law 103-252
have requested additional information on young children. This additional
information is requested, but is not required.

**General Requirements**

The 50 States, the District of Columbia, and Insular Areas that receive
regular LIHEAP block grant allocations of \$200,000 or more (e.g., the
Commonwealth of Puerto Rico) must submit the required data elements
included in: (1) the **Recommended Long Format for LIHEAP Assisted
Households**, and (2) the **Recommended Format for LIHEAP Applicant
Households**. The data are to be submitted with each grantee\'s LIHEAP
grant application, and must include data on households which applied for
LIHEAP assistance and on households which received LIHEAP assistance
during the Federal Fiscal Year (October 1 - September 30) prior to the
Federal Fiscal Year (FFY) for which funds are being requested. The data
must be reported separately for heating, cooling, winter/year round
crisis, summer crisis, and weatherization assistance. Grantees may
choose to operate their programs on a different program year (e.g.,
starting January 1 or July 1). However, the household data still needs
to be reported for the FFY.

The **Recommended Long Format for LIHEAP Assisted Households** also
includes space for grantees to report additional information on children
that was requested by the House and Senate Committee Reports. Grantees
are asked to provide the information, if available, in order to allow us
to respond to Congressional requests, but the additional data are not
required.

In order to reduce the burden on small grantees, all Indian tribes and
tribal organizations and those Insular Areas that receive regular LIHEAP
block grant allocations of less than \$200,000 are required to submit
only the data elements included in the **Recommended Short Format for
LIHEAP Assisted Households**.

LIHEAP grant applications will not be considered to be complete without
submission of the data. Consequently, LIHEAP grants will not be awarded
until data reports for the previous year are received.

Given that the *LIHEAP Household Report* needs to be included as part of
the LIHEAP grant application (which is due before the end of the prior
FFY), estimated household data will be accepted with the application so
as not to delay the awarding of LIHEAP grants for the following FFY.
Final LIHEAP household data need to be submitted to OCS by **December 1,
2007** in preparation of the Department's *LIHEAP Report to Congress for
FFY 2006*.

There are several references to the term, "unduplicated" household
count. The term is defined as counting a household only once for a given
category. Examples include the following:

1.  An unduplicated count of assisted households for each type of LIHEAP
    assistance---counting a household only once for each type of LIHEAP
    assistance received. For example, a household receives two heating
    assistance benefits and three winter crisis assistance benefits.
    Count that household only once under the heating assistance category
    and once under the winter crisis assistance category.

2.  An unduplicated count of households receiving any type of LIHEAP
    assistance---counting a household only once regardless of receiving
    more than one type of LIHEAP assistance. For example, a household
    receives both heating assistance and winter crisis assistance. Count
    that household once under the "any type of LIHEAP assistance"
    category.

3.  An unduplicated number of assisted households by HHS Poverty
    Guideline Interval---counting a household only once within the
    different poverty intervals for each type of LIHEAP assistance
    received. For example, a household receives heating assistance and
    has a poverty level of 79% poverty. Count that household under the
    interval of "75%-100% poverty."

4.  An unduplicated household count of target groups assisted---counting
    a household only once for each type of target group that the
    household falls under. For example, a heating assistance household
    includes three persons over 60 years old---one of whom is frail
    elderly and one disabled person---and two young children. Count that
    household only once under "all" for 60 years or older, only once
    under "frail elderly," only once under "disabled," only once under
    "age 5 years or younger," and only once under "elderly, disabled, or
    young child."

**Recommended Short Format for LIHEAP Assisted Households**

Those Insular Areas that receive regular LIHEAP block grant allocations
of less than \$200,000 and **all** Indian Tribes and tribal
organizations must report only on the data elements described below.

##### **Number of assisted households**

Report an unduplicated count of assisted households for each type of
LIHEAP assistance listed. If a household receives more than one type of
LIHEAP assistance, count that household once under each type of
assistance provided to the household. If a household receives two
benefits or services under the same type of assistance (e.g., two
benefit checks, or one benefit check and warm blankets, under the
heating assistance component), count that household only once under that
type of assistance. If the same household also received a benefit or
service under another type of assistance (e.g., winter crisis assistance
check), also count that household once under that of assistance.

**Recommended Long Format for LIHEAP Assisted Households**

The 50 States, the District of Columbia, and Insular Areas that receive
regular LIHEAP block grant allocations of \$200,000 or more must report
on the **required** data elements described below and at their option,
on the **requested** data elements described below.

