3 COOLING ASSISTANCE

Eligibility, 2605(c)(1)(A), 2605 (b)(2) - Assurance 2 3.1 Designate The income eligibility threshold used for the Cooling component: Add Household size Eligibility Guideline Eligibility Threshold 1 1 State Median Income 60.00% 2 2 State Median Income 60.00% 3 3 State Median Income 60.00% 4 4 State Median Income 60.00% 5 5 State Median Income 60.00% 6 6 State Median Income 60.00% 7 7 State Median Income 60.00% 8 8 State Median Income 60.00% 9 9 State Median Income 60.00% 3.2 Do you have additional eligibility requirements for Cooling assistance? Yes No 3.3 Check the appropriate boxes below and describe the policies for each. Do you require an Assets test? Yes No If yes, describe: Do you have additional/differing eligibility policies for: Renters? Yes No If yes, describe: Renters Living in subsidized housing? Yes No If yes, describe: Renters with utilities included in the rent? Yes No If yes, describe: Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: Priority in eligibility to elderly, disabled, or young children. An additional benefit is provided if at least one member of the household is elderly, disabled, or a child aged five or under. Individuals with a disability? Yes No If yes, describe: Priority in eligibility to elderly, disabled, or young children. An additional benefit is provided if at least one member of the household is elderly, disabled, or a child aged five or under. Young children? Yes No If yes, describe: Priority in eligibility to elderly, disabled, or young children. An additional benefit is provided if at least one member of the household is elderly, disabled, or a child aged five or under. Households with high energy burdens? Yes No If yes, describe: Other? Yes No If yes, describe: Explanations of policies for each "yes" checked above: Priority in eligibility to elderly, disabled, or young children. An additional benefit is provided if at least one member of the household is elderly, disabled, or a child aged five or under. 3.4 Describe how you prioritize the provision of cooling assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. Vulnerable populations are eligible for an increased benefit when applying for heating assistance (see attached benefit payments matrix): •Applicant with one or more elderly member may receive an additional $100 per household. •Applicant with one or more disabled members may receive an additional $100 per household. •Applicant with one or more young children aged 5 or younger may receive an additional $150 per household. Determination of Benefits 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 3.5 Check the variables you use to determine your benefit levels. (Check all that apply): Income Family (household) size Home energy cost or need: Fuel type Climate/region Individual bill Dwelling type Energy burden (% of income spent on home energy) Energy need Other - Describe: Applicant households with one or more vulnerable population members (elderly, disabled, or young children) are eligible for an increased benefit (see 3.4 above and attached). Benefit Levels, 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 3.6 Describe estimated benefit levels for the fiscal year for which this plan applies. Please note: the maximum and minimum benefits must be shown in the payment matrix. Minimum Benefit $400 Maximum Benefit $1,350 3.7 Do you provide in-kind (e.g., fans, air conditioners) and/or other forms of benefits? 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.