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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 exists when a household's energy source for heating and/or cooling has been disconnnected or scheduled for disconnection, depleted and there are insufficient resources to resolve the situation. A crisis may also include natural disaster events, public health emergencies, and supply shortage emergencies declared by state or federal government. 4.3 What constitutes a life-threatening crisis? When an eligible household is faced with an adverse situation that jeopardizes the health and/or safety of the household members. This would include a household member that has a medical condition that require the operation of medical equipment, such as oxygen, and/or extreme weather conditions that would keep the household cool/warm. 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: For Bill Payment Crisis Assistance: Eligible applicants are required to provide support documentation to establish a crisis situation. (i.e. Disconnect/Shut-Off Notice, Final Bill and proof of new account, doctor's statements or medical reports, and/or written estimates to refill fuel tanks). Crisis is First Come - First Serve. Per Section 5.1, D. of the Louisiana LIHEAP Service Delivery Guide, Life-threatening crisis—Service shall be delivered within 18 hours from the date of the completed application. o If the health or safety risk is due to illness or medical need, clients must provide documentation verifying the health or safety risk. o If the health or safety risk is from extreme weather conditions, either heat or cold, the Subgrantee may document the emergency with a print-out of the weather advisory documenting the emergency by utilizing an internet weather advisory site. For Equipment Repair and Replacement Crisis Assistance: Clients are not required to have a disconnect or pending shut-off; however, documentation of non-working heating or cooling equipment must be provided. For Disaster Relief Crisis Assistance: Clients are not required to have a disconnect, pending shut-off, or non-working equipment. 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: Disaster Relief LHC use of LIHEAP Funding for Disaster Relief is based on LIHEAP regulations at 45 C.F.R. 96.50(e). Allowable uses of LIHEAP funds to deal with crisis situations, particularly with respect to assistance for home energy related needs resulting from a hurricane or other natural disaster, include: - Costs to temporarily shelter or house individuals in hotels, apartments, or other living situations in which homes have been destroyed or damaged, i.e., placing people in settings to preserve health and safety and to move them away from the crisis situation. - Costs for transportation (such as cars, shuttles, buses) to move individuals away from the crisis area to shelters, when helath and safety is a endangered by loss of access to heating or cooling. - Utility reconnection costs - Repair or replacement cost for furnaces and air conditioners - Insulation repair - Coats and blankets, as tangible benefits to keep individuals warm - Crisis payments for utilities and utility deposits - Purchase and installation of fans and air conditioners - Purchase and installation of generators All related activities must be pre-approved by LHC and will be targeted to areas covered by a disaster declaration. 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $1,000 Other - Describe: Eligible households can receive only one crisis benefit payment, not to exceed $1000, during a 12 month period. For utility bill assistance, the crisis benefit payment will cover only the amount of the disconnect notice, if the services have NOT been disconnected at the time of application. If utilities have been disconnected at the time of application, the total benefit requested should include all costs to connect or reconnect services, except any other non- energy related charges. In the event a household is in transition, a Final Bill and proof of a new account, showing the total cost to restore services, should be used to provide assistance and calculate the benefit. The referenced bill should clearly state "Final Bill". A recent statement from the vendor, preferably on letterhead, within the past 30 days may be used to calculate a benefit payment. The intent of this provision does not arbitrarily substitute the mandatory Disconnect Notice, or cause any inconsistency with the LHC's established policy for LIHEAP crisis assistance. For equipment repair/replacement, the amount of the equipment plus installation, not to exceed $1000 per household. For disaster relief, the amount of the in-kind benefits, not to exceed $1000 per household. In the event that Supplemental funds are granted or available within the year due to unforeseen circumstances (i.e. public health emergencies, etc.), LHC reserves the right to develop a separate benefit matrix to deliver bill payment assistance that meets the need of the particular crisis based on the amount of funds awarded or still available. Applicants impacted by the crisis will be eligible for Supplemental funds in addition to eligibility for regular crisis assistance. In the event of unforeseen circumstances (i.e. public health emergencies, natural disaster, etc.), LHC reserves the right to allow past due balances to be included in the crisis assistance benefit payment. This right will be implemented by LA LIHEAP Notice and with a defined period only. Louisiana allows for community solar participants to receive a benefit using the same LA LIHEAP benefit calculation. 