2021-10-26 Low Income Household Water AssistanceGood Life. Great Mission.
DEPT. OF HEALTH AND HUMAN SERVICES Pete Ricketts, Governor
Low Income Household Water Assistance Program Vendor Agreement
PURPOSE: This Agreement ("Agreement") between the State of Nebraska, Department of Health and Human
Services, ("DHHS"), and the [ City of Blair, Nebraska ("Vendor") shall govern the purchase of water
services from the Vendor on behalf of households eligible for the Low Income Household Water Assistance
Program (LIHWAP). The federal funds will be used to assist eligible households with arrearages, rates and fees
associated with reconnection or prevention of disconnection of service, and rate reduction for such services.
The parties acknowledge that this Agreement and the services provided by the Vendor are governed by and
subject to the federal and state laws and regulations per General Terms and Conditions for Mandatory: Formula,
Block and Entitlement Grants and LIHWAP supplemental terms and conditions. Expenditure of LIHWAP funds
is governed by the Notice of Award, Nebraska'sapproved LIHWAP state plan, and the requirements of the
Administration for Children and Families Office of Community Services.
1. DURATION
1.1 Term. This Agreement shall be in effect beginning on the date that DHHS notifies the Vendor that they
have been approved for enrollment. The Agreement shall not bind, nor purport to bind, DHHS for any
commitment over the original Agreement period.
1.2 Modifications. All modifications to this Agreement shall be in writing and agreed upon by both parties.
1.3 Termination. This Agreement will terminate effective immediately upon a determination by DHHS that
the Vendor is not in compliance with the terms of this Agreement. The Vendor will be notified within 15
calendar days of the termination.
1.3.1 Either DHHS or the Vendor may terminate this Agreement with or without cause and without
cost by giving the other party at least 30 calendar days' written notice. Termination by either
party shall not discharge any obligation owed by either party on behalf of the household that has
been awarded the benefit.
2. RESPONSIBILITIES
2.1 DHHS. DHHS shall:
2.1.1 Equitably provide outreach activities to potentially eligible households.
2.1.2 Based on established criteria, determine household eligibility promptly for LIHWAP.
2.1.3 Provide the household notification of approved services.
2.1.4 Review utility account documentation. DHHS will request additional documentation or
clarification of charges as needed. No payment will be made without all required documentation
of charges.
2.1.5 Provide payment to the Vendor for eligible households after receipt of all required
documentation for services rendered, according to this Agreement, and upon full compliance by
the Vendor with the terms herein.
2.1.6 Issue payments to the Vendor by Electronic Funds Transfer (EFT). Payments will be issued in a
lump sum. DHHS will identify to the Vendor each eligible customer on whose behalf DHHS will
make payment for water services, and the payment amount each customer is eligible to receive.
The Vendor will be notified of payment details via the email address provided by the Vendor.
The detailed payment information will arrive via e-mail two (2) to three (3) days after payment is
issued or via mail five (5) to seven (7) days after payment is issued.
2.1.7 Comply with all relevant state and federal laws and regulations, the Notice of Award, terms and
conditions set forth by the Administration for Children and Families, program policies, and
Nebraska's approved LIHWAP state plan in the implementation of LIHWAP.
2.1.8 Establish such fiscal control and fund accounting procedures as may be necessary to assure the
proper disbursal of and accounting for federal funds paid to the state per all relevant state and
federal laws and regulations, the Notice of Award, terms and conditions, program policies, and
Nebraska's approved LIHWAP state plan, including procedures for monitoring the assistance
provided under this title.
2.1.9 Monitor a portion of the Vendors to ensure compliance with the Vendor Agreement and program
policies. By signing the Vendor Agreement, Vendors agree to be periodically monitored and
provide necessary monitoring information when requested.
2.1.10 Provide the Vendors selected for compliance monitoring with a LIHWAP Monitoring Report to
describe the information needed.
