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Energy Assistance Program

Illinois Department of

Commerce and Economic Opportunity

2016

PROCEDURES MANUAL

July 1, 2015

TABLE OF CONTENTS

SECTION I – ENERGY ASSISTANCE PROGRAM OVERVIEW Page

Purpose ...............................................................................................................I.1

Legislative Background .....................................................................................I.1

Program Design (PIPP, DVP, Cash) ..................................................................I.3

Section I -- Exhibits ...........................................................................................I.6

SECTION II – ENERGY ASSISTANCE PROGRAM BENEFITS

Energy Assistance (PIPP, DVP, Cash) ..............................................................II.1

Crisis/Reconnection Assistance .........................................................................II.3

Furnace Assistance Component .........................................................................II.7

Cooling Assistance……………………………………………………………II.15

Section II – Exhibits…………………………………………………………..II.16

SECTION III - OUTREACH

Outreach Responsibilities .................................................................................III.1

Outreach Plan ....................................................................................................III.2

Coordination and Referral Procedures ..............................................................III.2

Consumer Education .........................................................................................III.4

Publicity ............................................................................................................III.4

SECTION IV - INTAKE

Intake Strategy ..................................................................................................IV.1

Home Visits/Mail-In Applications ....................................................................IV.2

Special Accommodations..................................................................................IV.3

Locations for Outreach/Intake ..........................................................................IV.3

Scheduling Outreach/Intake ..............................................................................IV.4

Application/Eligibility ......................................................................................IV.4

Authorization to Apply……………………………………………………….IV.4

Client Confidentiality Rights ............................................................................IV.5

Client Appeals Rights .......................................................................................IV.5

Section IV – Exhibits ........................................................................................IV.6

SECTION V – DOCUMENTATION

Income Documentation.....................................................................................V.1

Multiple Applications.......................................................................................V.2

Zero Income Adult vs. Household....................................................................V.3

Department of Human Services (DHS)........................................................... V.4

Unemployment Compensation (UCB)............................................................ V.6

Interest..............................................................................................................V.6

Self-Employment..............................................................................................V.6

Other Income....................................................................................................V.6

Other Types of Documentation……………………………………………….V.9

Child Custody/Energy Assistance Application……………………………….V.10

Legal Name…………………………………………………………………...V.10

Social Security Numbers……………………………………………………...V.10

Proof of Responsibility for Energy Consumption…………………………….V.11

Goof Faith Effort (GFE)……………………………………………………....V.11

Rent Amount Verification………………………………………………….....V.13

Document Request Form……………………………………………………...V.14

Medical Certification and/or Cooling Medical Condition…………………….V.14

Section V – Exhibits…………………………………………………………..V.15

SECTION VI – APPLICATION INSTRUCTIONS

Application Instructions ....................................................................................VI.1

Section VI – Exhibits…………………………………………………………VI.12

SECTION VII – VERIFICATION, AUTHORIZATION, NOTIFICATION &

PAYMENT

Verification .......................................................................................................VII.1

Reviewing the Application ...............................................................................VII.2

Incomplete Application .....................................................................................VII.2

Assuring All Documentation is Complete ........................................................VII.2

Verification of Income ......................................................................................VII.3

Reconnection Assistance Income Verification .................................................VII.4

Incomplete Documentation ...............................................................................VII.5

Request for Documentation ..............................................................................VII.5

Verification of Utility Account Customer ........................................................VII.5

Verification of Rental Expenses .......................................................................VII.5

Eligibility Determination ..................................................................................VII.6

Payment Authorization .....................................................................................VII.6

Client Notification ............................................................................................VII.6

Vendor Notification ..........................................................................................VII.6

Electronic Vendor Notification .........................................................................VII.7

Energy Assistance Program Payments..............................................................VII.7

Correction of Client Benefit Errors...................................................................VII.8

Transfer of Payments and Refunds from Vendors ............................................VII.9

When Payments Are Sent to DCEO………………………………………….VII.9

Recoupments………………………………………………………………....VII.10

Death of Applicant…………………………………………………………...VII.10

Section VII – Exhibits……………………………………………………….VII.11

SECTION VIII – FISCAL PROCEDURES

Cash Requests ...................................................................................................VIII.1

Budget Modifications........................................................................................VIII.1

Budget Flexibility .............................................................................................VIII.1

Formal Budget Modifications ...........................................................................VIII.1

Equipment Purchases ........................................................................................VIII.2

Equipment Disposal…………………………………………………………..VIII.2

Cost Categories/Allowable Expenses ...............................................................VIII.3

iii

Section VIII – Exhibits .....................................................................................VIII.5

SECTION IX – FILING SYSTEMS

Required Subject File Types ...............................................................................IX.1

