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Low Income Home Energy Assistance Program Division 10 Service 415 Program 415 Chapters 05 - 65 North Dakota Department of Health and Human Services

Include your assessment of the household's efforts to arrange payments with the supplier or secure assistance from other sources. Identify any factors that contribute to the emergency or the household's ability/inability to improve circumstances, and to your decision to approve/deny the application.

If appropriate add information about making household current with vendor, referral to Self Reliance, referral to Energy Share, completion of the SFN 11, and other agencies the household is being referred to.

Evaluation and Plan Summarize your recommendations for referrals or other action plan, and evaluate the household's motivation and outlook for self-sufficiency