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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 HHS Poverty Guidelines 200.00% 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: 200% FPL for LIHEAP Weatherization ("LIHEAP Wx"), instead of 150% so the income guidelines are in sync with DOE WAP. No cap for LIHEAP Wx jobs, justification is still required for jobs exceeding $10,000. An energy audit to identify eligible measures is required. 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? 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. LIHEAP Wx uses the DOE WAP priority point system that assigns points for those households that have a household member who is elderly, disabled, or has a child 5 or under. In addition, we give additional points for those households that have a high energy burden. Our allocation to subgrantees is also based on census data that includes poverty data. After the total number of points is determined for each household, the applicants are ranked from highest to lowest, per county of residence. The households with the highest number of points receive priority in assistance and will be served subject to available funds. Renters are required to secure landlord permission and a signed Landlord Agreement is required prior to any work being performed. 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? $0 5.10 Do you use an Average Cost per Unit (ACPU). Yes No 5.10a If so, what is the ACPU amount? $10,000 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: Health & Safety 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.