Required Subject File Contents………………………………………………..IX.1

Grant Agreement File……………………………………………………….....IX.1

Client File……………………………………………………………………...IX.2

Contents of LIHEAP Client File………………………………………………IX.2

Required Filing Procedures……………………………………………………IX.3

Possible Alternatives for Organizing Client Files……………………………..IX.4

Ineligible Applicants…………………………………………………………..IX.4

Insurance Files…………………………………………………………………IX.5

Personnel File………………………………………………………………….IX.5

Correspondence File…………………………………………………………...IX.5

Regulations File………………………………………………………………..IX.6

Vendor File…………………………………………………………………….IX.6

Record Release and Retention ............................................................................IX.6

Section IX – Exhibits…………………………………………………………..IX.8

SECTION X – HEARINGS AND APPEALS

Dispute Procedures…………………………………………………………...X.1

Informal Conference .........................................................................................X.1

State Review .....................................................................................................X.2

Formal Hearing .................................................................................................X.2

Section X – Exhibits .........................................................................................X.4

SECTION XI – REPORTING

Reporting Procedures ........................................................................................XI.1

Reporting Time Frames ....................................................................................XI.1

Reporting Content .............................................................................................XI.1

Vendor Agreement ............................................................................................XI.2

General Agreement…………………………………………………………...XI.2

Securing the Agreement……………………………………………………....XI.2

Section XI – Exhibits ........................................................................................XI.3

SECTION XII – DISASTER RECOVERY PLANNING

Disaster Contingency ........................................................................................XII.1

Reporting and Payment .....................................................................................XII.1

Summary ...........................................................................................................XII.2

Section XII – Exhibits .......................................................................................XII.3

Page 1 of 2

2016 ENERGY ASSISTANCE PROGRAM

PROCEDURES MANUAL

Overview of Additions, Changes, etc. updated 10/19/15

Redundant information was removed from Section I and updated in Section II

All Sections

Made corrections throughout the manual to reflect the suspension of the PIPP.

All Sections

Made corrections throughout the manual to reflect no PY2016 Cooling Program

All Sections

DCEO will no longer be declare an Emergency period

All Sections

Replaced the word Benefit Check to Two Party Check

All Sections

Reconnection Assistance amount reduced from $1,000 to $750

All Sections

Made corrections to indicate GFE/CPR, as clients will now be responsible to pay their

outstanding balance in order to get LIHEAP benefit(s) to help reconnected.

All Sections

No DVP/RA benefits will be provided unless it results in reconnection

All Sections

Corrected program dates, October 1

, November 1

, and December 1

. Furnace is

October 1

-March 31

. All are until end of program or until funds are exhausted.

I.12

Updated Income Guidelines for 2016

II.4

New 18 hour reconnection assistance definitions, instructions, and requirements

II.7

Continue to document in the file, but to meet the 18/48 hour requirement written

permission is not needed to use a contractor for the assessment. An IHWAP

certified staff member must complete the Final Inspection.

II.8

Added information on when and where Furnace Assistance application data must be

entered into LIHEAP.net. From initial client contact through LAA Paid status the

LAA must make Activity History entries so other LAA staff or GMs will know the

job status at all times.

II.10

Reminder: A Manual J (or equivalent) sizing chart is required for all furnace

replacements.

II.10

The mileage rate has increased to .57 cents per mile

II.11

Added the updated Mechanical Measures and Cost Limits, to align with IHWAP.

II.12

Returned to former policy: The cost of the Health and Safety items needed for the safe

restoration of heat are not included in the cost limit.

II.20

Replaced Benefit Matrices

2016 ENERGY ASSISTANCE PROGRAM PROCEDURES MANUAL

Overview of Additions, Changes, etc.

Page 2 of 2

II.29

Up-dated Applicant File Checklist, which is now an optional form. It is recommended

the LAAs use the OEA checklist or some LAA-developed file checklist.

V.7

• Other income, such as income from selling farm crops or livestock or similar

bulk product once a year, must be divided by 12 months to equal the 30 day

income requirement

• Commission checks that cover more than one month should be divided by the

appropriate number of months to equal the 30 day income requirement

V.10

LIHEAP HHS Information Memorandum published December 12, 2014 states: The

income of all household members – regardless of eligibility – must be documented,

verified, and included in the calculation of the LIHEAP benefit amount.

V.14

If the urgency of the application status does not allow for the Documentation Request

form and/or GFE letter to be sent, and the LAA handles the client notification via

phone or in person, then the client contact must be documented in the file and/or in the

LIHEAP.net App Comments section.

V.20

Updated Zero Income Affidavit

V Exhibits

TANF chart revised per DHS table. Group I Adult & Children, # in unit 5 increased

from $552 to $555

VI.21-22

The minor change relates to client authorization for the new HHS Performance

Measures data exchange process between the utilities/vendor and the Department for

the purpose of program evaluation and analysis

VII.8-9

Added new policy regarding “Correction of Client Benefit Errors.”

