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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 crisis is determined when a low-income household is facing imminent disconnection within seven (7) calendar days and/or needs restoration of its heating or cooling fuel source. A crisis may also result from a weather-related emergency affecting all or a specific area of the state. Clients who utilize pre-pay vendors may be treated as a crisis. During the LIHEAP heating program, a household can only receive either a regular heating benefit or a crisis heating benefit. During the LIHEAP cooling program, a household can only receive either a regular cooling benefit or a crisis cooling benefit. Only one benefit payment is allowed per program component, either regular or crisis. 4.3 What constitutes a life-threatening crisis? A life-threatening situation is a crisis application with a life-threatening medical condition that could be intensified if a crisis energy assistance applicant is without energy service. It must be validated by a medical professional such as a physician, public health official, licensed practitioner of the healing arts, or county health director. 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 program requires that each client submit documentation of shut-off notice or empty tank in order to be eligible for crisis assistance. Policy requires each client to submit a copy of the applicant’s Secure and Verifiable Documents Under O.C.G.A. § 50-36-2 (e.g., driver’s license, state-issued photo ID, etc.) for verification of age to qualify during the priority intake for the elderly and medically homebound populations. Medically homebound is defined as a household which, in the judgement of the eligible entity, contains no person who is able to travel to a LIHEAP intake location, and who is unable to send a representative to apply for energy assistance on their behalf, due to a medical condition which currently qualifies the applicant/household for home services through Medicaid or Medicare, and/or the household receives home delivered meals, home-health agency services, or homemaker services or the applicant/household member has disabilities which confines all adult residents to the home. The household is required to submit documentation of medically homebound status. 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: 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $0 Other - Describe: 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. Applications are completed at local CAAs, senior centers, churches, and other designated places determined appropriate to take applications. 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. The LIHEAP Staff will travel to their home to complete the application. Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. The LIHEAP staff will travel to the applicant's home to complete the application. 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? The LIHEAP staff will travel to the applicant's home to complete the application. Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $810.00 maximum benefit Summer Crisis $500.00 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 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. Rules delay the disconnection of utilities for 30 days with medical certification. Also, the power or gas company cannot disconnect the service unless a bill is at least 45 days overdue and proper notification has been sent. No disconnection will occur during protection dates if the customer agrees and adheres to a payment plan. Also, if the temperature is going to be under 32 degrees Fahrenheit or if there is excessive heat for more than three (3) days, disconnection is not permissible, so shut offs are limited during both the summer and winter per state laws. 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.