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Section 4 - CRISIS ASSISTANCE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES August 1987, revised 05/92, 02/95, 03/96, 12/98, 11/01 OMB Clearance No.: 0970-013 Expiration Date: 02/28/2027

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM(LIHEAP) MODEL PLAN

Section 4: CRISIS ASSISTANCE

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?

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