IX.2

Including the Benefit Summary page in the client file is now optional. However,

when an LAA receives a list of files to be reviewed a final status Benefit Summary

page must be included in the file.

IX.6

New Office of Management and Budget (OMB) Circular Guidance 2 CFR Part 200

(former OMB Circulars A-110, Common Rule, A-87, A-133 and A-122 as applicable)

and OMB Guidance 45 CFR Part 75.

IX.7

Record Retention - Local agencies are to keep program files (LIHEAP and/or PIPP)

for a minimum of four (4) years following the Department’s final written approval of

all required close-outs or until that program year’s audit is finally resolved, unless the

Department notifies the LAA prior to the expiration of the for years that a longer

period is required Records may be kept electronically.

SECTION I

ENERGY ASSISTANCE PROGRAM OVERVIEW

SECTION I –ENERGY ASSISTANCE PROGRAM OVERVIEW

Purpose ..............................................................................................................I.1

Legislative Background ....................................................................................I.1

Program Design ................................................................................................I.3

Section I -- Exhibits ..........................................................................................I.6

I.1

SECTION I

ENERGY ASSISTANCE PROGRAM OVERVIEW

Purpose

The primary purpose of the Energy Assistance Program is to assist low-income citizens by

offsetting the rising cost of home energy through direct financial assistance, energy counseling,

outreach and education. The program allows the State of Illinois to reach not only the

increasingly vulnerable low-income population, but also to serve as an important entry point

for a variety of other needed social services for the low-income population.

While the energy bills a low-income family incurs may not be higher than that of the average

family, their relative poverty means it takes a larger percentage of their income to pay them.

Thus, while the average family pays approximately 5% of their income toward their energy

bills, a low-income family may pay 33% or more of their income toward their energy bills in

the absence of any energy assistance.

Legislative Background

The Low-Income Home Energy Assistance Act of 1981 (Title XXVI of the Omnibus Budget

Reconciliation Act of 1981, Public Law 97-35), as amended in 2005 by Subtitle B of the

Energy Policy Act of 2005 (Public Law 109-58), created the Low Income Home Energy

Assistance Act of 1981. Under this Act, the Secretary of the U.S. Department of Health and

Human Services (HHS) is authorized to make grants to states to assist low-income

households in meeting the costs of energy consumed for heating and, where medically

necessary, cooling of residences. States must comply with sixteen assurances prior to receipt

of funds:

1. How the Energy Assistance Program funding will be used

2. Which client eligibility criteria will be implemented

3. How outreach efforts will be conducted

4. How Energy Assistance Program activities will be coordinated with similar &

related Federal programs

5. What benefit payment levels will be established for the Energy Assistance

Program

6. How local administering agencies are designated and procedures followed to

choose a successor agency to operate the Energy Assistance Program

7. How payments will be made to vendors

8. How the State will assure that low-income clients will have equal access to the

Energy Assistance Program

9. How administrative costs will be used

10. How the State will ensure that fiscal accountability will be maintained and audits

will be conducted

11. Agree to cooperate with federal investigations

I.2

12. How the general public will be given the opportunity to review and comment on

the Energy Assistance Program design

13. What rights will be given to the client, and how appeal procedures will be

established

14. What policies will be established for nondiscrimination, tracking energy usage,

funding allocation, and reporting

15. How statewide outreach and intake efforts will be coordinated

16. How the State will provide services that encourage households to reduce their

home energy needs

These assurances are designed to ensure minimum and basic continuity of program design

among states. However, the Act does allow states flexibility to develop and implement plans

that meet their own diverse needs and circumstance.

The Energy Assistance Act of 1989, as amended, details the specifics of the Energy Assistance

Program (the original Low Income Home Energy Assistance Program, or LIHEAP). In July of

1991, the Illinois General Assembly amended the Illinois Energy Assistance Act of 1989

establishing a low-income energy assistance policy and a program that incorporates fuel

assistance, home weatherization and other measures designed to more effectively assist eligible

households to meet home energy costs. In January of 1998, Public Act 90-561, the Electric

Service Customer Choice and Rate Relief Law of 1997, was signed into law. This law adds an

additional funding source for the Illinois Energy Assistance Program.

There are several major differences in the utilization of the State funds as compared to the

Federal HHS funding. The restrictions on State funding are:

1. Furnace Assistance work is not allowed; therefore all furnace work must be done

with Federal funds.

2. Cash payments are not allowed; therefore all cash payments must be made with

Federal funds.

3. Payments to delivered fuel (propane, fuel oil, woods, etc.) vendors are not

allowed; and, therefore all delivered fuel payments must be made with Federal

funds.

