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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 HHS Poverty Guidelines 150.00% 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. The household has a past due or disconnect notice, if electric or natural gas is the primary heating or cooling source. The household is within 4 (four) days of running out of bulk fuel (coal, wood, kerosene, fuel oil, or propane) is bulk fuel is the primary heating source. Have 10 (ten) or less days of pre-paid electric. • 4.3 What constitutes a life-threatening crisis? Kentucky’s definition of life-threatening situation is in the state regulations 921 KAR 4:116 (13): Life-threatening means, at the time of application, a household is or will be without heating or cooling within eighteen (18) hours and temperatures are at a dangerous level as determined by the National Weather Service. In addition to this language, if a household has no heating/cooling source or has a disconnection notice for their primary source of heating/cooling and the health or wellbeing of a household member would be in danger if the heating/cooling crisis is not alleviated. Each application is evaluated on a case-by-case basis to determine if there is a crisis and whether it is life-threatening. Other factors taken into consideration are weather conditions, extreme temperatures, ages of household members and household members’ health 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: 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: Crisis situations will be addressed by CAK within 48 hours. 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $400 Other - Describe: Crisis benefit amounts are determined by the amount of funds it takes to get the client out of crisis. We do have a maximum benefit amount of $400. Clients can receive up to this maximum dollar amount in one or more crisis events. 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. Offices are located in all 120 (one hundred twenty) KY counties. 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. Virtual or home interviews may be conducted for clients in these situations. Laptops are taken with the worker to the client to complete the applicaion. Return of required documents and appropriate signatures allow completing the application. Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. 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? Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $400.00 maximum benefit Summer Crisis $0.00 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 Currently, there is one agency distributing blankets to clients. 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. 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 Benefits may be replaced if lost due to a natural disaster. 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.