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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 All Household Sizes State Median Income 60.00% 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 household in crisis is one where service has been discontinued or is threatened to be discontinued, is out of fuel or will run out of fuel or is responsible for heating costs that are included in rent and has received an eviction notice. 4.3 What constitutes a life-threatening crisis? A life threatening crisis means a household whose members' health and/or well-being would likely be endangered if energy assistance or repair or replacement of the primary heating source is not provided. 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): 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): 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: The household must provide the following verification to be considered in a crisis at which point the case will be processed expeditiously to assure the health and safety of the household. 1. A shut-off notice or other documentation of intent to terminate heating services by the heating supplier or landlord or that termination of services has occurred; 2. A declaration by the household that the bulk fuel supply has been or will be depleted within the next two weeks and the specific amount needed to maintain heat; 3. An eviction notice and a statement from the landlord that the client will not be evicted for thirty (30) days, if approved, for those households where heat is included in rent. 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: The furnace repair and replacement program, a component of our heating assistance program provides emergency year round support for inoperable home heating systems. Once eligibility is determined for the LIHEAP heating fuel assistance program the recipient is automatically eligible for the furnace repair or replacement program, if they have an inoperable heating system; which is handled by a sub-contractor, Energy Outreach Colorado, and a separate application is required for the benefit. Renters are only offered a repair or replacement of an inoperable heating system if the landlord qualifies for LEAP. The disconnect/out of heating fuel component of the crisis program is part of the regular heating assistance benefit. All crisis situations are fast tracked and applications are processed expeditiously. The furnace repair and replacement program is not a crisis program, it is an extension of our heating assistance program. 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $0 Other - Describe: The benefit for the furnace repair or replacement program is set at the amount of benefit required to resolve the inoperable home heating system with the average benefit of the program not to exceed $4,800. The furnace repair and replacement component of our heating assistance program is an extension of our heating assistance program and is available through the federal fiscal year or until funds run out. The crisis benefit for the heating fuel impending disconnect/already disconnected or out of fuel component of the program is the amount needed to remedy the situation not to exceed the benefit amount of the basic heating assistance benefit or the $1,000 maximum benefit whichever is lower. 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. 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. Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. 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? Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $1,000.00 maximum benefit Summer Crisis $0.00 maximum benefit Year-round Crisis $0.00 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 Colorado LIHEAP requires that Energy Outreach Colorado, the agency responsible for the management of the Crisis Intervention Program (furnace repair and replacement), make blankets, space heaters, and alternative lodging available if deemed necessary to assure the health and safety of the eligible LIHEAP households where the primary heating system is inoperable or when a fuel tank cannot be accessed due to severe weather. 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): 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. The Colorado Public Utilities Commission set forth the following mandate for the State's four regulated utility providers: Medical Certificates - a customer who has a medical certificate may not be shut off for 60 days with a potential 30 day extension. In addition, Xcel Energy (serves the largest number of LIHEAP households) has the following moratorium: Xcel Energy will not shut off a customer 55 or older that lives alone during the winter months. Xcel offers a company sponsored program for customers who are on ventilators whereby electric service will not be discontinued for 12 months with potential for recertification. Regulated utility providers who enter into agreement with Colorado LIHEAP agree to provide continuous service for 60 days to LIHEAP households from the date of approval. Households that have been disconnected, will have service restored within 24 hours of approval and will continue utility services for at least 60 days. 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 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.