##### **Number of Assisted Households\--Required Data**

Report an unduplicated count of assisted households for each type of
LIHEAP assistance provided. If a household receives more than one type
of LIHEAP assistance, count that household once under each type of
assistance provided to the household. If a household receives two
benefits or services under the same type of assistance (e.g., two
benefit checks, or one benefit check and warm blankets, under the
heating assistance component), count that household only once under that
type of assistance. If the same household also received a benefit or
service under another type of assistance (e.g., winter crisis assistance
check), also count that household once under that type of assistance.

Report in row 7 an unduplicated count of households receiving any type
of LIHEAP assistance. Count each household once regardless of how many
different types of LIHEAP assistance the household received during the
fiscal year. Report the data for number of households assisted and
target group populations.

##### **Number of Assisted Households by Poverty Level\--Required Data**

Count an assisted household under the poverty level which is determined
by the household\'s **gross annual income** and the number of
**household members**. Gross income is the household\'s income before
any deductions or adjustments, such as taxes or medical costs, are made
to household income. Household members represent those related and/or
unrelated individuals who are living together as one economic unit for
whom residential energy is customarily purchased in common or who make
undesignated payments for residential energy in the form of rent.

A household\'s gross annual income can change during the fiscal year. If
a household received two benefits or services under the same type of
LIHEAP assistance, use the household\'s gross annual income at the time
of the initial determination of benefits or services in calculating that
household\'s poverty level for statistical reporting.

If gross income determinations are made using less than a full year\'s
income for a household, the months of income used in making the LIHEAP
income eligibility determination should be projected proportionally for
12 months to construct an annual income amount for that household. Gross
income is also needed for those households that are categorically
eligible for LIHEAP assistance, such as households receiving Temporary
Assistance for Needy Families (TANF), SSI, Food Stamps, or certain
needs-tested veterans' benefits.

Poverty levels must be reported according to the intervals set out in
the format. The poverty levels must be based on the HHS Poverty
Guidelines in effect at the beginning of the FFY. The HHS Poverty
Guidelines are normally published in February, and may be put into
effect at any time between the date of publication and October 1, the
beginning of the following FFY, or by the

beginning of a grantee\'s fiscal year, whichever is later. The poverty
levels for the *LIHEAP Household Report* must be based on the HHS
Poverty Guidelines that were in effect at the beginning of that FFY.

The calculation and aggregation of individual poverty levels are best
handled by computer programming. The specific method of calculating an
assisted household\'s poverty level for FFY 2006 is as follows:

-   Obtain information on the assisted household\'s gross income and
    number of members in that household.

-   Refer to the 2006 HHS Poverty Guidelines for your State's dollar
    amount that constitutes 100 percent of the Poverty Guidelines for
    the number of members in the assisted household. The 2006 HHS
    Poverty Guidelines are available towards the end of these
    instructions.

-   Divide the assisted household\'s gross income by the dollar amount
    equal to 100 percent of the 2006 HHS Poverty Guidelines, multiply
    the result by 100, and express the result as a rounded percent of
    the 2006 HHS Poverty Guidelines.

-   Based on the calculated percent, count the assisted household under
    the appropriate poverty interval. Adding the number of assisted
    households by poverty intervals should result in the unduplicated
    number of assisted households for each type of LIHEAP assistance.

Below are three examples of calculating an assisted household\'s poverty
level for the *LIHEAP Household Report for FFY 2007*.

1.  A heating assistance household from Kentucky has a gross income of
    \$14,645 and one household member. According to the 2006 HHS Poverty
    Guidelines for Kentucky, \$9,800 represents 100% of the Poverty
    Guidelines for a 1-person household. Divide \$14,645 by \$9,800 and
    multiply by 100 = 149.4388%. Rounding off to the nearest whole
    percent = 149% of the 2006 HHS Poverty Guidelines. The household is
    counted under the interval of "125% to 150% poverty" for heating
    assistance.

2.  A winter crisis assistance household from South Carolina has a gross
    income of \$28,576 and five household members. According to the 2006
    HHS Poverty Guidelines for South Carolina, \$23,400 represents 100%
    of the HHS Poverty Guidelines for a 5-person household. Divide
    \$28,576 by \$23,400 and multiply by 100 = 122.1197%. Rounding off
    to the nearest whole percent = 122% of the 2006 HHS Poverty
    Guidelines. The household is counted under the interval of "100% to
    125% poverty" for winter crisis assistance.

