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 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: Verification from the landlord is required to verify utilities are included as part of the rent. A copy of the lease may also be used. Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: Adults 60 and older on a fixed income may pre-register for heating assistance. Individuals with a disability? Yes No If yes, describe: Disabled individuals in a household with fixed incomes may pre-register for heating assistance. Young children? Yes No If yes, describe: Households with children wiith fixed incomes may pre-register for heating assistance. 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. The highest benefit is provided to the households with the lowest income and highest energy burden based on family size and fuel type. 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: Benefit levels differ between individuals residing in subsidized and unsubsidized housing types. 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 $15 Maximum Benefit $250 2.7 Do you provide in-kind (e.g., blankets, space heaters) and/or other forms of benefits?2 Yes No If yes, describe. CAAs may purchase bulk blankets, sleeping bags, etc. Space heaters are loaned to participants and are tracked. 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.