4. Payments to Rural Electric Cooperatives (REAs) or Municipal Utilities may not

be made unless the entity has agreed to participate in the program and collect the

monthly meter charge.

5. Benefits are designated as heat-related only.

The Energy Assistance Act was amended in July of 2002 to require the Department to ensure

that a disproportionate share of available Federal funds is not provided to customers of

municipal and rural electric cooperative utilities who do not assess the charges outlined in the

Act. Total Federal benefits provided to all such utilities in any given county are, therefore,

limited to the percentage of Federal funds received by all such utilities in each county during

the years prior to the 1998 program year applied to the current Federal county allocation. This

limitation applies to the total of all Energy Assistance Program benefit types, excluding

emergency periods. When the limit is reached, further applicant households will be denied.

I.3

In July of 2009, Public Act 96-33, the Illinois General Assembly amended the Energy

Assistance Act (305 ILCS 20) and added the Percentage of Income Payment Plan (PIPP) as

an option for the Energy Assistance Program for eligible residential customers. Section

18(c)(8) requires PIPP to be operational on September 1, 2011. The PIPP will:

1- Bring participants’ gas and electric bills into the range of affordability;

2- Provide incentives for participants to make timely payments;

3- Encourage participants to reduce usage and participate in conservation and energy

efficiency measures that reduce the customer’s bill and payment requirements; and,

4- Identify participants whose homes are most in need of weatherization.

Program Design – Energy Assistance

According to funding availability, local agencies will offer three types of assistance:

1. Percentage of Income Payment Plan (PIPP): (Temporarily Suspended) The main

objective of the PIPP is to make energy bills more affordable and to help maintain home

energy service throughout the year. The PIPP will help reduce bills only if participants

make the required full, on-time monthly payments. By enrolling in the PIPP, the

household has agreed to enter into a monthly budget payment plan with the participating

utility. The utility will reduce the account’s pre-program arrearage, for each on-time

monthly payment made by the bill due date, up to a total of $1,000 for the program year.

2. Cash Assistance - Applicant households who:

1. indirectly purchase energy as an undesignated portion of rent, or

2. are public housing authority tenants whose lease contains a “subject to

surcharge” clause

will be eligible to receive assistance in the form of a one-time cash payment made

directly to the household if the applicant’s rental expenses are greater than 30% of

the household’s gross income. The Payment Matrices will be used to determine

assistance levels. These payments will vary by the household’s size, income and

geographic location within the state.

3. Direct Vendor Payments - Applicant households that purchase energy directly from

vendors are eligible to receive energy assistance benefits in the form of a one-time

payment made directly to the applicable vendor (Direct Vendor Payment or DVP)

representing a percentage of the average primary and secondary bills for the winter

months, October through May. The Payment Matrices are based on a percentage of

those average energy costs. These matrices will be used to determine assistance levels,

which vary by household income, fuel type, family size, and geographic location.

Benefits to these households will be split between primary and secondary vendors in

accordance with the payment matrix. Secondary electric service must be an integral part

of the heating system in order to qualify for a benefit.

I.4

A. Crisis Assistance/Reconnection Assistance (RA): The Illinois Department of

Commerce and Economic Opportunity may set aside a portion of the State’s

allocation for use in emergency situations. Under this component, funds may be used

for either weather or other emergencies that affect the entire eligible population or

for emergency-related situations that affect an individual household to the extent

funds are available.

In the event of a weather-related natural disaster or extreme weather conditions, the

Illinois Department of Commerce and Economic Opportunity will develop an

appropriate response designed to eliminate the threat to life and health. Under such

conditions, the Department may utilize a portion of current program year Energy

Assistance Program funding to provide assistance to low-income households

affected by the extreme weather condition. This assistance will be limited to energy-

related crisis activities, such as pledges of payment to utilities, replacement of fuel

tanks, heating system and water heater repair, purchase of fans, operation or support

of local cooling centers, coordination with local social service agencies, air

conditioners (where medically necessary), etc.

Energy assistance will be offered starting on October 1, 2015, and will continue to be

available through May 31, 2016 or until the funding is exhausted.

B. Furnace Assistance: Furnace benefits, which include repair, or replacement, will be

utilized to restore a vital heat supply to the home. It will be operated by Local

Administering Agencies’ weatherization program (see Local Administering

Agencies map in Section II), which are uniquely situated to define and develop

individualized responses to energy-related emergencies and emergency furnace

repair to restore a home heating source.

C. Cooling: At the discretion of the Department, cooling assistance may be offered

during the summer months to eligible at-risk households, such as households with a

person who is elderly and/or has a disability, households containing a child under 6

years of age, or households with a documented medical condition.