2.2 Vendor. The Vendor shall:
2.2.1 Provide DHHS a copy of the Employer Identification Number document or Social Security card
which was issued to the Vendor and which displays the number used by the IRS as the Vendor's
tax identification number. Notify DHHS immediately when the tax identification number is
changed. A new W-9 form must be completed and returned to DHHS.
2.2.2 Provide DHHS with at least one designated contact person who shall be available to respond by
telephone and electronic mail to all reasonable inquiries regarding LIHWAP household accounts,
including but not limited to: address; accountholder name; account number; line item accounting
of amount owed and service it is owed for, water burden, payment history; how the LIHWAP
payment was applied; and the impact of the payment.
2.2.3 Notify DHHS within ten (10) days when: the name of the company; ownership of the company;
contact person; contact or billing information; services to be provided; or service coverage area
changes.
2.2.4 Notify DHHS within ten (10) days if a LIHWAP payment is made for a customer residing in the
Vendor's service area but with incorrect account information.
2.2.5 Notify DHHS if the business owner or another key employee is employed by DHHS, as well as
if a member of his or her immediate family is employed by DHHS. Immediate family is a spouse
or other person who resides in the same household as the owner and is a dependent of the owner.
2.2.5.1 DHHS will evaluate the relationship to determine if there is a conflict of interest that will
preclude the Vendor from providing LIHWAP services to a designated locality(s).
Conflict of interest is defined as a situation that has the potential to undermine the
impartiality of a person in an official position because of the possibility of a clash
between the person's self-interest and professional interest or public interest.
2.2.6 Not serve as the Vendor for a household in which he or she is a current recipient of assistance
from LIHWAP. Current is defined as during the present federal fiscal year.
2.2.7 Not serve as the Vendor for a dwelling or property that he or she owns.
2.2.8 Apply LIHWAP payments to the approved services for the LIHWAP eligible households
identified by DHHS. Provide the services to each eligible and approved residential household for
which payment is provided under LIHWAP.
2.2.9 Charge LIHWAP households using the Vendor's normal billing process the difference between
the actual amount due and the amount of the payment made with LIHWAP funds.
2.2.10 Charge LIHWAP eligible households the same price for services that are charged to non -eligible
households, as determined by the Vendor approved rate -setting process.
2.2.11 Not treat LIHWAP eligible households adversely because of such assistance under applicable
provisions of state, territorial or tribal law, or public regulatory requirements.
2.2.12 Not apply LIHWAP payments to account balances that have previously been written off or paid
with other funds.
2.2.13 Not apply LIHWAP payments to commercial accounts. LIHWAP payments must only be
applied to residential accounts.
2.2.14 Accept payment guarantees from DHHS to restore services and eliminate arrearages. The Vendor
must immediately apply payment guarantees to the customer accounts for the appropriate
services.
2.2.15 Within 1 business day of receipt of the payment guarantee inform DHHS of the following: the
payment guarantee was applied to the customer account; the new balance; and whether
reconnection occurred or disconnection was alleviated.
2.2.16 Not terminate water service to an eligible customer covered by this Agreement except under the
conditions set forth in the Nebraska Rev. Stat. §§ 70-1603 through 70-1614.
2.2.17 Identify LIHWAP payments made for eligible household accounts as payment received from the
LIHWAP.
2.2.18 Provide a statement to LIHWAP households indicating the cost of home drinking water and/or
wastewater services provided.
2.2.19 Maintain any credit amount, on the designated account, as a credit until used by the customer for
water services or the customer ends service with the Vendor.
2.2.20 Transfer any credit balance to the new account, within thirty (30) days, if the customer moves
and remains with the same Vendor.
2.2.21 Not exchange the household's credit authorization for cash or give any cash equivalent for
excess credit.
2.2.22 Return to DHHS within thirty (30) days of service ending any credit balance of LIHWAP funds.
2.2.23 Return to DHHS within thirty (30) days any LIHWAP payment for a customer not residing in the
Vendor service area.
2.2.24 Return to DHHS within thirty (30) days of Vendor closing or being sold any LIHWAP credit
balance. Funds may not be transferred to another Vendor.
