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Eligibility - 2604(c), 2605(c)(1)(A) 4.1 Designate the income eligibility threshold used for the crisis component Add Household size Eligibility Guideline Eligibility Threshold 1 1 State Median Income 60.00% 2 2 State Median Income 60.00% 3 3 State Median Income 60.00% 4 4 State Median Income 60.00% 5 5 State Median Income 60.00% 6 6 State Median Income 60.00% 7 7 State Median Income 60.00% 8 8 State Median Income 60.00% 9 9 State Median Income 60.00% 10 9 State Median Income 60.00% 11 10 State Median Income 60.00% 12 12 State Median Income 60.00% 13 13 State Median Income 60.00% 14 14 HHS Poverty Guidelines 150.00% 4.2 Provide your LIHEAP program's definition for determining a crisis. If you administer multiple crisis assistance programs (winter, summer, and/or year-round), Include all program definitions. The definition of a crisis emergency is when loss of heat is imminent. Imminent loss of heat is defined as less than 1/4 tank for oil, kerosene, or propane or less than a 10-day supply for other deliverable fuels, or heat or heat related utility service is scheduled for termination. Any HEAP eligible household's crisis emergency must be resolved within 48 hours from the time of the emergency application. 4.3 What constitutes a life-threatening crisis? The definition of a life-threatening emergency is when a HEAP applicant or recipient household is without heat or utility service required to operate a heating source. Any HEAP eligible household's life-threatening emergency must be resolved within 18 hours from the time of the emergency application. Crisis Requirement, 2604(c) 4.4 Within how many hours do you provide an intervention that will resolve the energy crisis for eligible households? 48Hours 4.5 Within how many hours do you provide an intervention that will resolve the energy crisis for eligible households in life-threatening situations? 18Hours Crisis Eligibility, 2605(c)(1)(A) Winter Crisis Summer Crisis Year-Round Crisis 4.6 Do you have additional eligibility requirements for Crisis Assistance? 4.7 Check the appropriate boxes below to indicate type(s) of assistance provided 0 Do you require an Assets test? Do you give priority in eligibility to: Older Adults (60 years or older)? Individuals with a disability? Young Children? Households with high energy burdens? Other (Specify): In Order to receive crisis assistance: Must the household have received a shut-off notice or have a near empty tank? Must the household have been shut off or have an empty tank? Must the household have exhausted their regular heating benefit? Must renters with heating costs included in their rent have received an eviction notice? Must heating/cooling be medically necessary? Must the household have non-working heating or cooling equipment? Other (Specify): Do you have additional/differing eligibility policies for: Renters? Renters living in subsidized housing? Renters with utilities included in the rent? Explanations of policies for each "yes" checked above: Crisis assistance eligibility criteria: In addition to verified crisis emergency, as described in Sections 4.2 and 4.3, meeting income, residence, citizenship, living situation, responsibility for heating costs, and providing a valid Social Security Number (SSN) for all household members that have a SSN, applicants for crisis assistance must have exhausted their Regular benefit, and meet the asset test in order to be eligible. If the applicant for crisis assistance has a credit remaining from their Regular benefit but the credit is less than the minimum delivery amount for a deliverable fuel then the applicant can receive a crisis benefit, if otherwise eligible. All applicants and household members for crisis assistance are asset (resource) tested. Applicants for the Emergency benefit must not have more than $2,500 (or $3,750 for households containing a vulnerable member aged 60 years or older, or child under age 6) in available liquid resources to be eligible. Only available liquid resources are counted. Declared liquid resources can be verified using the following: checking account statements, savings statements or bankbooks, stock certificates, bank or dividend statements, savings bonds, and statements from the institution where funds are deposited or managed. Renters with heat included in their rent and renters residing in government subsidized housing with heat included in their rent are not eligible for Emergency HEAP, with the exception of eligible households that pay a supplier directly for heat-related utility service. These households may be eligible for a HEAP Emergency Domestic Heat-Related Utility benefit if such benefit is necessary to resolve the heat-related energy crisis of the household. Determination of Benefits 4.8 How do you handle crisis situations? Separate component Benefit Fast Track, no separate amount of crisis funds is issued. Rather benefits are issued to crisis customers within crisis response time frames. Other - Describe: If the Regular HEAP benefit is open and a household has yet to apply for and receive a Regular benefit, NYS will utilize the Regular benefit to ameliorate an energy emergency. OTDA HEAP policy requires districts take appropriate action to resolve applicant energy related life-threatening or crisis energy emergency, as declared at the time of application for HEAP benefits as follows: (1) No later than 18 hours after a household applies for benefits and declares an energy emergency, districts must provide some form of assistance that will resolve the life-threatening energy emergency. (2) No later than 48 hours after a household applies for benefits and declares an energy emergency, districts must provide some form of assistance that will resolve the crisis energy emergency. If HEAP eligibility cannot be determined within the 18 to 48-hour timeframe and thus the emergency cannot be resolved with the issuance of a HEAP benefit, the district must take at least one of the following actions: (1) Referral to Public Assistance (2) Referral to community resource (3) Verify the availability of or access to safe supplemental heat (4) Verify access to temporary alternate housing 4.9 If you have a separate component, how do you determine crisis assistance benefits? Amount to resolve the crisis. $0 Other - Describe: Amount to resolve the crisis, up to a maximum of $900. Crisis Requirements, 2604(c) 4.10 Do you accept applications for energy crisis assistance at sites that are geographically accessible to all households in the area to be served? Yes No Explain. There is a certification network in all districts for walk-in applicants. 4.11 Do you provide individuals who are individuals with a disability the means to: Submit applications for crisis benefits without leaving their homes? Yes No If No, explain. Travel to the sites at which applications for crisis assistance are accepted? Yes No If No, explain. Local districts have homebound unit staff that can travel and assist homebound applicants in their own homes. If you answered "No" to both options in question 4.11, please explain alternative means of intake to those who are homebound or physically disabled? Benefit Levels, 2605(c)(1)(B) 4.12 Indicate the maximum benefit for each type of crisis assistance offered. Winter Crisis $900.00 maximum benefit Summer Crisis $0.00 maximum benefit Year-round Crisis $0.00 maximum benefit 4.13 Do you provide in-kind (e.g. blankets, space heaters, fans) and/or other forms of benefits? Yes No If yes, Describe Temporary relocation benefit with a maximum total benefit not to exceed $500 per program year. Propane tank deposits to eligible households with a maximum total benefit not to exceed $500 per program year. 4.14 Do you provide for equipment repair or replacement using crisis funds? Yes No If you answered "Yes" to question 4.14, you must complete question 4.15. 4.15 Check appropriate boxes below to indicate type(s) of assistance provided. Winter Crisis Summer Crisis Year-round Crisis Heating system repair Heating system replacement Cooling system repair Cooling system replacement Wood stove purchase Pellet stove purchase Solar panel(s) Utility poles / gas line hook-ups Other (Specify): 4.16 Do any of the utility vendors you work with enforce a moratorium on shut offs? Yes No If you responded "Yes" to question 4.16, you must respond to question 4.17. 4.17 Describe the terms of the moratorium and any special dispensation received by LIHEAP clients during or after the moratorium period. The NYS Public Service Commission (PSC) regulated utilities agree to provide a two-week moratorium encompassing the Christmas and New Year holidays. 4.18 If you experience a natural disaster, do you intend to utilize LIHEAP crisis funds to address disaster related crisis situations? 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.