Two Priority Groups will be served during the priority period of October and

November:

1. Priority Group I – includes households with a person who is elderly and/or has a

disability, and begins October 1. The Priority Group I households without home

energy service (are disconnected or under imminent threat of disconnection from their

primary and/or secondary energy source) may be served beginning October 1 with

Reconnection Assistance including Furnace Assistance applications (the first criterion

for Furnace Assistance is: there must be an Approved DVP application before a Furnace

application may be completed).

I.5

2. Priority Group II - includes families with children under the age of 6 years, and

disconnected households, and begins November 1. The Priority Group II

households without home energy service (are disconnected or under imminent threat of

disconnection from their primary and/or secondary energy source) may be served

beginning November 1 with Reconnection Assistance including Furnace Assistance

applications (the first criterion for Furnace Assistance is: there must be an Approved

DVP application before a Furnace application may be completed).

Beginning December 1 all program benefits will be available to all eligible low-income

households. Applications will be taken through May 31 or until funding is depleted, whichever

comes first.

Eligibility for the Energy Assistance Program is limited to applicant households (defined in

Exhibit I.9) at or below 150% of the federal poverty income level. Income guidelines (Exhibit

I.12) are based on the household’s gross income for 30 days, beginning with the date of

application.

In accordance with the Energy Assistance Act (305 ILCS 20), as amended, the Department

will set aside an amount of up to 33% of the total funding for client payments to be used for

households that receive Temporary Assistance for Needy Families (TANF); Aid to the Aged,

Blind and Disabled (AABD); and households at or below 50% of the poverty level.

SECTION I

ENERGY ASSISTANCE PROGRAM OVERVIEW

EXHIBITS

Energy Assistance Program Design Flow Chart ........................ I.6

Applicant Household Definition and Determination .................. I.7-9

Determination ........................................................................... I.9

Income Guidelines ...................................................................... I.10

LAA Energy Assistance Program Time Frames.. ...................... I.11

LIHEAP DESIGN:

Moving the Client Through

The Eligibility Process

Yes

No No

Yes Yes

Is monthly rent

greater than 30%

of income?

Issue

Denial

Letter

Does household pay

own bills?

Is household income

eligible?

Yes

GFE&35 Met?

Is household

disconnected or

imminent threat?

Renter Household

Receives Cash

Assistance

Notification to

Household of

Eligibility

Issue denial

letter for RA &

DVP

DVP: Issue Assistance

to Utility on

household’s behalf

$$ issued to

Household

Notification to

Household of

eligibility

Notification to Utility of

assistance to be provided

on household’s behalf

$$ issued to

Utility

I.6

I.7

APPLICANT HOUSEHOLD

Definitions

1) Household is defined as an individual(s) living in private living quarters (a space

with a private entrance, kitchen and bathroom facilities) for which residential heat

is purchased in common. An individual room within a primary residence does not

qualify.

2) Applicant: Every individual in the household is an applicant. Each applicant

must be a legal resident of Illinois and either a citizen of the United States or a

qualified alien.

A qualified alien is a non-citizen whose status (at the time the client

applies for, receives, or attempts to receive a Federal public benefit) on

the date of their entry into the U.S. is listed below:

• Lawfully admitted permanent resident (LPR) under the Immigration

and Nationality Act (INA);

Exception: Permanent Residents previously admitted under a status in

the Refugee group, have eligibility determined the same way as the

Refugee’s group without regard to work quarters.

• Asylee granted such status under section 208 of the INA;

• Refugee admitted to the U.S. under section 207 of the INA;

Exception: Non-citizens who have been certified as a victim of

trafficking by the Office of Refugee Resettlement (ORR), have

eligibility determined in the same way as Refugees, without regard to

qualified alien status. See Section 305.13, Qualified Aliens Eligible

Without Restriction .

• Non-citizen whose deportation is being withheld under section 243(h)

of the INA (Note: after April 1, 1997, withholding of deportation is

under section 241(b)(3));

• Parolee paroled into the U.S. under section 212(d)(5) of the INA for a

period of at least 1 year;

• Conditional entrant into the U.S. under section 203(a)(7) of the INA as

in effect prior to April 1, 1980;

• Cuban or Haitian entrant under section 501(e) of the Refugee

Education Assistance Act of 1980;

• Amerasian immigrant under section 584 of the Foreign Operations,

Export Financing, and Related Programs Appropriations Act of 1988

(usually the children of Vietnamese women and Americans present in

Vietnam during the Vietnam War era); or

• a battered immigrant spouse, battered immigrant child, immigrant

parent of a battered child or an immigrant child of a battered parent:

I.8

- with a petition pending under 204(a)(1)(A) or (B) or 244(a)(3) of the

INA;

- who is no longer living in the same household as the abuser; and

- who can establish a connection between the battery and the need for

SNAP benefits. Examples include, but are not limited to, the following

situations in which benefits are needed: to enable the applicant to

become self-sufficient, to escape the abuser to ensure the safety of the

applicant, because the applicant has lost financial support or his or her

home in leaving the abuser, or because of a disability that was a result of

the abuse.