3.  A weatherization assistance household from Wyoming has a gross
    income of \$29,876 and nine household members. According to the 2006
    HHS Poverty Guidelines for Wyoming, \$37,000 represents 100% of the
    HHS Poverty Guidelines for a household with 9 members. Divide
    \$29,876 by \$37,000 and multiply by 100 = 80.74595%. Rounding off
    to the nearest whole percent = 81% of the 2006 HHS Poverty
    Guidelines. The household is then counted under the interval of "75%
    to 100% poverty" for weatherization assistance.

> ***Number of assisted households by target groups\--Required Data***

Each target group requires an unduplicated count of assisted households
by type of LIHEAP assistance received that have at least one member who
is either of the following at the time of LIHEAP eligibility
determination:

1.  elderly broken out:

    a.  for all assisted households having at least one member 60 years
        or older and

    b.  for those households having at least one member 60 years or
        older who is frail elderly

> (i.e., having a condition lasting 6 months or more that substantially
> limits one or more basic physical activities that prevent the person
> going outside the home without assistance).

2.  disabled (using the grantee\'s definition of \"disabled\", as the
    LIHEAP statute does not define the term);

3.  age 5 years or under (include all children who are not yet 6 years
    old, that is, up to 5 years and 364 days old); and

4.  a person who is either 60 years or older, disabled, or age 5 years
    or under.

Please note the following (see also examples of Counting Target Group
Households for LIHEAP Household Report at the end of the instructions):

-   If an assisted household has members who are 60 years or older,
    disabled, or age 5 years or under, count that household once under
    each target group. For example, a household receiving heating
    assistance includes one child 2 years old, another child 4 years
    old, and an elderly member who also is disabled. This household
    would be counted once under each of the following target groups
    (required data) for the heating assistance component: 60 years or
    older; disabled; and age 5 or under.

-   An assisted household with two or more members in the same target
    group is to be counted once. For example, a household with two
    members who are 65 years old each would be counted once under \"60
    years or older.\"

-   An assisted household having one or more members that are elderly,
    disabled, or a young child are to be counted once for each type of
    LIHEAP assistance that is provided in the fiscal year.

-   An assisted household having one or members that are elderly,
    disabled, or a young child are to be counted once in row 7
    regardless of the number of different types of assistance received
    during the fiscal year.

##### **Breakout of assisted households by young children\--Requested Data**

The count of assisted households with at least one child 5 years or
younger is **required**. Counts of assisted households with at least one
child who is (1) 2 years old or under and (2) between 3 years through 5
years are **requested, i.e., optional,** data items if the grantee
elects to report the data.

Both House Report 103-483 and Senate Report 103-251 on S. 2000, the
predecessor to Public Law 103-252 (the Human Services Amendments of
1994), instructed the Department to develop reporting requirements that
distinguish between children under 3 years of age and those 3 through 5
years of age.

If reporting the requested data, **first** count the number of assisted
households with at least one child 5 years or under for each type of
LIHEAP assistance provided. Using that count of assisted households,
count the number of those assisted households with at least one child
who is 2 years old or under. Repeat the same procedure for those
assisted households with at least one child between 3 years through 5
years old.

  -----------------------------------------------------------------------
  The sum of the number of households with at least one child 2 years or
  under (requested data) and the number of households with at least one
  child 3 years through 5 years (requested data) should **be greater**
  than the number of households with at least one child 5 years or under
  (required data). Households with children under the two age groups
  would be counted twice, once under each of the requested age category.
  Further clarification of counting households by target group is
  illustrated in the examples on the last page of the instructions.

  -----------------------------------------------------------------------

**Recommended Format for LIHEAP Applicant Households**

The 50 States, the District of Columbia, and Insular Areas that receive
regular LIHEAP block grant allocations of \$200,000 or more must report
on the data elements described below.

Information is needed on all households that apply for LIHEAP
assistance, whether or not they actually receive LIHEAP assistance. The
definition of \"applicant\" households is left to LIHEAP grantees, as
the LIHEAP statute does not define the term. Consequently, there will be
variation in counts due to differences in how grantees define
\"applicant\" households. For example, some grantees may not count those
households screened out before a formal LIHEAP application is completed.
Also, some grantees may not have households complete a LIHEAP
application form once the program closes. (Those households that receive
LIHEAP assistance should also be reported on the LIHEAP Assisted
Household Report.)

##### **Number of applicant households\--Required Data**

Report an unduplicated count of households applying for each type of
LIHEAP assistance, whether or not they actually receive assistance. If a
household applies for each type of LIHEAP assistance or is categorically
eligible, count that household once under each relevant type of
assistance. If a household applies for two benefits or services under
the same type of assistance (e.g., two benefit checks, or one benefit
check and warm blankets, under the heating assistance component), count
that household only once under that type of assistance. If the same
household also applies for benefits or services under another type of
assistance (e.g., winter crisis assistance check), count that household
also once under that type of assistance.

