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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 State Median Income 60.00% 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: LIHEAP Weatherization funds are used primarily for repair, modification, or replacement of heating system equipment, which can include domestic hot water and other space conditioning systems. Any component of the household’s main heating system that is required for functioning can be repaired/replaced, including but not limited to boilers, furnaces, oil tanks, wood stoves, chimney/chimney liners, and distribution system. • While DOE WAP rules require a 15-year ‘look back’ period to pass before further work, a household in need of a heating system repair/ replacement could be revisited for heating system assessment and possible repair or replacement before 15 years had passed with a waiver. • Households may be provided with space conditioning system repair or replacement without providing a full weatherization of the entire dwelling. • A Building Performance Institute (BPI) certified energy auditor or person with NH DOE-approved qualifications is qualified to perform a final inspection for heating repair/replacement; QCI certification is not required. • Energy related roof repair requires an approved waiver in order for this measure to be covered under LIHEAP Weatherization. • NH has a maximum LIHEAP amount per dwelling of $20,000; any dwelling that will be above $15,000 per dwelling requires an approved waiver. • Any modification, repair, or replacement of cooling-only systems require a note of medical necessity from a qualified medical provider. • All WAP rules are subject to waiver request by Subgrantees, where exigent circumstances make compliance unfeasible. • 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? Priority is also given to those with non-functioning heating equipment 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. 5.7 – Rental unit dwellings are not eligible for the LIHEAP Weatherization funds without the use of a waiver approved by the NH Department of Energy. Rental unit dwellings of less than four units meeting WAP eligibility requirements may use LIHEAP Weatherization funds with approved waiver. 5.8 – The NH Weatherization Assistance Program, including the work done with LIHEAP Weatherization funds, utilizes a scorecard system to prioritize households for assistance. Priority is given to households with high energy usage, a household member who is elderly (60+), disabled, or has a child present (a child is defined as someone 19 years old or younger). Priority is also given to those with non-functioning heating equipment during the timeframe of October 1 – March 31 when we declare no-heat crisis situations. 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? $20,000 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: Carbon monoxide and/or smoke alarms 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.