ATTACHMENT 4 LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP)
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)
Use of this model plan is optional. However, the information requested is required in order to receive a Low Income Home Energy Assistance Program (LIHEAP) grant in years in which a grantee is not required to use the detailed model plan. Public reporting burden for this collection of information is estimated to average 20 minutes per
response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of 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.
GRANTEE ARKANSAS____________________ FFY 2012__________
Assurances
The DEPARTMENT OF HUMAN SERVICES_______________________agrees to:
(Grantee Name)
* This assurance is applicable only to States, and to territories whose annual regular LIHEAP allotments exceed $200,000. Territories with annual allotments of $200,000 or less and Indian tribes/tribal organizations are not subject to Assurance 15.
Certification to the Assurances: As Chief Executive Officer, I agree to comply with the sixteen assurances contained in Title XXVI of the Omnibus Budget Reconciliation Act of 1981, as amended.* By signing these assurances, I also agree to abide by the standard assurances on lobbying, debarment and suspension, and a drug-free workplace.
* Indian tribes/tribal organizations, and territories with annual regular LIHEAP allotments of $200,000 or less, are not subject to assurance 15, and thus must only certify to 15 assurances.
** If a person other than the Chief Executive Officer of the State or territory, or Tribal Chairperson or Board Chairperson of a tribal organization, is signing the certification to the assurances, a letter must be submitted delegating such authority. (PLEASE ATTACH DELEGATION of AUTHORITY.) The delegation must include authority to sign the assurances, not just to administer the program.
*** HHS needs the EIN (Entity Identification Number) of the State, territory or Tribal agency that is to receive the grant funds before it can issue the grant.
In the above assurances which are quoted from the law, "State" means the 50 States, the District of Columbia, an Indian Tribe or Tribal Organization, or a Territory; "title" of the Act refers to Title XXVI of the Omnibus Budget Reconciliation Act of 1981 (OBRA), as amended, the "Low Income Home Energy Assistance Act"; "section" means Section 2605 of OBRA; and, "subsection" refers to Section 2605(b) of OBRA.
ADDITIONAL CERTIFICATIONS AND REQUIREMENTS
Attached are additional certifications required as follows:
* Lobbying certification, which must be filed by all States and territories. If applicable, Form LLL, which discloses lobbying payments, must be submitted. (Tribes and tribal organizations are EXEMPT.)
* Debarment and suspension certification, which must be filed by all grantees.
* Drug-free workplace requirement certification, which must be filed by all grantees, unless the grantee has filed a statewide certification with the Department of Health and Human Services. STATES ONLY: If you have filed a statewide certification for the drug-free workplace requirement, please check here:______
*, One of the requirements included in the 1994 reauthorization of the statute is that grantees must include in their annual application for funds a report on the number and income levels of households applying for and receiving LIHEAP assistance, and on the number of recipient households that have members who are elderly, disabled, or young children.
All Tribes and those territories with allotments of less than $200,000 need only submit data on the number of households served by each component (heating, cooling, weatherization and crisis). The approval for the collection of information contained in the LIHEAP Household Report is covered by OMB approval number 0970-0060.
* Though not a part of this application, the report on funds to be carried over or available for reallotment as required by section 2607(a) for the preceding year must be submitted by August 1 of each year. A grant award for the current fiscal year may not be made until the carryover/reallotment report is received. The approval for the collection of information contained in the LIHEAP Carryover and Reallotment Report is covered by OMB approval number 0970-0106.
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief, that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS
Certification Regarding Debarment, Suspension, and Other Responsibility Matters-Primary Covered Transactions
Instructions for Certification
Voluntary Exclusion-Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.
Certification Regarding Debarment, Suspension, and Other Responsibility Matters-Primary Covered Transactions
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transactions
Instructions for Certification
Certification Regarding Debarment, Suspension, Ineligibility an Voluntary Exclusion-Lower Tier Covered Transactions
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
This certification is required by the regulations Implementing the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F. Sections 76.630(c) and (d)(2) and 76.645(a)(1) and (b) provide that a Federal agency may designate a central receipt point for STATE-WIDE AND STATE AGENCY-WIDE certifications, and for notification of criminal drug convictions. For the Department of Health and Human Services, the central pint is: Division of Grants Management and Oversight, Office of Management and Acquisition, Department of Health and Human Services, Room 517-D, 200 Independence Avenue, SW Washington, DC 20201.
Certification Regarding Drug-Free Workplace Requirements (Instructions for Certification)
Drug-Free Workplace common rule apply to this certification. Grantees' attention is called In particular, to the following definitions from these rules: '
Controlled substance means a controlled substance in Schedules I through V of the Controlled Substances Act (21 U.S.C. 812) and as further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal or State criminal drug statutes;
Criminal drug statute means a Federal or non-Federal criminal statute involving the manufacture, distribution, dispensing, use, or possession of any controlled substance;
Employee means the employee of a grantee directly engaged in the performance of work under a grant, including:
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will Or will continue to provide a drug-free workplace by:
Place of Performance (Street address, city, county, state, zip code)
P. 0. Box 1497 Slot 330_________________________________________________
Little Rock, AR 72203-1497______________________________________________
Check if there are workplaces on file that are not identified here. Alternate II. (Grantees Who Are Individuals)
[55 FR 21690, 21702, May 25, 1990]
LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) PROGRAM INTEGRITY SUPPLEMENT Recent Audit Findings
No Legislative or Federal audit findings have been reported for the Low Income Home Energy Assistance Proeram (LIHEAP) in the last four years.
