Low Income Household Water Assistance Program (LIHWAP) Water Landscape and Equity Research

Water Utility Affordability Survey
Introduction
Thank you for your interest in our water utility survey. Our agency, the Office of
Community Services, administers the Low Income Household Water Assistance
Program (LIHWAP), the first-ever low-income federal water assistance program.
LIHWAP provides funding to states, tribes, and territories across the United States
to help low-income households with their water and wastewater bills. With this
survey, we are trying to better understand the scope of water and wastewater debt so
that we can help ensure that both households and utilities get the money and
support they need. This program directly benefits utilities by providing payments on
behalf of customers who are behind on their water or wastewater bills. This survey
will take 30 minutes or less to complete and is broken into 6 sections. Your
information will be kept private.
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC
BURDEN: The purpose of this information collection is to gather data related to
water and sewer costs so we can better assist LIHWAP grantees. Public reporting
burden for this collection of information is estimated to average 30 minutes per
respondent, including the time for reviewing instructions, gathering and
maintaining the data needed, and reviewing the collection of information. This is a
voluntary collection of information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information subject to the
requirements of the Paperwork Reduction Act of 1995, unless it displays a currently
valid OMB control number. The OMB # is 0970-0531 and the expiration date is
09/30/2025. If you have any comments on this collection of information, please
contact Gwen Donley at gwendolyn.donley@acf.hhs.gov.

Water Utility Affordability Survey
Utility Information
The following questions will ask you some basic information about your water utility.
1. Approximately how many residential connections do you have (as of December 1, 2022)?

2. What is the size of your administrative staff? (Administrative staff includes staff who are
responsible for customer service, billing, support, etc.)
Less than 3
3-5
More than 5

3. Which of the following services do you provide? (Check all that apply)
Water
Wastewater

4. What is your water source? (Check all that apply)
Groundwater
Surface water

5. What is the ownership structure of your utility? (Check all that apply)
Publicly owned (i.e., owned by commissions, municipalities, etc.)
Privately owned (i.e., owned by a corporation, Homeowners Association, etc.)
Tribally owned
Other (please specify)

6. What is the approximate square mileage covering residences you bill for water or
wastewater?
<5
5-50
51-100
>100

7. How is your service area defined? (Check all that apply)
Neighborhood/Community
Municipality
Zip Code(s)
Public Service Area
HOA
County
Other (please specify)

8. Please expand on your answer to question 7. What is your service area?

Water Utility Affordability Survey
Disconnection
9. At any point during the 2022 calendar year, was there a moratorium that disallowed
residential water or sewer service shut-offs?
Yes
No

Water Utility Affordability Survey
Disconnection
The following questions refer to residential accounts to whom you provide water or
wastewater services.
10. Please estimate how many residential accounts received notice that their water and/or
wastewater services would be shut off or disconnected due to nonpayment at any point
during the 2022 calendar year:

11. Please estimate how many residential accounts had their water/wastewater services shut
off or disconnected due to nonpayment at any point during the 2022 calendar year:

Water Utility Affordability Survey
Arrearages
The following questions refer to residential accounts to whom you provide water or
wastewater services. Please answer to the best of your ability.
12. Please estimate how many residential accounts fell behind (arrearages) on their water
and/or wastewater bills at any point during the 2022 calendar year:

13. What was the average amount of money owed (arrearages) per residential account (out of
those that owed an arrearage at any point in 2022)?

14. What is the total amount of money owed (arrearages) as of December 1, 2022 that your
utility is owed for water and/or wastewater bills?

Water Utility Affordability Survey
EPA Size Category
15. What is the population size served by your utility?
Very small (<500 people)
Small (501-3,300 people)
Medium (3,301-10,000 people)
Large (10,001-100,000 people)
Very Large (>100,000 people)

Water Utility Affordability Survey
Rates
The following questions refer to residential accounts to whom you provide water or
wastewater services.
16. What is your billing frequency?
Monthly
Quarterly
Twice Annually
Annually

17. What is your base rate for water services per billing period ($)?

18. How many gallons or cubic feet are included in your base rate per billing period?

19. Is your flow rate/volume charge measured using gallons or cubic feet?
Gallons
Cubic feet

20. What is your flow rate/volume charge for water services per billing period?
_____$
per ______ gallon/cubic
foot

21. Is your wastewater charged by a flat fee?
Yes
No

Water Utility Affordability Survey
Rates, Continued
22. Wastewater flat fee amount ($):

Water Utility Affordability Survey
Rates, Continued
23. Is your wastewater fee charged based on water usage?
Yes
No

Water Utility Affordability Survey
Rates, Continued
24. If no, please explain:

Water Utility Affordability Survey
Other Fees, Shut-Off Fee
Our federal program, LIHWAP, is able to cover costs related to unpaid or late bills,
disconnections, and other fees, so we are interested in learning about the types of
fees charged by utilities. In collecting this information, we are not evaluating or
critiquing your utility's policies.
25. Does your utility charge a shut-off fee (disconnection or reconnection of
water/wastewater)?
Yes
No

Water Utility Affordability Survey
Other Fees, Shut-Off Amount
26. Shut-off fee amount ($):

Water Utility Affordability Survey
Other Fees, Late Fee
27. Does your utility charge late fee(s) on bills owed?
Yes
No

Water Utility Affordability Survey
Other Fees, Late Fee Amount
28. Late fee amount ($):

Water Utility Affordability Survey
Other Fees, Additional
29. Does your utility charge other fees (ex: interest on unpaid balances, collection fees)?
Yes
No

Water Utility Affordability Survey
Other Fees, Describe
30. Please describe other fees:

31. If there are any other details related to rates, disconnections, arrearages, or fees that you
would like to add, please do so here:

Water Utility Affordability Survey
Contact Information
All of your information will be kept private. We will use this to make sure we don't
collect duplicate responses and for data quality verification.
32. Your name(s):

33. Name of the utility you work for:

34. Primary address of the utility:
Address
Address 2
City/Town
State/Province

-- select state --

ZIP/Postal Code

35. Your job title(s) or role(s):

36. Phone (including area code):

37. Email address:

38. May we contact you if we have any questions about your survey responses?
Yes
No

Water Utility Affordability Survey
Closing
Thank you for completing this survey. Your responses are helping us understand the
water and wastewater needs of communities across the country, and how programs
like the Low Income Household Water Assistance Program can help both households
and utilities. We appreciate your time. If you have any questions or concerns, please
reach out to Gwendolyn Donley at gwendolyn.donley@acf.hhs.gov.
39. If you would like to add any comments or additional details, please do so here: