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 All Household Sizes State Median Income 60.00% 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: Applicants who rent their home and have utilities included in the rent must have an out-of- pocket rent responsibility (i.e., their rent is not 100% subsidized) in order to establish that an energy burden exists. 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. Our matrix awards an additional 2 points ($50) toward the heating fuel for members of a vulnerable population. 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: Vulnerable populations: an additional 2 points ($50) will be awarded to households who have at least one member who is elderly, disabled, a young child, or a veteran/active duty military. Individual bill: because energy burden is more difficult to determine directly when it is included in rent, but is generally lower, additional points will be assessed to households where utilities are not included in the rent. Electricity: Because electric service is generally required to operate a thermostat, all approved households will be eligible for a benefit to their electric service as well as their heating service. The electric benefit will be $50-$100, variable according to household income relative to household size. 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 $100 Maximum Benefit $625 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.