If an alien refuses to document their status, they are ineligible. United States

citizenship will be documented by applicant’s statement.

Qualified alien status must be documented by one of the following:

1) Immigration and Naturalization Service (INS) form I-551 (Permanent

Resident card) or 151 (Alien Registration Receipt Card).

2) Reentry Permit (a passport booklet for lawful permanent resident

aliens).

3) INS Form I-94, arrival and departure record. This form must be

annotated with one of the following terms or a combination of terms:

refugee, parolee, paroled, asylum, annotated with 204, 207, 208,

212(d) (5), 243 (h), or 244 of the INS Act.

4) INS Form I-688. This form must be annotated with a reference to

section 210 (a) of the Immigration and Naturality Act. Note: Form I-

688A or B is not acceptable.

5) Violence Against Women’s Act applicant needs a I-797 receipt in

order to show eligibility (to prove VAWA beneficiary)

6) An I-360 Violence Against Women’s Act self-petition (to prove

VAWA beneficiary).

7) Refugee Travel Document (INS Form I-571) as proof of status for

refugees.

3) Elderly: An applicant or household member age 60 or above is considered

elderly, and the household is eligible to apply for benefits during the priority

period.

4) Disabled: An applicant (any household member) is considered to be disabled

for the purposes of the Energy Assistance Program and eligible to apply for

benefits during the priority period if he or she is: determined to be totally and

permanently disabled or blind by a governmental entity or medical

professional and receiving or has been approved for Federal Social Security

Disability benefits, Civil Service Disability or Federal Supplemental Security

Income benefits based on blindness or disability, Veterans Administration

Disability benefits, Railroad Retirement Disability benefits, or any State

Pension or payment based on blindness or disability.

I.9

Documentation may include the following sources: receipt of Supplemental

Security Income (SSI), receipt of Social Security Disability (under age 62

with social security number followed by claim letter A, HA, W, or C, if adult

child), an award letter stating permanent and total disability, a Veterans

Administration disability award letter, Medicare Card, or a bank statement

indicating any household member receives SSI.

Determination

Eligibility is based on all individuals living together at the time of application. This

includes individuals who are only away from the home due to employment such as

truck drivers and salesmen.

Individuals meeting or living under the following conditions will be considered

ineligible:

1. Individuals living in professional, practical or domiciliary nursing or boarding

homes who do not pay a home energy supplier directly for heating costs.

2. Individuals residing in hotels, motels, dormitories or temporary shelters who

do not pay a home energy supplier directly for heating costs.

3. Individuals living in government subsidized housing unless they are paying a

home energy supplier directly for their heating costs or are billed for any out-

of-pocket heating costs by the landlord or housing authority.

4. Individuals who are incarcerated.

5. Students or military personnel who are not actually living in the home.

6. Individuals defined as roomers, boarders or live-in attendants.

Roomer/boarder is defined as an individual living in the household who

receives wages to provide medical/child care and who is not responsible for

any household expenses.

7. Passenger vehicles (cars, trucks, vans) are not considered permanent

structures and are ineligible for energy assistance.

I.10

ENERGY ASSISTANCE PROGRAM

2016 INCOME GUIDELINES

Family

Size

150%

30 Day Income

150%

Annual Income

$1,471

$17,655

$1,991

$23,895

$2,511

$30,135

$3,031

$36,375

$3,551

$42,615

$4,071

$48,855

$4,591

$55,095

$5,111

$61,335

$5,631

$67,575

$6,151

$73,815

$6,671

$80,055

$7,191

$86,295

$7,711

$92,535

$8,231

$98,775

$8,751

$105,015

$9,271

$111,255

$9,791

$117,495

$10,311

$123,735

For families with more than 18 persons, add $520 for each additional person. $6,240

These figures are based on the 2014 Federal Poverty Guidelines published in the US Department of Health

and Human Services in the Federal Register/Volume 80/Number 14/January 22, 2015. The state reserves

the right to adjust these levels based on the availability of federal appropriations.

I.11

LAA ENERGY ASSISSTANCE PROGRAM TIMEFRAMES

PROCESS CALENDAR DAYS

A. INTAKE

If an appointment system is used

Home Visits

Appointment must be given within

60 calendar

days of the date it is requested.

When a home visit is determined necessary, the

client who is in need of the home visit must be

served within

60 calendar days from the date of

request.

B. TAKING THE APPLICATION

Application Taken/Documentation Collected

Denial (Lack of Information)

Option to reverse a Denial due to delay in

collection of information (within 90 days

from application date)

-15 days (or appropriate program end deadline)

Between the 16

and 30

day from the date of

application.

