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Eligibility, 2605(c)(1)(A), 2605(b)(2) - Assurance 2 5.1 Designate the income eligibility threshold used for the Weatherization component Add Household Size Eligibility Guideline Eligibility Threshold 1 All Household Sizes HHS Poverty Guidelines 200.00% 5.2 Do you enter into an interagency agreement to have another government agency administer a WEATHERIZATION component? Yes No 5.3 If yes, name the agency and attach a copy of the Internal Agreement or Contract. 5.4 Is there a separate monitoring protocol for weatherization? Yes No WEATHERIZATION - Types of Rules 5.5 Under what rules do you administer LIHEAP weatherization? (Check only one.) Entirely under LIHEAP (not DOE) rules Entirely under DOE WAP (not LIHEAP) rules Mostly under LIHEAP rules with the following DOE WAP rule(s) where LIHEAP and WAP rules differ (Check all that apply): Income Threshold Weatherization of entire multi-family housing structure is permitted if at least 66% of units (50% in 2- & 4-unit buildings) are eligible units or will become eligible within 180 days Weatherize shelters temporarily housing primarily low income persons (excluding nursing homes, prisons, and similar institutional care facilities). Other - Describe: Mostly under DOE WAP rules, with the following LIHEAP rule(s) where LIHEAP and WAP rules differ (Check all that apply.) Income Threshold Weatherization not subject to DOE WAP maximum statewide average cost per dwelling unit. Weatherization measures are not subject to DOE Savings to Investment Ration (SIR ) standards. Other - Describe: Eligibility, 2605(b)(5) - Assurance 5 5.6 Do you require an assets test? Yes No 5.7 Do you have additional/differing eligibility policies for : Renters Yes No Renters living in subsidized housing? Yes No Renters with utilities included in the rent? Yes No 5.8 Do you give priority in eligibility to: Older Adults? Yes No Individuals with a disability? Yes No Young Children? Yes No House holds with high energy burdens? Yes No Other? Yes No If you selected "Yes" for any of the options in questions 5.6, 5.7, or 5.8, you must provide further explanation of these policies in the text field below. Renter eligibility: If a dwelling is to be weatherized for a client who is not the owner of the dwelling, an agreement must be entered into between the landlord and the subgrantee agency, which outlines the owner's responsibilities. The agreement must be signed before work can begin on the weatherization project. In the Weatherization Selection Tool, priority, with regard to the selection of homes to be weatherized, will be given to landlords who provide assistance in the weatherization of their property. This assistance may be given through donated materials, monetary assistance or a combination of the two. A condition of the agreement includes the agreement not to raise the tenant's rent for two (2) years (some exceptions apply) beginning on the date of the weatherization projection completion (that is the approved post inspection date). Additionally, the owner cannot evict the tenant without cause during that period. Should the owner chose to violate the agreement, he or she may be billed for the pro-rated share of cost of the weatherization project. (See Renters Eligibility for Weatherization attachment) Priority in eligibility: LIHEAP WX works in conjunction with DOE WX and DOE BIL WX; therefore, the client eligibility is in accordance with 440.16 (a), which requires each applicant household requesting LIHEAP WX Assistance must complete the application process for eligibility determination. All applications taken must be taken in the Virtual ROMA system. During the interaction process the caseworker/case manager must obtain vital information about social and economic conditions of the entire household. Virtual ROMA has a dedicated Weatherization Portal (T.H.R.I.V.E.) with functionality within the system to allow WX Subgrantees to process referrals and set appointments for weatherization services. Furthermore, T.H.R.I.V.E. automatically puts the eligible client on a wait list for each agency which is prioritized by the automated DOE WX selection tool programmed in T.H. R.I.V.E, which prioritizes the elderly, disabled, households with children, high energy users and households with high energy burdens for WX services. Benefit Levels 5.9 Do you have a maximum LIHEAP weatherization benefit/expenditure per household? Yes No 5.9a If yes, what is the maximum? $12,000 5.10 Do you use an Average Cost per Unit (ACPU). Yes No 5.10a If so, what is the ACPU amount? $0 Types of Assistance, 2605(c)(1), (B) & (D) 5.11 What LIHEAP weatherization measures do you provide ? (Check all categories that apply.) Weatherization needs assessments/audits Energy related roof repair Caulking and insulation Major appliance repairs Storm windows Major appliance replacement Furnace/heating system modifications/repairs Windows/sliding glass doors Furnace replacement Doors Cooling system modifications/repairs Water Heater Water conservation measures Cooling system replacement Roof top solar Community solar projects Compact florescent light bulbs Other - Describe: Power Strips, LEDS); Electrical Repairs; Insulation 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.