2.2.25 Returned funds must be remitted to DHHS — Accounting PO Box 94906 Lincoln, NE 68509-
9947.
2.2.26 All funds returned to DHHS must include the following:
2.2.26.1 Name of client the payment was issued for;
2.2.26.2 Client ID number the payment was issued for;
2.2.26.3 Address and city the payment was issued for;
2.2.26.4 Accountholder's name the payment was issued for;
2.2.26.5 Account number the payment was issued for;
2.2.26.6 Date the original payment was posted to the account;
2.2.26.7 Reason funds are being returned; and,
2.2.26.8 Amount of funds being returned for each account.
2.2.27 Maintain current records and comply with any state or local regulations required for service
provision.
2.2.28 Cooperate with any federal, state, or local investigation, audit, or program review. The Vendor
shall allow DHHS representatives access to all records relating to LIHWAP households for
compliance verification with this Agreement.
2.2.29 Understand that failure to cooperate with any federal, state, or local investigation, audit, or
program review may result in immediate disqualification from participation in LIHWAP.
2.2.30 Take corrective action in the time frame specified by DHHS if violations of this Agreement are
discovered. Corrective action may include but is not limited to providing detailed documentation
of the changes made and detailed plans for future changes that will bring the Vendor into
compliance.
2.2.30.1 Understand that failure to implement corrective actions may result in immediate
disqualification from participation in the LIHWAP.
2.2.31 Collect and provide data within the time frame specified by DHHS and in the format requested
by DHHS. The data must be provided to DHHS (or an authorized agent of DHHS) for
verification, research, evaluation, analysis, and reporting. The household's signed LIHWAP
application will authorize the Vendor to release this information to DHHS.
2.2.32 Retain all books, records, and other documents relevant to this agreement for a minimum of five
(5) years or until litigation, claim, negotiation, audit, or other action involving the records has
been completed, if it was initiated prior to the expiration of this five (5) year period. These
records may be used for a variety of program purposes including: program planning; program
capacity building; assessing the impact of LIHWAP and other benefits on low-income
households; and supporting funding decisions.
2.2.33 Provide at no cost to DHHS, in the format requested:
2.2.33.1 Written account information, including: account number; address; accountholder
name; and other household -specific information.
2.2.33.2 Written information regarding the household's home drinking water and/or wastewater
usage, current balance and itemized charges, bill payment history, and arrearage.
2.2.33.3 Immediate written confirmation that the payment guarantee was applied to the
household account, inform of the new balance, and inform whether reconnection
occurred or disconnection was alleviated.
2.2.33.4 Other data as requested.
2.2.34 Complete the Vendor Monitoring Report and supply the report and supporting documentation to
DHHS within five business days of the request when selected for compliance monitoring.
2.3 JOINT DUTIES. Both the Vendor and DHHS shall:
2.3.1 Meet as needed to discuss any issues, recommendations, unmet needs, and lessons learned.
3. CONDITIONS
3.1 Authorities. Nothing herein shall be construed as authority for either party to make commitments that
will bind the other party beyond the scope of services contained herein.
3.2 Discrimination. The Vendor shall not discriminate against any household because of race, religion,
color, sex, national origin, age, disability, political beliefs, sexual orientation, gender identity, or any
other basis prohibited by state law relating to discrimination. The Vendor shall not discriminate against a
LIHWAP eligible household concerning terms, deferred payment plans, credit, conditions of sale,
deposit, water rate, including service charges, reconnection charges payment plan arrangements, or
discounts offered to other customers. The Vendor shall comply with all LIHWAP regulations, state and
federal statutes and regarding civil rights and equal opportunity employment, including Title VI of the
Civil Rights Act of 1964, 42 U.S.C. §§ 2000d et seq.; the Rehabilitation Act of 1973, 29 U.S.C. §§ 794
et seq.; the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101 et seq.; and the Nebraska Fair
Employment Practice Ace, Neb. Rev. Stat. §§ 48-1101 to 48-1125.
