HomeMy WebLinkAbout21- Low Income Home Water Wastewater Assistance Program Contract - DPHHS Greg Gianforte, Governor
Adam Meier, Director
Department of Public Health and Human Services
Human and Community Services Division Intergovernmental Human Services Bureau PO Box 202956 Helena, MT 59620-2956
DATE: July 19, 2021
TO: Public Water System Providers
FROM: Sara Loewen, DPHHS Intergovernmental Human Services Bureau Chief
SUBJECT: Low-Income Home Water Assistance Program (LIHWAP) Contractor Application
and Contract
A temporary emergency Low-Income Home Water Assistance Program1 (LIHWAP) is being
developed to provide low-income households assistance in paying their water and wastewater
bills. Funds will be sent directly to Public Water System (PWS) operators to be credited to
income eligible household accounts to reduce arrearages, prevent shutoffs and reduce monthly
rates. This program is slated to operate from October 1, 2021 through September 30, 2023.
Households will apply for assistance through a process coordinated with the Low-Income
Energy Assistance (LIEAP) program.
The MT Department of Public Health and Human Services is providing the opportunity to PWS
providers to participate in this program through a contract with the Department in order to
receive and provide this assistance to income eligible households. The Department is beginning
the process of securing contracts with PWS providers interested in participating in the LIHWAP.
The following documents are enclosed:
1. A copy of the (DPHHS-HWAP-001) Low Income Home Water Assistance Program
Contractor Application and Contract for the time period October 1, 2021 through
September 30, 2023.
Complete the Contractor Information sections, including the Contractor Taxpayer ID
number field. Sign the bottom of page three. The contract will be signed by a
Department representative and a copy will be returned for your records.
2. A Taxpayer Identification Number (TIN) Verification (W-9) form. The completed W-9
form is required to receive payments from the Department. The W-9 form will be used
to verify the TIN and the address where the 1099 form will be sent.
1 The LIHWAP program is authorized under Section 533 Title V of Division H of the Consolidated
Appropriations act of 2021, Public Law No: 116-260 and as provided for under The American Rescue Plan Act
(ARPA). Additional information can be found at: https://www.acf.hhs.gov/ocs/programs/lihwap.
DocuSign Envelope ID: AC18ECE7-B5B2-4E54-92FE-9515E4A892AB
3. A Payment Address Form to complete and return if the mailing address for the LIHWAP
payment is to be made to an address other than the one entered on the W-9 form.
4. A Direct Deposit Sign-up Form to complete if your company would prefer to have
payments made directly to your financial institution. A written Statement of Remittance
(SOR) will be mailed as usual but LIHWAP funds will be available at least one day earlier.
In order to participate and receive funds under this program, items #1 and #2 (above) must be
completed and returned, along with items #3 and #4 if applicable.
These documents should be mailed to:
DPHHS LIHWAP, PO Box 202925, Helena, MT 59620
We encourage all Public Water System providers to complete the above information in order to
participate in the program and allow their customers to receive this assistance.
Look for additional information (coming soon) at www.lieap.mt.gov. A list of frequently asked
questions will be available. You can also email Program Specialist Sheri Shepherd at
sshepherd2@mt.gov.
Thank you for considering participating in the Low Income Home Water Assistance Program
aimed at reducing arrearages and rates of low-income households, particularly those with the
lowest incomes, that pay a high proportion of household income for drinking water and
wastewater services.
Sara Loewen
Intergovernmental Human Services Bureau Chief
Human and Community Services Division, MT DPHHS
DocuSign Envelope ID: AC18ECE7-B5B2-4E54-92FE-9515E4A892AB
DPHHS-HWAP-001 Montana Department of Public Health and Human Services
(Rev. 7/2021) Human and Community Services Division, P.O. Box 202956, Helena, Montana 59620-2956
2021-2023
LOW INCOME HOME WATER/WASTEWATER ASSISTANCE PROGRAM
CONTRACTOR APPLICATION AND CONTRACT
Contractor Name:
Mailing Address: Type(s) Service Supplied: ❑Water and Wastewater
❑Water Only ❑Wastewater only
City, State Zip: Contractor Taxpayer ID# (EIN or SSN)
Email Address: Telephone #:
Type of Entity: ❑ Partnership (Must use EIN) ❑Individual/Sole Proprietor (EIN or SSN)❑Corporation (Must use EIN)
A completed Form W-9 must be submitted with this contract.
Contractor Number Issued by DPHHS:
THIS CONTRACT, is entered into by and between the MONTANA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES (hereinafter
referred to as the "Department"), and the home Public Water or Wastewater supplier identified above, (hereinafter referred to as the
"Contractor").
