3 COOLING ASSISTANCE

Eligibility, 2605(c)(1)(A), 2605 (b)(2) - Assurance 2 3.1 Designate The income eligibility threshold used for the Cooling component: Add Household size Eligibility Guideline Eligibility Threshold 1 All Household Sizes HHS Poverty Guidelines 150.00% 3.2 Do you have additional eligibility requirements for Cooling assistance? Yes No 3.3 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 cooling utilities to be eligible for cooling. Renters with utilities included in the rent? Yes No If yes, describe: For renters with utilities included in rent, the household must be responsible for a portion of the cooling utilities. Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: To qualify for cooling assistance, a household must qualify for LIHEAP and include a household member who is a child under age six who receives Aid to Dependent Children (ADC); is age 70 or older; has a severe illness or condition which is aggravated by extreme heat as verified by a medical statement signed by a licensed healthcare provider; or has received an air conditioner from DHHS within four years of the application date. Thus, DHHS gives priority to elderly individuals (70 and over), individuals with a severe illness or condition aggravated by extreme heat, and young children (5 years and under and ADC-eligible) for cooling assistance purposes. Individuals with a disability? Yes No If yes, describe: Young children? Yes No If yes, describe: To qualify for cooling assistance, a household must qualify for LIHEAP and include a household member who is a child under age six who receives Aid to Dependent Children (ADC); is age 70 or older; has a severe illness or condition which is aggravated by extreme heat as verified by a medical statement signed by a licensed healthcare provider; or has received an air conditioner from DHHS within four years of the application date. Thus, DHHS gives priority to elderly individuals (70 and over), individuals with a severe illness or condition aggravated by extreme heat, and young children (5 years and under and ADC-eligible) for cooling assistance purposes. Households with high energy burdens? Yes No If yes, describe: To qualify for cooling assistance, a household must qualify for LIHEAP and include a household member who is a child under age six who receives Aid to Dependent Children (ADC); is age 70 or older; has a severe illness or condition which is aggravated by extreme heat as verified by a medical statement signed by a licensed healthcare provider; or has received an air conditioner from DHHS within four years of the application date. Thus, DHHS gives priority to elderly individuals (70 and over), individuals with a severe illness or condition aggravated by extreme heat, and young children (5 years and under and ADC-eligible) for cooling assistance purposes. Other? Medical necessity Yes No If yes, describe: The medical necessity for cooling assistance is documented on the IM-55. A new IM-55 was implemented in 2020 to simplify and create a more efficient process. In 2021, a revision was made to the IM-55 to include an additional medical condition. In 2022, minor revisions were made, and in 2023, revisions were made to the form to accommodate changes related to the approval process. See the attached IM-55 form. Explanations of policies for each "yes" checked above: 476 NAC 2-003. COOLING ASSISTANCE. To qualify for cooling assistance, a household must qualify forthe Low Income Home Energy Assistance Program and include a household member who:(A) Is a child under age 6 who receives Aid to Dependent Children;(B) Is age 70 or older;(C) Has a severe illness or condition which is aggravated by extreme heat as verified by amedical statement signed by a licensed healthcare provider; or(D) Has received an air conditioner from the Department within four years of the applicationdate. 3.4 Describe how you prioritize the provision of cooling assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. DHHS reviews the household size, income, and dwelling type to determine the benefit payment amount. Households with the least income receive higher benefit payment amounts. Additionally, as previously stated, to be eligible for cooling a household member must be age 70 or older; be a child under the age of six and receiving ADC; have received an air conditioner from DHHS within the four years of the application date; or have a severe illness or condition aggravated by extreme heat. See the 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. Determination of Benefits 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 3.5 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: The LIHEAP Cooling Season Payment Table (matrix) is subject to update (closer to the cooling season) based on funding availability. The cooling season is June through August. Benefit Levels, 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 3.6 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 $273 Maximum Benefit $700 3.7 Do you provide in-kind (e.g., fans, air conditioners) and/or other forms of benefits? Yes No If yes, describe. LIHEAP funds are utilized to provide financial assistance to households meeting the cooling assistance and other eligibility requirements to purchase window air conditioning units. In some instances, financial assistance is provided for a portable air conditioner rather than a stationary window air conditioner. DHHS provides financial assistance to eligible households to assist with central air conditioner (cooling system) repair and replacement up to $750. 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.