3.3 Confidentiality. The Vendor agrees that any information and data obtained related to households shall be
collected and held confidential, during and following the term of this Agreement. Household
information shall not be disclosed without the individual's and DHHS's written consent and only per
federal or state law. Vendors who utilize, access, or store personally identifiable information as part of
the performance of this Agreement are required to safeguard this information and immediately notify
DHHS of any breach or suspected breach in the security of such information. The Vendor shall allow
DHHS to both participate in the investigation of incidents and exercise control over decisions regarding
external reporting.
3.4 Subcontracts. DHHS reserves the right to require the Vendor to obtain permission to subcontract any
portion of the work. If requested by DHHS, the Vendor shall furnish DHHS with the names,
qualifications, and experience of their proposed subcontractors. The Vendor shall, however, remain
liable for the work to be done by its subcontractor(s) and shall assure compliance with all requirements
of the Agreement.
3.5 Fraud. The Vendor will be permanently disqualified from participating in LIHWAP upon the first
finding of LIHWAP fraud. Fraud includes, but is not limited to: intentionally providing false
information to DHHS or knowingly allowing others to do so; intentional failure to notify DHHS of a
change in circumstances that affects payments received by the Vendor; intentionally accepting payments
that the Vendor knows or by reasonable diligence would know, the Vendor is not entitled to under an
overpayment or otherwise; or intentionally malting a claim for a payment to which the Vendor is not
entitled under the terms of this Agreement and all applicable rules, regulations, laws, and statutes.
Repayment must be made unless contrary to a court order.
3.6 Non -fraud overpayments. For overpayments received by the Vendor that are not the result of intent to
defraud, the Vendor shall be required to repay the full amount to DHHS.
3.7 Reporting fraud. The Vendor agrees to report any known fraud activity by the household to DHHS. This
may include but is not limited to the following:
3.7.1 The LIHWAP participant not disclosing all income.
3.7.2 The LIHWAP participant not using awards appropriately.
3.7.3 The LIHWAP participant not giving truthful information.
3.8 Business practices. The Vendor certifies that neither it nor its principals are debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any state or federal department or agency. No Vendor may participate in LIHWAP in any
capacity or be a recipient of federal funds designated for this program if the provider has been debarred
or suspended or otherwise found to be ineligible for participation in federal assistance programs under
Executive Order 12549, "Debarment and Suspension." (See 45 CFR 75.212.)
3.9 Bindiniz on heirs and assigns. This Agreement shall be binding upon and inure to the benefit of the
respective successors and assign of each party but does not otherwise create, and shall not be construed
as creating, any rights enforceable by any person not a party to this Agreement.
3.1ODue authorization. The persons executing this Agreement on behalf of a party represent and warrant to
the other party that he or she has been duly authorized by such party executing this Agreement.
3.11 Severability. If any provision of this Agreement or the application thereof to any person or
circumstance is held to be invalid, the invalidity shall not affect other provisions of this Agreement,
which shall be given effect without regard to the invalid provision or application.
The parties to this Agreement acknowledge the information, specified above, and will provide the
accomplishment of this service in a mutually acceptable and efficient manner.
Vendor Name: City of Blair, Nebraska
Signature of Authorized Representative for Vendor
Richard Hansen, Mayor 10/26/2021
Printed Name/Title of Representative for Vendor Date
4. WATER UTILITY INFORMATION FORM
Vendor Name: city of Blair, Nebraska
Doing Business As (DBA), if applicable:
Vendor Legal Name (as used on Federal Tax Return
Owner Name:
for Business): City of Blair Nebraska
City of Blair, Nebraska
Type of Entity:
Taxpayer Identification (ID) Number:
❑ Sole Proprietor ❑ Partnership
1 to 0 0' I 0
❑ Corporation 0 Government Entity
❑ Social Security Number (SSN)
❑ Trust ❑ Estate
. Employer Identification Number (EIN)
Utility: ❑ Investor -Owned 1Z Municipal
❑ Individual Taxpayer Identification
Number (ITIN)
❑ Cooperative ❑ Other
❑ Limited Liability Company (LLC)
Is the LLC incorporated? ❑ Yes ❑ No
❑ Single Member or ❑ Multiple Member
Vendor Contact/Title: Sarah Backman
Telephone Number: 402-426-4191
Physical Address: 218 S 16th St Blair NE 68008
Mailing Address: 218 S 16th St. Blair NE 68008
Email Address: sbackman@blairnebraska.
