2 HEATING ASSISTANCE

Eligibility, 2605(b)(2) - Assurance 2 2.1 Designate the income eligibility threshold used for the heating component: Add Household size Eligibility Guideline Eligibility Threshold 1 All Household Sizes HHS Poverty Guidelines 150.00% 2.2 Do you have additional eligibility requirements for Heating Assistance? Yes No 2.3 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: Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period of time at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period. Each sub- grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various off-site locations to accommodate the elderly and disabled populations. Individuals with a disability? Yes No If yes, describe: Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period of time at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period. Each sub- grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various off-site locations to accommodate the elderly and disabled populations. Young children? Yes No If yes, describe: Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period. Each sub-grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various offsite locations to accommodate elderly and disabled populations. Households with high energy burdens? Yes No If yes, describe: Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period. Each sub-grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various off-site locations to accommodate the elderly and disabled populations. Other? Yes No If yes, describe: Explanations of policies for each "yes" checked above: Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period of time at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period of time. Each sub-grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various offsite locations to accommodate elderly and disabled populations. Determination of Benefits 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 2.4 Describe how you prioritize the provision of heating assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. Sub-recipients have the option to provide priority scheduling to the vulnerable groups identified above for a period at the start of the program year. This targeted scheduling is not intended to exclude non-targeted households for more than an initial period. Each sub-grantee’s decision and plan to provide priority scheduling must be approved by Commerce in their annual application. Sub-recipients also have the option to provide targeted intake appointments for the vulnerable groups identified above. These services are provided directly at various offsite locations to accommodate elderly and disabled populations. 2.5 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) 2.6 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 $250 Maximum Benefit $1,250 2.7 Do you provide in-kind (e.g., blankets, space heaters) and/or other forms of benefits?2 Yes No If yes, describe. Policy 1.4.2 (A) & (B): Other Repairs & Services (These services are not categorized as Weatherization. These services do not require an initial inspection by a Building Performance Institute certified Energy Auditor.) Sub-recipients may choose among the following list of OES services to resolve a heat-related crisis situation, but must not exceed $1,000: 1. Provide blankets, space heaters, air conditioners, fans, and other emergency supplies. a. Client Files must document the request and/or need for services. 2. Repair or replace broken and/or damaged windows. a. If the cost to replace the windows is less than the cost to repair, then they will be replaced. 3. Provide limited roof repair when the roof conditions and inclement weather both pose a threat to the health and safety of the dwelling’s occupants. a. Roof repair is held to the same policy guidelines as broken and/or damaged windows. 4. Purchase a small generator to serve as an emergency energy source for a life-threatening health condition. a. Client Files must document the request and/or need for the service. 5. Provide air conditioners. a. Client Files must document the request and/or need for services b. If household is a renter, then the air conditioner provided must be portable. c. If households is an owner, then the air conditioner provided can be portable or window mount. 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.