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. Per Section 3.3, A.1. of the Louisiana LIHEAP Service Delivery Guide, the Subgrantee must devise and plan to distribute service funds throughout the entire service delivery area. This process ensures a fair distribution of funds based on the percentage of eligible population in each geographic location. Subgrantee must be able to provide some type of weekly presence in each parish it serves. 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. Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. Per Section 3.3, A.4. of the Louisiana LIHEAP Service Delivery Guide, the Subgrantee shall develop a fair and consistent means by which home-bound applicants may be provided the opportunity to apply for services. Subgrantee shall make provisions for home-bound and infirmed applicants in accordance with Section 2604I (3) (B) of Public Law 97-35 by either traveling to the applicant or may allow a homebound applicant to designate an authorized representative to apply for LIHEAP services on their behalf. A signed statement by the applicant that names the authorized representative is required. The designated person should sign all LIHEAP forms using their name and the applicant’s name (e.g. “Jane Doe for Mark Jones”). 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 $0.00 maximum benefit Summer Crisis $0.00 maximum benefit Year-round Crisis $1,000.00 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 Subgrantees may provide an in-kind benefit (in accordance with the Louisiana Disaster Relief Policy), not to exceed $1000 per household, in times of disaster relief. An explanation of the disaster should be included in the applicant's file. The cost for disaster relief will be reimbursed to the Subgrantee. The Subgrantee should expend the funds necessary to resolve the crisis situation in a timely manner. In the event that Supplemental funds are granted or available within the year due to unforeseen circumstances (i.e. public health emergencies, etc.), LHC reserves the right to develop a separate benefit matrix to deliver bill payment assistance that meets the need of the particular crisis based on the amount of funds awarded or still available. Applicants impacted by the crisis will be eligible for Supplemental funds in addition to eligibility for regular crisis assistance. 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): Subgrantees may provide minor repair or replacement up to $1000 of heating or cooling equipment. An explanation of the emergency should be included in the applicant's file. The cost for equipment plus installation, if any, will be reimbursed to the Subgrantee not to exceed $1000. The total reimbursement from LIHEAP may not exceed the total amount for a Crisis benefit payment. The Subgrantee should expend the funds necessary to resolve the crisis situation in a timely manner. 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. The utility vendors agree to accept energy benefit pledges on behalf of LIHEAP eligible customers in crisis situations facing threatened or actual interruption of services. Per Louisiana Public Service Commission: Disconnection during extreme weather: An electric or natural gas utility shall not disconnect service for a residential customer in a parish on a day when the following extreme weather conditions exist within that parish: Winter: The previous day’s highest temperature did not exceed 32 degrees Fahrenheit, and the temperature is predicted to remain at or below that level for the next 24 hours, according to the nearest National Weather Service (NWS) reports; or Summer: The nearest NWS issues a heat advisory as defined by the NWS 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 Disaster Relief LHC use of LIHEAP Funding for Disaster Relief is based on LIHEAP regulations at 45 C.F.R. 96.50(e). Allowable uses of LIHEAP funds to deal with crisis situations, particularly with respect to assistance for home energy related needs resulting from a hurricane or other natural disaster, include: - Costs to temporarily shelter or house individuals in hotels, apartments, or other living situations in which homes have been destroyed or damaged, i.e., placing people in settings to preserve health and safety and to move them away from the crisis situation. - Costs for transportation (such as cars, shuttles, buses) to move individuals away from the crisis area to shelters, when helath and safety is a endangered by loss of access to heating or cooling. - Utility reconnection costs - Repair or replacement cost for furnaces and air conditioners - Insulation repair - Coats and blankets, as tangible benefits to keep individuals warm - Crisis payments for utilities and utility deposits - Purchase and installation of fans and air conditioners - Purchase and installation of generators All related activities must be pre-approved by LHC and will be targeted to areas covered by a disaster declaration. 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.