Office Fax Number: 402-426-4195
Account Inquiry/Payment Guarantees Contact: Sarah
Telephone Number: 402-426-4191
Mailing Address: 218 S 16th St Blair NE 68008
Email Address: sbackman@blairnebraska.org
Payments Contact/Title: Sarah Backman
Telephone Number: 402-426-4191
Mailing Address: 218 S 16th St Blair NE 68008
Email Address Regarding Payments: sbackman@
SERVICES PROVIDED AND BILLED BY VENDOR blairnebraska.org
0 Water Fees 1Z Wastewater/Sewer Fees ❑ Other
❑ Storm water Fees ❑ Groundwater Fees
OTHER SERVICES INCLUDED ON WATER BILL
0 None ❑ Electricity ❑ Other
❑ Natural Gas ❑ Trash
LOCALITIES SERVED
Please indicate which localities you will serve by entering each name of the locality in a box.
1.1 �� 6 i 661 C
After signing the agreement and completing the vendor profile data pages, email pages to:
DI-114S.1,11-IWAPMailbox ca nebraska. ov
Remember to keep a copy for your records.
The General Terms and Conditions apply to all mandatory grant programs. These Supplemental Terms and
Conditions are additional requirements applicable to the program named below.
By acceptance of awards for this program, the grantee agrees to comply with the requirements included in both
the General and Supplemental Terms and Conditions for this program.
Office of Community Services (OCS)
LOW INCOME HOUSEHOLD WATER ASSISTANCE PROGRAM (LIHWAP)
Assistance Listing No. 93.568(B) (with modifications based on P.L. 116-260)
APPLICABLELEGISLATION,'STATUTE, REGULATIONS
1. The administration of this program is authorized under Section 533 Title V of Division H of the
Consolidated Appropriations Act, 2021, Public Law No: 116-260. Consistent with legislative
instructions, program requirements use existing processes, procedures, and policies currently in place to
provide assistance to low-income households. In particular, OCS has closely modeled the Low Income
Household Water Assistance Program's (LIHWAP) terms and conditions on assurances and requirements
outlined in the Low Income Household Energy Assistance Act, 42 U.S.C. 8621 et seq.
2. The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards
is located under 45 CFR Part 75. In accordance with 45 CFR 75.101 applicability, this program must
comply with 45 CFR Part 75 in its entirety. No exceptions have been identified.
3. Additional applicable regulations and requirements can be found in the General Terms and Conditions
for Mandatory: Formula Block and Entitlement Grants.
COST SHARING OR MATCHING (NON-FEDERAL SHARE) OF PROGRAM FUNDING
4. The federal financial participation rate (FFP) is 100 percent for this program. The federal award
provides funds for 100 percent of allowable, legitimate program costs.
5. There is no non-federal cost share/matching required for this program. Program funds for this program
are awarded with a 100 percent FFP rate for program costs.
FINANCIAL REPORTING AND REQUIREMENTS
6. The OMB approved Financial Reporting form for this program is the SF -425 Federal Financial Report
SF -425 Federal Financial Report. Grantees must track and report on LIHWAP funds separately from
appropriated LIHEAP funds.
Effective April 19, 2021 Page 1 of 6
Supplemental Terms and Conditions Low Income Household Water Assistance Program (LIHWAP)
a. This report is submitted annually and must be submitted no later than December 30, which is 90
days following the end of each federal fiscal year (FFY).
b. A first interim report is due 90 days following the end of FFY 2021.
c. A second interim report interim report is due 90 days following the end of FFY 2022.
d. A final report (cumulative, covering the entire project period) is due 3 months following the end of
FFY 2023.