WITNESSETH THAT, in consideration of the mutual covenants and agreements herein contained, the parties agree as follows:
1.The purpose of this contract shall be to assist low income households (Eligible Customers) to offset the cost of water and/or
wastewater services under the Low Income Home Water/Wastewater Assistance Program (LIHWAP) is authorized under Section
533 Title V of Division H of the Consolidated Appropriations Act, 2021, Public Law No: 116-260 and as provided for under the
American Rescue Plan Act. ,
2.The effective date and duration of this contract shall be October 1, 2021 through September 30, 2023.
3.To receive direct payments from the Department under LIHWAP, the Contractor agrees:
a.To provide appropriate and timely delivery of home water and/or wastewater services to Eligible Customers.
b.To charge the Eligible Customers the difference between the actual cost of the home water and/or wastewater services and
the amount of the payment made by the Department.
c.Not to adversely discriminate in the cost, services or treatment provided to the Eligible Customer on whose behalf a LIHWAP
payment is made.
d.To provide to the Department upon request, with written reconciliation and confirmation 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. The reconciliation must show amount applied to each eligible recipient account for arrearages, late
fees, reconnection fees and/or regular monthly bill rate reduction.
e.To clearly enter, on LIHWAP households’ bill, the amount of LIHWAP payment(s) received in a manner which identifies the
payment as received from LIHWAP.
f.That any funds paid by the Department will be used only to meet an Eligible Customer's home water and/or wastewater
service needs. Resale or transfer of funds paid to any other party is prohibited.
g.Provide all cost and consumption data for LIHWAP recipients to the Department.
4.In consideration of the assurances given in Section 3 of this contract, the Department agrees each Federal Fiscal Year to:
a.Determine which customers are eligible for LIHWAP.
b.Pay the Contractor an amount determined by the Department LIHWAP policies in accordance with the approved LIHWAP
State Plan.
c.Upon receipt of LIHWAP eligibility notification, pay the Contractor on a schedule determined by the Department.
City of Bozeman
PO Box 1230
Bozeman, MT 59771-1230
x
EIN 81-6001238
kdonald@bozeman.net 406-582-28318
Local Government
DocuSign Envelope ID: AC18ECE7-B5B2-4E54-92FE-9515E4A892AB
5.The Contractor agrees to:
a.Credit the payment amount to the eligible customer’s account when received and identified by the statement of remittance.
b.Use the LIHWAP payment only to pay home water and/or wastewater service obligations the LIHWAP customer previously
incurred or incurs during the period from October 1, 2021 through September 30, 2023. for which the payment was issued,
Funds may be used to reduce arrearages and/or rates charged to the eligible household o provide continuity of water
services, including prevention of disconnection and restoration of water services to households whose water services were
previously disconnected.
c.Return to the Department any LIHWAP-attributable credit balance no later than September 30, 2023 and include customer’s
name, LIHWAP benefit issuance date, and account number with the returned funds.
d.Return to the Department within ninety (90) days from the date of discontinued service, which includes, but is not limited to,
changes of address, account number, or death of recipient, any credit balance and/or line of credit in an eligible customer’s
account that is identifiable as LIHWAP funds. Include customer’s name, LIHWAP benefit issuance date, and account number
with remittance.
e.Provide as requested, to facilitate State compliance with Federal reporting requirements, LIHWAP recipients’ annual water
and/or wastewater service consumption data and written reconciliation of LIHWAP funds applied to the recipient’s account..
f.The mailing address for returned funds is DPHHS/HCSD, P.O. BOX 202956, HELENA, MT 59620.
g.LIHWAP funds may not be used for the purchase or improvement of land or the purchase, construction, or permanent
improvement of any building or facility.
h.Report any financial fraud, abuse or misconduct by recipients or in the administration of LIHWAP. If there are reasonable
grounds to believe that fraud, abuse or misconduct has occurred call 406-447-4269 or email sshepherd2@mt.gov.
i.Cooperate with all investigations of suspected fraud, abuse or misconduct.
6.The Contractor will comply with the Civil Rights Act of 1964. The Contractor agrees that no person shall, on the grounds of race,
color, national origin, creed, sex, religion, political ideas, marital status, age or handicap be excluded from employment or
participation in, be denied benefits, or be otherwise subject to discrimination under any program or activity connected with the
implementation of this contract, and further agrees that affirmative steps will be taken to employ or advance in employment
qualified handicapped individuals. The Contractor further agrees that all hiring done in connection with this contract shall be based
on merit qualification genuinely related to competent performance of the occupational task.
7.The use or disclosure, by any party, of any information concerning a claimant in violation of any rule of confidentiality, or for any
purpose not directly connected with the administration of the Department's or the Contractor's responsibility with respect to
services hereunder, is prohibited, except on written consent of the claimant, or the court appointed guardian of a claimant.