Compliance Monitoring
Compliance monitoring is conducted by the LIHEAP staff. The most common findings are listed below and may be discovered during compliance monitoring reviews:
* Overpayment of program funds due to improper or no documentation of household's income and the non-existence of a crisis as verified by the household's energy supplier.
* Underpayment of benefits to households due to the use of excluded income.
* Failure to document and verify payments of program funds to energy suppliers via payment vouchers, etc.
* Unable to locate all records for compliance review. J
* No notification to household of disposal of application.
Two reviews, instead of one, will be conducted during a program year at those agencies that have shown to have a high percentage rate of errors during the first review. Also, the percentage of case records reviewed by LIHEAP staff during each program will be increased.
Fraud Reporting Mechanisms
Sub-grantees will be requested to include telephone numbers, including the Department of Human Services (DHS) Fraud Hotline toll free number, in program media notices to the general public concerning the LIHEAP program. During public hearings, which are held each year, the public will be requested to report any instance of fraud to both the sub-grantee agency and DHS. Program and hot line telephone numbers are also included on the DHS web site.
Telephone Hotlines
The DHS Division of County Operations maintains a toll free number ( 1-800-422 -6641) to report allegations of fraud and program abuse.
Verifying Applicant Identities
During the application process, the sub-grantee uses Social Security Numbers (SSN's) provided by the applicant to cross reference the applicant's information with other state and federal agencies, i.e. the Department of Workforce Services, the Social Security Administration, the Office of Child Support Enforcement and the Department of Human Services (see Social Security Number Request section).
Social Security Number Request
Social security numbers are used to verify income and other client data. An encrypted file containing Social Security Numbers are remitted to sub-grantees who implement the LIHEAP program. The files are used in compliance with the Privacy Act of 1974 and clients are informed of how their SSN numbers will be used by the Department of Human Services. Please refer to the "Cross Checking against Social Security Numbers against Government Systems/Databases" section for additional information concerning the use of SSN numbers to prevent fraud.
Cross Checking Social Security Numbers against Government Systems/Databases
Applications are processed by sub-grantees using information provided by state and federal agencies i.e., the Department of Workforce Services, the Social Security Administration, the Office of Child Support Enforcement and DHS. Social Security Numbers (SSN's) are an intricate part of any verification process when cross checking information. Client SSN's maintained by DHS are used to verify citizenship with the Social Security Administration, verify death matches against records maintained by the Department of Health Bureau of Vital Statistics and compared to a list of incarcerated persons provided by the Department of Community Corrections.
The sub-grantee agencies who implement the program use Social Security Numbers provided by the applicant to verify income.
Verifying Applicant Income
Income verification is completed by the sub-grantee agencies who implement the program. All income is verified by using supporting documentation i.e., check stubs, information from the Department of Workforce Services, the Social Security Administration, the Office of Child Support Enforcement and DHS. In addition, the DHS Division of County Operations uses "The Work Number" to verify recent earned income directly from employers.
Privacy Protection and Confidentiality
The Department of Human Services has extensive policies and procedures in place to prevent and report fraud and misuse of applicant information. Policies are provided to CAP agencies to take all measures necessary to prevent improper use of applicant information. Through collaboration, the state will study additional measures to implement in the near future.
Training and Technical Assistance
Training is provided each year to staff of the sub-grantee agencies and to non-governmental individuals, including energy suppliers and non-profit agencies. Also, technical assistance is continuously provided during the program year.
Audits of Local Administering Agencies
Each sub-grantee agency is required to have an audit completed by a professional audit firm of all programs and components within the agency. The audit results are provided to DHS for review. Any agency with audit findings is required to submit a plan of corrective action.
LIHEAP Benefits Policy
In an effort to prevent fraud, sub-grantee records are reviewed each year by LIHEAP staff. Additionally, energy suppliers are randomly selected and contacted to verify and document information contained in the applicant's case records. Energy suppliers are also monitored to verify utility costs provided to the sub-grantees as well as conducting a second party review of the payments made to the suppliers on behalf of the applicants.
Procedures for Unregulated Energy Vendors
There are no procedures for unregulated energy vendors in place at this time. We plan to collaborate with other states for ideas and measures which they are using to prevent fraud and improper payments to these vendors.
Verifying the Authenticity of Energy Suppliers
Energy supplier authenticity is verified through applicants' energy bills, by obtaining the list of energy suppliers and a.review of a percentage of suppliers each year. Also, each agency is required to enter into a contract with each supplier to which payments are made.
016.20.11 Ark. Code R. 007