7. Project Period. The project period for this award is synonymous with the obligation period, as follows:
from the date of the award through the end of FFY 2023 (September 30, 2023). Any federal funds not
obligated by the end of the obligation period will be recouped by this Department.
8. Liquidation Deadline. All obligated federal funds awarded under this grant must be liquidated no later than
3 months after the end of the project period (i.e., December 31, 2023). Any funds from this award not
liquidated by this date will be recouped by this Department.
9. The following are the grant/fiscal requirements based on modifications of existing LIF EAP policies and
requirements:
a. The grantees may use up to 15 percent of grant funds for planning and administering the funds
under this award. The grantee will pay from non-federal sources the remaining costs of planning
and administering the program under this award and will not use federal funds for such remaining
cost. Administrative costs of the owners or operators of public water systems or treatment works
that may be charged to this award, if any, are subject to this limitation and must be included
together with the grantee's costs of planning and administration when calculating compliance.
b. The grantee will ensure that fiscal control and fund accounting procedures will be established as
may be necessary to assure the proper disbursal of and accounting for federal funds paid to the
state under this award, including procedures for monitoring the assistance provided under this
award, and provide that the grantee will comply with the provisions of chapter 75 of title 31,
United States Code (commonly known as the "Single Audit Act").
c. The grantee may expend funds for immediate expenses necessary for planning and administering
the use of funds upon receipt of the award. However, prior to the expenditure of grant funds for
any payments to owners or operators of public water systems or treatment works on behalf of low-
income households, the grantee must submit an implementation plan for OCS review and
acceptance in a format provided by OCS that will (a) include the eligibility requirements to be
used by the state for each type of assistance to be provided under this grant, (2) describe the
benefit levels to be used by the state, territory, or tribe for LIHWAP assistance, (3) describe any
steps that will be taken to target assistance to households with high home water burdens, and (4)
provide a plan of administration including a plan of oversight and monitoring of any subrecipient
organizations comparable to the processes and procedures for comparable grant programs. Not
later than May 30, 2021, OCS will make available a Model State and Tribal Implementation Plan
format to be used in developing and submitting the implementation plan for review.
PROGRAM REPORTING AND REQUIREMENTS
10. Grantees must track and report on LH-1WAP program activities under this award separately from LIHEAP.
The grantee must report annually on the following data elements, using an OMB -approved reporting format
to be provided by OCS:
a. the amount, cost, and type of water assistance provided for households eligible for assistance
under this award;
b. the type of water assistance used by various income groups;
Effective April 19, 2021 Page 2 of 6
Supplemental Terns and Conditions LoNv Income Household Water Assistance Program (LIHWAP)
c. the number and income levels of households assisted by this award;
d. the number of households that received such assistance and include one or more individuals who
are 60 years or older, include a household member with a disability, or include young children
(ages 5 and younger);
e. the impact of each grantee's LIHWAP program on recipient and eligible households (e.g., amount
of assistance to each household, and whether assistance restored water service or prevented
shutoff); and
f. administrative information regarding local providers (if applicable), agreements with water
utilities, recommendations, accomplishments, unmet needs and lessons learned.
11. The following are the program requirements, consistent with instructions in P.L. 116-260, Section 533
and consistent with existing program requirements for Low -Income Home Energy Assistance Program
(LIHEAP) and other closely related programs:
a. Federal funds awarded under this grant shall be used as part of an overall emergency effort to
prevent, prepare for, and respond to the coronavirus, with the public health focus of ensuring that
low-income households have access to safe and clean drinking water and wastewater services.
b. Funds will be used to provide assistance to low-income households—particularly those with the
lowest incomes—that pay a high proportion of household income for drinking water and
wastewater services. Assistance to households will be accomplished by providing funds to owners
or operators of public water systems or treatment works to reduce arrearages of and rates charged
to such households for such services. Grantees may use LIHWAP funding to cover arrearages
arising at any time, including prior to this award.
c. Grantees shall, in carrying out programs funded with this grant, as appropriate and to the extent
practicable, use existing processes, procedures, policies, and systems in place to provide assistance
to low-income households, including by using existing programs and program announcements,
application and approval processes.