8.The Contractor will comply with all applicable regulations and formal Department policies, including those pertaining to licensing, in
performing this contract.
9.The Contractor agrees to submit all reports and documents required by this contract or by federal or state law or regulations, timely
in the form required by the Department.
10.The Contractor agrees that it will, at all times, indemnify the Department and hold it harmless from any and all losses and claims that
may result to the Department because of any negligence on the part of the Contractor, its agents, representatives or employees.
11.The Contractor agrees not to subcontract, assign or transfer any work contemplated under this contract without prior written
approval of the Department.
12.The Contractor shall not be liable for failure to perform under this contract if such failure to perform arises out of causes beyond the
control and without the fault or negligence on the part of the Contractor. Such causes may include, but are not restricted to, acts of
God or the public enemy, fires, floods, epidemics, quarantine restrictions, freight embargoes, and unusually severe weather; but in
every case the failure to perform must be beyond the control and without the fault or negligence of the Contractor.
13.The parties agree that if anticipated government funds are reduced or become unavailable any time during the term of the contract,
the Department is not obligated to continue performance of this contract beyond the date the federal or state funds are reduced or
become unavailable.
14.If the Contractor fails to provide services called for by this contract or to provide such services within the time specified herein, or
any extension thereof, the Department may withhold payment or by written notice of default to the Contractor, terminate the
whole or any part of the contract upon written notice. This contract may be canceled or terminated by either of the parties without
DocuSign Envelope ID: AC18ECE7-B5B2-4E54-92FE-9515E4A892AB
cause, however; the parties seeking to terminate or cancel this contract must give written notice of its intention to do so to the
other party at least thirty (30) days prior to the effective day of cancellation or termination.
15.The State of Montana, the Department, the U.S. Department of Health and Human Services, and the Comptroller General of the U.S.,
or any of their duly authorized representatives, shall have the right of access to any books, documents, papers and records of the
Contractor which are pertinent to the services provided under this contract, for purposes of making audit, excerpts or transcripts.
Further, for purposes of verifying cost or pricing data submitted in conjunction with the negotiation of this contract or any
amendments thereto, the State shall until the expiration of eight (8) years from the completion date of a program year, have the
right to examine those books, records, documents, papers, and other supporting data which involve transactions related to this
contract or which will permit adequate evaluation of the cost or pricing data submitted, along with the computations and
projections used therein. The Contractor's accounting procedures and practices shall conform to generally accepted accounting
principles.
16.Financial records, supporting documents, statistical records and all other records supporting the services provided by the Contractor
under this contract shall be retained for a period of eight (8) years from the completion date of a program year. The Contractor
agrees to make the records described herein available at all reasonable times at the Contractor's general offices. If any litigation,
claim or audit is started before the expiration of the eight-year period, the records shall be retained until all litigations, claims or
audit findings involving the records have been resolved.
17.The Contractor assures the Department that the Contractor is an independent contractor providing services for the Department and
that neither the Contractor nor any of the Contractor’s employees are employees of the Department under this contract, nor will be
considered employees of the Department under any subsequent amendment to this contract unless otherwise expressed.
The Contractor must obtain and maintain workers’ compensation coverage for the Contractor and the Contractor’s employees as
provided in Montana law (39-71-401 and 39-71-405, MCA, and as they may be subsequently amended, modified or altered). The
Contractor must provide the Department with proof of compliance with the relevant statutory provisions cited herein. The
Contractor need not obtain workers’ compensation coverage or an exemption therefrom, if the contract is one for casual
employment as exempted at 39-71-401(2)(b), MCA.
18.The parties agree that in the event of litigation concerning this contract, venue shall be in the First Judicial District in and for the
County of Lewis and Clark, State of Montana.
19.This instrument contains the entire contract between the parties and no statements, promises or inducements made by either party
or agents of either party that are not contained in this contract, shall be valid or binding. This contract may not be enlarged,
modified or altered except in written amendments.
IN WITNESS THEREOF, the parties have executed this contract on the dates set out below.
CONTRACTOR
______________________________________________________
Signature of Authorized Agent Date
______________________________________________________
Title of Authorized Agent
(Owner, Partner, Manager, Bookkeeper, President/Vice President, Office Clerk)
MONTANA DEPARTMENT OF PUBLIC
HEALTH AND HUMAN SERVICES
______________________________________________________
Sara Loewen, Date
Intergovernmental Human Services Bureau Chief
Human and Community Services Division
DocuSign Envelope ID: AC18ECE7-B5B2-4E54-92FE-9515E4A892AB
11/10/2021
11/10/2021
City Manager