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 State Median Income 60.00% 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: Renters with utilities included in the rent? Yes No If yes, describe: Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: Elderly residents that have a medical need for cooling are given priority and once their applications is reviewed and found eligible, their utility providers are contacted to protect their services from shut off. Individuals with a disability? Yes No If yes, describe: Disabled individuals that have a medical need for cooling are processed immediately their applications are received and their utility providers are contacted by program staff to ensure that their services are protected from termination of service. Young children? Yes No If yes, describe: Households with high energy burdens? Yes No If yes, describe: Other? N/A Yes No If yes, describe: Explanations of policies for each "yes" checked above: Depending on availability of funds, cooling is a medically necessary program benefit. Many elderly households with young childlren and disabled members are eligible for a cooling benefit, if they submit a doctor's note prescribing medical cooling for that household member, or they have a current Utility Critical Care Certification form, approved by their utility. 3.4 Describe how you prioritize the provision of cooling assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. Depending on the availability of funds, cooling assistance is available to households with at least one member having a medical condition that requires cooling. 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: 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 $118 Maximum Benefit $1,278 3.7 Do you provide in-kind (e.g., fans, air conditioners) and/or other forms of benefits? Yes No If yes, describe. 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.