i. Grant resources may be used to make payments only with respect to households in which
one or more individuals are receiving the following:
1. assistance under the State program funded under part A of title IV of the Social
Security Act;
2. supplemental security income payments under title XVI of the Social Security
Act;
3. food stamps under the Food Stamp Act of 1977;
4. payments under section 415, 521, 541, or 542 of title 38, United States Code, or
under section 306 of the Veterans' and Survivors' Pension Improvement Act of
1978; or
5. payments under the Low Income Home Energy Assistance Program (LII-IEAP);
or
ii, households with incomes that do not exceed the greater of the following:
1. an amount equal to 150 percent of the poverty level for such state; or
2. an amount equal to 60 percent of the state median income;
3. except that a state, territory, or tribe may not exclude a household from
eligibility in a fiscal year solely on the basis of household income if such income
is less than 110 percent of the poverty level for the state; but, the state, territory,
or tribe may give priority to those households with the highest home water costs
or needs in relation to household income.
d. The grantee will establish criteria and procedures for determining income eligibility comparable to
established procedures and requirements for LIHEAP. The grantee will conduct outreach
activities designed to ensure that eligible households, especially those with the lowest incomes,
Effective April 19, 2021 Page 3 of 6
Supplemental Terms and Conditions Low Income Household Water Assistance Program (LIHWAP)
that pay a high proportion of household income for drinking water and wastewater services, are
made aware of the assistance available under this title and any similar assistance available under
the Community Services Block Grant program or through other emergency relief such as the
Pandemic Emergency Assistance Fund and the U.S. Department of Treasury's Emergency Rental
Assistance Program.
e. The grantee will coordinate its activities under this title with similar and related programs
administered by the Federal Government and such state, territory, or tribe, particularly low-income
utility support programs such as LIHEAP, the Community Services Block Grant (CSBG),
Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), the
Social Service Block Grant, and the Emergency Rental Assistance Program.
f. The grantee will provide, in a timely manner, that the highest level of assistance will be furnished
to those households that have the lowest incomes and the highest water costs or needs in relation
to income, taking into account family size, except that the state, territory, or tribe may not
differentiate in implementing this section between the households described in condition I I (c)(i)
and I I(c)(ii) (above).
g. The grantee will establish policies, procedures, and benefit levels on behalf of households that
prioritize continuity of water services, including prevention of disconnection and restoration water
services to households for which water services were previously disconnected.
h. The grantee will provide funds to owners or operators of public water systems or treatment works
("owners or operators") to reduce arrearages of and rates charged to eligible households for such
services. For all payments to owners or operators on behalf of individual households, the grantee
must establish procedures to:
L notify, or require the owner or operator to notify, each participating household of the
amount of assistance paid on its behalf,
ii. ensure that the owner or operator will charge the eligible household, in the normal billing
process, the difference between the actual amount due and the amount of the payment
made by the LIHWAP grant;
iii, ensure that any agreement the grantee enters into with an owner or operator under this
paragraph will contain provisions to ensure that no household receiving assistance under
this grant will be treated adversely because of such assistance under applicable provisions
of state, territorial or tribal law or public regulatory requirements;
iv. ensure that the provision of payments to the owner or operator remains at the option of
the grantee, in consultation with local subgrantees; and
v. ensure that the owner or operator provides written reconciliation and confirmation on a
regular basis that benefits have been credited appropriately to households and their
services have been restored on a timely basis or disconnection status has been removed if
applicable.
i. The amount of any home water assistance benefits provided under this program for the benefit of
an eligible household shall not be considered income or resources of such household (or any
member thereof) for any purpose under any State, Territorial, or Tribal law, including any law
relating to taxation, public assistance, or welfare programs.
j. The grantee will not exclude income -eligible households (described above in condition 11(c)(ii))
from receiving home water assistance benefits.
k. The grantee will establish procedures to treat owners and renters equitably under the program
assistance provided with these grant resources.
