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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 is considered to be in crisis if the household has been disconnected from energy service or the household heating oil is at 5% or less of capacity. A household is considered to be in crisis if the household has a balance with an energy service vendor of $200 or more after the regular benefit is applied to the bill. 4.3 What constitutes a life-threatening crisis? A household is considered to be in a life-threatening crisis if the household depends on energy service for medical life support equipment and one of the following applies: (a) the household has been disconnected from energy service; (b) the household heating oil is at 5% or less of capacity; or (c) the household has received notice that a disconnection will occur within 48 hours or less. To qualify for life-threatening crisis assistance a member of the household must rely on energy service for emergency medical and life-support equipment. A household is considered to be in a life-threatening crisis if the household has a balance with an energy service vendor of $200 or more after the regular benefit is applied to the bill. 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: Applicants who are residents of a dwelling unit where utilities are included in the rent must provide proof in the form of a utility bill that they are directly responsible for paying their own energy costs. Applicants that have received a shut-off notice or have a near empty tank and meet one of the following: (a) are age 55 or older or (b) use a breathing machine, will be considered for crisis assistance. Applicants who have already exhausted their regular benefit will be considered for crisis assistance if the household has been disconnected from energy service, or the household heating oil is at 5% or less capacity. For the bulleted items following “In order to receive crisis assistance”, any one of the checked “yes” bulleted items will be considered a qualifying event. If an applicant goes through the regular application process, is granted a benefit, and still has a need for crisis assistance, the crisis application is processed at the same visit. 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: Ordinarily a crisis application will be treated separately from a regular benefit application. However, see item 4. 7, just above. 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 $500.00. 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. DOEE accepts applications for energy crisis assistance at two sites that are geographically accessible to all households in the area to be served (one located in the Northwest quadrant and one located in the Southeast quadrant of the District of Columbia). The two sites are located at 1207 Taylor Street NW and 2100 Martin Luther King Jr. Ave SE. Also, see response to Section 4.11. 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. During normal operations, all LIHEAP applicants schedule appointments through the District of Columbia’s 3-1-1 information call line. When calling 3-1-1, physically disabled applicants may request a home visit to complete the application process. 3-1-1 call operators forward all home visit requests to LIHEAP staff and LIHEAP staff contact the applicant within 24 hours or the next business day to make arrangements for the home visit. In addition, physically disabled applicants may apply online at doee.dc.gov, fax, /Liheapor mail their application to The Department of Energy and Environment located at 1200 First Street NE 5th floor, Washington, DC 20002. If they are unable to apply online, by e- mail or mail, they may request an in-home visit. 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? During normal operations, all LIHEAP applicants schedule appointments through the District of Columbia’s 3-1-1 information call line. When calling 3-1-1, physically disabled applicants may request a home visit to complete the application process. 3-1-1 call operators forward all home visit requests to LIHEAP staff and LIHEAP staff contact the applicant within 24 hours or the next business day to make arrangements for the home visit. In addition, physically disabled applicants may apply online at doee.dc.gov,/Liheapfax,, or mail their application to The Department of Energy and Environment located at 1200 First Street NE 5th floor, Washington, DC 20002. If they are unable to apply online, by e-mail or mail, they may request an in-home visit. 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 Subject to available funding, electric space heaters, fans and blankets are provided to households that have been disconnected from energy service or the home heating oil supply is at 5% or less of capacity. The households must have been approved for LIHEAP in the current fiscal year. 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 utility vendors for the District of Columbia do not enforce a winter moratorium on shut-offs. However, under D. C. Official Code §34- 1506.01(b), “[a]n electric company shall not disconnect residential electric service during the day preceding and the day of a forecast of extreme temperature or if the forecast of extreme temperature precedes a holiday or weekend day, on any day during the holiday or weekend.” D. C. Official Code § 34-1506.01(a) states, “[f]or the purposes of this section, the term ‘forecast of extreme temperature’ means a National Weather Service forecast for the District of Columbia of 95 degrees Fahrenheit or above during any time of a day or of 32 degrees Fahrenheit or below during any time of a day.” In addition, Chapter 3 of Title 15 of the District of Columbia Municipal Regulations (DCMR), commonly referred to as the District of Columbia’s Public Service Commission (PSC) “Consumer Bill of Rights” or “CBOR,” requires utilities to postpone disconnections for a period not to exceed twenty-one (21) days “if the Utility is provided with a physician’s certificate or notice from a public health official which states that Disconnection would be detrimental to the health and safety of a bona fide occupant of the premises.” 15 DCMR § 311.1. 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.