2 HEATING ASSISTANCE

Eligibility, 2605(b)(2) - Assurance 2 2.1 Designate the income eligibility threshold used for the heating 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 8 State Median Income 60.00% 10 9 State Median Income 60.00% 11 10 State Median Income 60.00% 12 11 HHS Poverty Guidelines 150.00% 13 12 HHS Poverty Guidelines 150.00% 14 13 HHS Poverty Guidelines 150.00% 15 14 HHS Poverty Guidelines 150.00% 16 15 HHS Poverty Guidelines 150.00% 2.2 Do you have additional eligibility requirements for Heating Assistance? Yes No 2.3 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: Individuals with a disability? Yes No If yes, describe: Young children? Yes No If yes, describe: Households with high energy burdens? Yes No If yes, describe: Other? Yes No If yes, describe: Explanations of policies for each "yes" checked above: Determination of Benefits 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 2.4 Describe how you prioritize the provision of heating assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. Households in elderly and disabled buildings have an early application period. The CAA do outreach one month prior to the regular application period by going to public/subsidized housing buildings. The CAA provide assistance in the application process for the vulnerable and take applications onsite. 2.5 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: Public/Subsidized Housing – The level of benefits for eligible households in public/subsidized housing will be a flat-rate, determined annually and based on their eligible household size: Household size 1-2 Household size 3-5 Household size 6 or more Photovoltaic Systems – The level of benefits for eligible households with photovoltaic systems generating less power than they are consuming will be a flat-rate, determined annually and based on their eligible household size: Household size 1-2 Household size 3-5 Household size 6 or more The level of benefits for eligible households not residing in public/subsidized housing or do not have photovoltaic systems shall be based on the total number of points assigned to the household in five categories. Points shall be assigned in the five categories as follows: 1) Income level – percent of the applicant household’s gross income is of maximum income limits established by the State for that size household. Percent of Max Income Limits Points: 151% FPL and above 0 101-150% FPL 1 51-100% FPL 2 0-50% FPL 3 2) Household size – the number of eligible persons in the applicant household. Persons Points 1 to 2 1 3 to 5 2 6 or more 3 3) Region difference – the island of residence of the applicant household. Region Points Oahu 1 Hawaii, Maui, Lanai, Molokai, Kauai 2 4) Vulnerability – applicant household consisting of one or more Points of the following types of individuals: a child age five and under, a disabled adult, or an adult age 60 and over. 5) Energy burden 30% or greater. Points 1 Benefit Levels, 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 2.6 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 $375 Maximum Benefit $1,400 2.7 Do you provide in-kind (e.g., blankets, space heaters) and/or other forms of benefits?2 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.