Effective April 19, 2021 Page 4 of 6
Supplemental Terms and Conditions Low Income Household Water Assistance Program (LIHWAP)
1. The grantee will provide for timely and meaningful public participation in the development of a
state, territory or tribe's LIHWAP implementation plan, such as publication and acceptance of
comments via the grantee's website.
m. The grantee will provide an opportunity for a fair administrative hearing to individuals whose
claims for assistance under a LII-IWAP plan are denied or are not acted upon with reasonable
promptness. Administrative hearing opportunities will be comparable to and may utilize existing
processes, procedures, and systems currently in place for the state, territory, or tribe's Low Income
Home Energy Assistance grant.
n. The grantee will be responsible for planning and prioritizing funds for households in communities
throughout the state with the exception of households within tribal jurisdictions for which OCS
has reserved a portion of LIHWAP funds. If the governing organization of any eligible tribal
government or organization located within the state declines or is not able to successfully apply
for available LIHWAP funds, the state grantee will then be responsible for including eligible
households within the tribe's jurisdiction in its outreach and service coverage.
o. LIHWAP grant funds may not be used by the grantee, or by any other person with which the
grantee makes arrangements to carry out the purposes of this grant, for the purchase or
improvement of land or the purchase, construction, or permanent improvement of any building or
other facility.
p. The grantee will permit and cooperate with federal investigations undertaken in accordance with
the following procedures:
i. OCS shall, after adequate notice and an opportunity for a hearing conducted within the
affected state, territory, or tribe, withhold funds from any grantee that does not utilize its
allotment substantially in accordance with the terms and conditions.
ii. OCS shall review and respond in writing in no more than 60 days to matters raised in
complaints of a substantial or serious nature that a grantee (or any person with which the
grantee makes arrangements to carry out the purposes of the grant) has failed to use funds in
accordance with these terms and conditions. Any violation of any one of the terms and
conditions that constitutes a disregard of such assurance shall be considered a serious
complaint.
iii. If OCS determines that there is a pattern of complaints from any state, territory, or tribe
during the grant period, OCS shall conduct an investigation of the use of funds received under
this award by the grantee in order to ensure compliance with terms and conditions.
iv. The HHS Office of the Inspector General (OIG) may conduct an investigation of the use of
funds received under this title by a state, territory, or tribe in order to ensure compliance with
the provisions of this title.
v. In the event of an investigation conducted by OCS, OIG, or another federal entity designated
by OCS, the grantee shall make appropriate books, documents, papers, and records available
to the Secretary or the Comptroller General of the United States, or any of their duly
authorized representatives, for examination, copying, or mechanical reproduction on or off the
premises of the appropriate entity upon a reasonable request thereof.
vi. In conducting any investigation under the procedures described above, OCS will not request
any information not readily available to such state, territory, or tribe, or require that any
information be compiled, collected, or transmitted in any new form not already available.
REAL PROPERTY REPORTING
12. Real Property Reports (SF -429s). The SF -429 Real Property forms are not applicable to this program.
Purchase, construction, and major renovation are not an allowable activity or expenditure under this grant.
Effective April 19, 2021 Page 5 of 6
Supplemental Terms and Conditions
EFFECTIVE PERIOD
Low Income Household Water Assistance Program (LIHWAP)
13. These program -specific Supplemental Terms and Conditions are effective on the date shown at the bottom
of the pages of this document and will remain in effect until updated. They will be updated and reissued
only as needed whenever a new program -specific statute, regulation, or other requirement is enacted or
whenever any of the applicable existing federal statutes, regulations, policies, procedures, or restrictions are
amended, revised, altered, orrepealed.
Signature of Governor's Authorized Official
Name of State/Territory:
Nebraska
LIHWAP State/Territory Lead Agency:
Department of Health and Human Services, Divisiorb
I certify that the LIHWAP State/Territory Lead Agency has reviewed and will abide by the conditions
outlined above. Digitally signed by
Stephanie -Stephanie-Beasley
Date: 2021.04.27
X Beasley 12:58:09 -05'00'
Governor's Authorized Official
Effective April 19, 2021 Page 6 of 6