##### **Applicant households by poverty level\--Required Data**

##### 

##### Follow the same instructions on pages 4-5 that indicate how to count the number of assisted households by poverty level. Adding the number of applicant households by poverty intervals (including households in which no income is available) should result in the unduplicated number of applicant households for each type of LIHEAP assistance.

EXAMPLE\--Counting Target Group Households for LIHEAP Household Report

Counting Households I-IV under Target Groups (ages are included in
addition to noting whether a household has at least one member who is:

**Required (Mandatory) Data Counts of Target Groups** **Requested
(Optional) Data Counts of Target Groups**

(**E**) elderly (**C**) a young child 5 years or younger (**C\***) a
young child age 2 years or under

(**D**) disabled (**C\*\***) a young child age 3 years through 5 years

+---------------+-----------+----------+----------+----------+--------+
| Sections of   | [         | [H       | [H       | [H       | Total  |
| LIHEAP        | HOUSEHOLD | OUSEHOLD | OUSEHOLD | OUSEHOLD |        |
| Household     | I]{.u     | II]{.un  | III]{.un | IV]{.un  | number |
| Report        | nderline} | derline} | derline} | derline} | of     |
|               | C         |          |          |          |        |
|               | athy\--29 | Al       | And      | Syl      | as     |
|               |           | ice\--46 | rew\--42 | via\--23 | sisted |
|               | F         |          | (**D**)  |          |        |
|               | rank\--36 | Tom\--17 |          | C        | hous   |
|               |           |          | Paul     | arl\--27 | eholds |
|               | Gr        | F        | ine\--35 |          |        |
|               | anny\--67 | ran---12 |          | Ray      |        |
|               | (**E**)   |          | Gran     | mond\--2 |        |
|               |           |          | dma\--72 | (        |        |
|               | Gr        |          | (**E**)  | **C\***) |        |
|               | amps\--76 |          |          |          |        |
|               | (**E**)   |          | Cha      | Chet\--4 |        |
|               | (**D**)   |          | rlie\--5 | (**      |        |
|               |           |          | (**      | C\***\*) |        |
|               |           |          | C\*\***) |          |        |
|               |           |          |          | E        |        |
|               |           |          |          | llen\--5 |        |
|               |           |          |          | (**      |        |
|               |           |          |          | C\*\***) |        |
+---------------+-----------+----------+----------+----------+--------+
|               |           |          | **       |          |        |
|               |           |          | REQUIRED |          |        |
|               |           |          | DATA**   |          |        |
+---------------+-----------+----------+----------+----------+--------+
| [Section      | 1         | 1        | 1        | 1        | 4      |
| 1]{           |           |          |          |          |        |
| .underline} - |           |          |          |          |        |
| Number of     |           |          |          |          |        |
| assisted      |           |          |          |          |        |
| households    |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| [Section      |           |          |          |          |        |
| 3]{           |           |          |          |          |        |
| .underline} - |           |          |          |          |        |
| Number of     |           |          |          |          |        |
| assisted      |           |          |          |          |        |
| households    |           |          |          |          |        |
| with at least |           |          |          |          |        |
| one member    |           |          |          |          |        |
| who is:       |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| 60 years or   | 1         | 0        | 1        | 0        | 2      |
| older (**E**) |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| Disabled      | 1         | 0        | 1        | 0        | 2      |
| (**D**)       |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| Age 5 years   | 0         | 0        | 1        | 1        | 2      |
| and under     |           |          |          |          |        |
| (**C**)       |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| [Section      |           |          | **R      |          |        |
| 4]{           |           |          | EQUESTED |          |        |
| .underline} - |           |          | DATA**   |          |        |
| Number of     |           |          |          |          |        |
| assisted      |           |          |          |          |        |
| households    |           |          |          |          |        |
| with at least |           |          |          |          |        |
| one member    |           |          |          |          |        |
| who is:       |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| Age 2 years   | 0         | 0        | 0        | 1        | 1      |
| or under      |           |          |          |          |        |
| (**C\***)     |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+
| Age 3 years   | 0         | 0        | 1        | 1        | 2      |
| through 5     |           |          |          |          |        |
| years         |           |          |          |          |        |
| (**C\*\***)   |           |          |          |          |        |
+---------------+-----------+----------+----------+----------+--------+