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Eligibility - 2604(c), 2605(c)(1)(A) 4.1 Designate the income eligibility threshold used for the crisis component Add Household size Eligibility Guideline Eligibility Threshold 1 9 State Median Income 60.00% 2 10 HHS Poverty Guidelines 150.00% 4.2 Provide your LIHEAP program's definition for determining a crisis. If you administer multiple crisis assistance programs (winter, summer, and/or year-round), Include all program definitions. A crisis exists when a household faces an energy burden that depletes or threatens to deplete their finances, which poses potential health and/or safety threat to the well-being of the household. A client is considered to be in a crisis when any of the following occur: The Household has received a utility shut-off or delinquency notice; The Standard LIHEAP benefit does not pay the full amount of the Applicant’s bill; The Household has received an eviction notice, if utilities are included in the rent; or The Household utilizes portable fuel or pre-pay utility service and has seven days or less of fuel available. Eligible LIHEAP crisis applicants must have their application reviewed within 48 hours, and a determination made if possible. 4.3 What constitutes a life-threatening crisis? A client is considered to be in a life-threatening crisis when both of the following situations exists: Self-certification stating that a utility shut-off would be dangerous to the health of a Household Member; and Self-certification stating that life-supporting equipment is used in the home and the equipment is dependent upon utility service for operation. Crisis Requirement, 2604(c) 4.4 Within how many hours do you provide an intervention that will resolve the energy crisis for eligible households? 48Hours 4.5 Within how many hours do you provide an intervention that will resolve the energy crisis for eligible households in life-threatening situations? 18Hours Crisis Eligibility, 2605(c)(1)(A) Winter Crisis Summer Crisis Year-Round Crisis 4.6 Do you have additional eligibility requirements for Crisis Assistance? 4.7 Check the appropriate boxes below to indicate type(s) of assistance provided 0 Do you require an Assets test? Do you give priority in eligibility to: Older Adults (60 years or older)? Individuals with a disability? Young Children? Households with high energy burdens? Other (Specify): N/A In Order to receive crisis assistance: Must the household have received a shut-off notice or have a near empty tank? Must the household have been shut off or have an empty tank? Must the household have exhausted their regular heating benefit? Must renters with heating costs included in their rent have received an eviction notice? Must heating/cooling be medically necessary? Must the household have non-working heating or cooling equipment? Other (Specify): N/A Do you have additional/differing eligibility policies for: Renters? Renters living in subsidized housing? Renters with utilities included in the rent? Explanations of policies for each "yes" checked above: Although the point system is not used for LIHEAP crisis assistance, the household must receive a Standard LIHEAP benefit either prior to or with the crisis payment. A shut-off notice, delinquency, or imminent loss is needed to qualify for crisis assistance. All Crisis payments will be at minimum $5.01 and at maximum $500. Determination of Benefits 4.8 How do you handle crisis situations? Separate component Benefit Fast Track, no separate amount of crisis funds is issued. Rather benefits are issued to crisis customers within crisis response time frames. Other - Describe: Crisis assistance is available to applicants who have already received non-crisis assistance within a twelve(12) month period. The applicant must have a delinquency notice, disconnect notice, a notice that the utility has already been disconnected, or an eviction notice if utilities are included in the rent. When the standard LIHEAP benefit at the time of application is not enough to cover the outstanding amount due, the applicant is eligible to receive a crisis payment with the initial LIHEAP application. Energy-Related Repair (ERR) (see weatherization). 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $0 Other - Describe: Amount to resolve the crisis, up to a maximum of $500, but no less than $5.01. Crisis Requirements, 2604(c) 4.10 Do you accept applications for energy crisis assistance at sites that are geographically accessible to all households in the area to be served? Yes No Explain. LIHEAP applications can be submitted through the DES online portal which is accessible at all times to anyone with an internet connection. Applications can also be submitted via fax, mail, and by appointment with a CAA. Various CAA and other community-based organizations offer satellite locations and partner with local agencies that are geographically accessible. Some CAAs travel to alternate locations to accommodate those who reside in rural areas. 4.11 Do you provide individuals who are individuals with a disability the means to: Submit applications for crisis benefits without leaving their homes? Yes No If No, explain. N/A Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. N/A If you answered "No" to both options in question 4.11, please explain alternative means of intake to those who are homebound or physically disabled? N/A Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $0.00 maximum benefit Summer Crisis $0.00 maximum benefit Year-round Crisis $500.00 maximum benefit 4.13 Do you provide in-kind (e.g. blankets, space heaters, fans) and/or other forms of benefits? Yes No If yes, Describe ADES does not directly provide in-kind benefits, however, CAA’s and CAA Subcontractors completing LIHEAP Intake offer blankets, space heaters, AC units, and fans, when available. 4.14 Do you provide for equipment repair or replacement using crisis funds? Yes No If you answered "Yes" to question 4.14, you must complete question 4.15. 4.15 Check appropriate boxes below to indicate type(s) of assistance provided. Winter Crisis Summer Crisis Year-round Crisis Heating system repair Heating system replacement Cooling system repair Cooling system replacement Wood stove purchase Pellet stove purchase Solar panel(s) Utility poles / gas line hook-ups Other (Specify): N/A 4.16 Do any of the utility vendors you work with enforce a moratorium on shut offs? Yes No If you responded "Yes" to question 4.16, you must respond to question 4.17. 4.17 Describe the terms of the moratorium and any special dispensation received by LIHEAP clients during or after the moratorium period. Several of Arizona's energy vendors enforce moratoriums with varying criteria. The largest energy vendors are represented below with their specific guidelines. These guidelines are in accordance with Arizona Administrative Code (AAC) 14-2-211. The Corporation Commission’s mission is to ensure safe, reliable, and affordable utility services. They may determine that other weather conditions are especially dangerous to one's health as the need arises. As stated in AAC 14-2-211 and Corporation Commission’s guidance, “A utility shall not disconnect: 1. Residential service to a customer from June 1 through October 15; 2. If the local weather forecast will include weather conditions that the Commission has determined, by order, are especially dangerous to health; 3. If the customer has paid at least half of the customer’s outstanding bill balance within the last 25 days; 4. If the customer’s outstanding bill balance is less than or equal to $75.00.” Arizona Public Service (APS) uses 32 degrees Fahrenheit as the point at which they stop disconnections for non- payment for low temperatures. In addition, APS also developed an internal business process where disconnections are suppressed for non-payment when high heat stress indexes are present, as determined by the Phoenix Heat Alert website that relies on heat and humidity predictions from the National Oceanic and Atmospheric Administration (NOAA). Southwest Gas (SWG) is prohibited from performing shut-offs during periods of time where weather will be especially dangerous to one's health. These weather conditions are defined as that period of time commencing with the scheduled determination date when the local weather forecast, as predicted by NOAA, indicates that the temperature will not exceed 32 degrees Fahrenheit for the next day's forecast. Salt River Project (SRP) self-initiates moratoriums in the winter and summer based on weather conditions. The duration of the self initiated moratorium fluctuates based on weather conditions. The criteria for moratoriums are extremely cold temperatures or excessive heat warnings issued by the National Weather Service. 4.18 If you experience a natural disaster, do you intend to utilize LIHEAP crisis funds to address disaster related crisis situations? Yes No If yes, describe N/A If any of the above questions require further explanation or clarification that could not be made in the fields provided, attach a document with said explanation here.