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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: For subsidized housing, the household must be responsible for a portion of the heating payment to be eligible for heating. Renters with utilities included in the rent? Yes No If yes, describe: For renters with utilities included in the rent, the household must be responsible for a portion of the heating. Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: Individuals with a disability? Yes No If yes, describe: Young children? Yes No If yes, describe: Households with high energy burdens? Yes No If yes, describe: Eligibility and the benefit payment amount for heating assistance are determined based on factors such as income level, dwelling type, fuel type, and the number of household members. Thus, households with the lowest income receive the highest benefit amount. Other? Yes No If yes, describe: Explanations of policies for each "yes" checked above: For subsidized housing, the household must be responsible for a portion of the heating payment to be eligible for heating. For renters with utilities included in the rent, the household must be responsible for a portion of the heating. Eligibility and the benefit payment amount for heating assistance are determined based on factors such as income level, dwelling type, fuel type, and the number of household members. Thus, households with the lowest income receive the highest benefit amount 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. DHHS reviews the household size, income, dwelling type, and fuel type to determine the benefit payment amount. Households with the least income, receive a higher benefit payment amount. See attached LIHEAP Heating Season Payment Table and LIHEAP Cooling Season Payment Table in the Low Income Home Energy Assistance Program (LIHEAP) Guidance Document 10.1.25. 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: In the future, DHHS plans to utilize the previous season's LIHEAP Energy burden data to evaluate whether the benefit levels are adequately reducing the energy burden for high energy-burdened households. 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 $154 Maximum Benefit $1,050 2.7 Do you provide in-kind (e.g., blankets, space heaters) and/or other forms of benefits?2 Yes No If yes, describe. 2.6 The 2025 LIHEAP Heating Season Payment Table is attached in the LIHEAP Guidance Document 10.1.25. The amounts may be adjusted at the discretion of DHHS based upon a variety of factors, which could include but are not limited to the amount of LIHEAP carry-over funds, the amount of LIHEAP funds received for the program year, the projected number of households to be served, disasters, and pandemics. 2.7 DHHS provides financial assistance for furnace (heating system) repair and replacement up to $750 for eligible households. If extenuating circumstances exist, DHHS may exceed the $750 maximum. 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.