Between the 16

and 90

day from the date of

application.

C. DETERMINATION AND NOTIFICATION

(Written/Verbal)

Energy Assistance Applicants

Reconnection Assistance Applicants and

Energy Assistance Program

Furnace Assistance

– 30 days from the date of the complete

applicant’s file (all information is in the file, date

received indicated).

48 hours from the date that the applicant’s file is

complete

and determined eligible (all

information

is in the file, date received indicated).

18 hours from the date that the applicant’s file is

complete

and determined eligible

if energy crisis

is life threatening.

D. PAYMENT

To the client or vendors

Within 15 days of the date the register is

returned (contingent upon availability of funds).

SECTION II

ENERGY ASSISTANCE PROGRAM BENEFITS

SECTION II – ENERGY ASSISTANCE PROGRAM BENEFITS

Energy Assistance .............................................................................................II.1

Crisis/Reconnection Assistance ........................................................................II.3

Furnace Assistance Component ........................................................................II.7

Cooling Assistance............................................................................................II.15

Section II – Exhibits..........................................................................................II.16

II.1

SECTION II

ENERGY ASSISTANCE PROGRAM BENEFITS

In compliance with Senate Bill 1918 and the Illinois Energy Assistance Act of 1989, as

amended, and to ensure that households having the lowest income receive an appropriate

portion of the statewide funding, an amount not less than 33% of the total LIHEAP funds for

benefits is available to serve households eligible for public assistance; e.g., those receiving

TANF, AABD or with incomes at or below 50% of the poverty level.

All applicants eligible for assistance under the bill payment assistance program will have the

choice to apply for the Percentage of Income Payment Plan (PIPP) program, or the traditional

Low Income Home Energy Assistance Program (LIHEAP).

ENERGY ASSISTANCE

Option 1: Percentage of Income Payment Plan (Currently Suspended)

The main objective of the PIPP is to make energy bills more affordable and to help maintain

home energy service throughout the year. The PIPP will help reduce bills only if participants

make the required full monthly payments. By enrolling in the PIPP, the household has agreed to

enter into a monthly budget payment plan with the participating utility. The utility will reduce

the account’s pre-program arrearage, for each on-time monthly payment made by the bill due

date, up to a total of $1,000 for the program year.

Participants are responsible for monthly payments toward their energy bills that are based on a

percentage of their total household income and are also responsible for any outstanding balance

on their account that cannot be addressed by the monthly State/DCEO Benefit. The State will

pay an amount not to exceed $1,800 (a maximum of $150/month) for all electric customers or

$1,200 (a maximum of $100/month) for Gas primary customers in any twelve (12) month period.

In addition, if the PIPP client obtains their secondary electric service from a PIPP-participating

vendor, they can also elect to participate in the PIPP with that vendor as well. In this instance,

DCEO will pay on behalf of the household a monthly benefit amount

not to exceed $600 (a

maximum of $50/month) for secondary electric customers in any twelve (12) month period.

Participant failure to make the required full monthly payments by the due date every month may

result in termination from the program, and they will not be eligible for the regular LIHEAP

program Direct Vendor Payment (DVP) until the next program year. Household income will

need to be recertified at least once a year in order to continue to be eligible and receive assistance

through the PIPP. Households with no income source will be reverified on a quarterly basis

(every three months).

There is a 12-month certification period for PIPP participants, unless other circumstance

should necessitate a lesser period of active participation (for example, moving to a non-PIPP

utility service area, being dropped for non-payment, etc.). Prior to the end of the

certification period, the head of household must schedule an appointment with the Local

II.2

Administering Agency (LAA) to recertify participation in the Statewide PIPP for the next

program year.

Option 2: Cash Assistance

Applicant households who:

1. indirectly purchase energy as an undesignated portion of rent, or

2. are public housing authority tenants whose lease contains a “subject to

surcharge” clause

will be eligible to receive assistance in the form of a one-time cash payment made directly to

the household if the applicant’s rental expenses are greater than 30% of the household’s gross

income. The Payment Matrices will be used to determine assistance levels. These payments

will vary by the household’s size, income and geographic location within the state.

Option 3: Direct Vendor Payments

Applicant households that purchase energy directly from vendors are eligible to receive energy

assistance benefits in the form of a one-time payment made directly to the applicable vendor

(Direct Vendor Payment or hereafter referred to as a “DVP”) representing a percentage of the

average primary and secondary bills for the winter months, October through May. The Payment

Matrices are based on a percentage of the average energy costs for those months. These matrices

will be used to determine assistance levels, which vary by household income, fuel type, family

size, and geographic location. Benefits to these households will be split between primary and

secondary vendors in accordance with the payment matrix. Secondary electric service must be

an integral part of the heating system in order to qualify for a benefit.

In order to receive a DVP, the energy vendor must agree to comply with 47 Illinois

Administrative Code – Part 100 and sign a Vendor Agreement. If a particular household’s

vendor does not agree to the provisions of the vendor agreement, the Local Administering

Agency will attempt to find an alternate vendor, or issue a two-party check payable to either

the applicant or to the original vendor.

In accordance with the Payment Matrices, DVPs for those shall be made as follows:

• If the energy vendor has signed a Vendor Agreement and provides both primary and

secondary service (heat-related) to an applicant, then the vendor will receive, on

behalf of the applicant, a total of the primary and secondary payment as listed in the

Payment Matrix.

• If the primary and secondary vendors have both signed, they will receive the

appropriate payments on behalf of the applicant as listed in the Payment Matrix.

II.3

• If the primary vendor has signed but the secondary vendor has not, then the primary

payment will be sent to the primary vendor and the secondary payment shall be sent

in the form of a two-party check to either the applicant or the vendor.

• If the secondary vendor has signed but the primary vendor has not, then the secondary

payment will be sent to the secondary vendor and the primary payment shall be sent

in the form of a two-party check to either the applicant or the vendor.

• If neither the primary nor secondary vendor has signed, then the local agency will

attempt to find an alternate energy vendor(s). If no alternate vendor(s) are found,

then the primary and secondary payments as listed in the Payment Matrix must be

sent in the form of a two-party check to either the applicant or the vendor(s).

• If the applicant has only primary energy service (no secondary) then only the primary

payment as listed in the Payment Matrix will be made to the vendor on behalf of the

applicant. If the vendor is unsigned, the payment must be sent in the form of a

benefit check to either the applicant or the vendor.

Households will only be allowed to receive Energy Assistance (one DVP per eligible utility

or Cash) one time per program year. A household that initially receives a Cash payment may

not return to apply for a DVP or Reconnection Assistance at a later date if their

energy/housing situation changes. A member of a household who receives a benefit may not

be served again, either as head of household or counted as a member of another household.

A. Crisis Assistance/Reconnection Assistance

Reconnection Assistance (RA) will be offered:

• October 1 only for applicants with an elderly household member (age 60 or older) or

with a disabled household member (who are disconnected or under imminent threat of

disconnection from their primary and/or secondary energy source); and/or

• November 1 for households without home energy service (disconnected or under

imminent threat of disconnection from their primary and/or secondary energy source)

and to households that contain children age 5 years or under (include all children who

are not yet 6 years old, that is, up to 5 years and 364 days old) as of the date of

application; and

• December 1 to all low-income households, including households who are under

imminent threat of disconnection. Reconnection Assistance is designed to help

households obtain a continuous supply of home energy with expedited processing.

RA benefits will be provided to those eligible households that apply for Energy

Assistance and are disconnected or are in imminent threat of disconnection.

Imminent Disconnection means the utility has planned the disconnection to occur

within seven (7) days. However, as in previous years, energy services must be

broken down by type of charge for households that are charged with meter tampering

or theft of service. The agency must separate costs of disconnection from costs

incurred after disconnection (e.g., tampering, theft, etc.). Only non-theft usage will

II.4

be paid with Energy Assistance Program funding. No RA payments are to be made to

energy vendors until a verified reconnection date has been established.

Reconnection costs include required deposits, setup fees and reconnect or “hookup”

charges. Energy Assistance Program funds do not include charges for theft of service or

tampering. For the purpose of households that utilize delivered fuel (propane, fuel oil,

coal, etc.) a disconnection or imminent threat occurs when the delivered fuel supplier

refuses to deliver and the fuel supply is less than or equal to 25% of the total delivered

fuel storage capacity. Households that heat with hot water or steam systems are eligible

to receive RA for disconnected water service.

Within the timeframes established by application priority group status, Reconnection

Assistance (RA) will be provided within 48 hours from the date and time the client’s

application is complete (all client documentation has been submitted and verified).

Reconnection Assistance will be provided within 18 hours from the date and time the

client’s application is complete if the energy crisis is life-threatening.

For the purpose of implementing the 18-hour processing provision, a life threatening

situation exists if the following conditions are met:

• The temperature is 32

Fahrenheit or below

• The household is not protected by Illinois Commerce Commission (ICC) rules or

similar local laws.

• Reconnection is the only available remedy; i.e., the household does not have

alternate shelter, lacks a safe temporary means of heat or is homebound.

Each agency is required to develop specific written procedures to implement the 18-hour

provision in an equitable manner, including from which source the outside temperature

will be established (e.g., via Intellicast.com for the client’s city of residence). The

temperature must be documented in the App Comments on LIHEAP.net, and it must also

be written in the upper right-hand corner of the printed client application.

Before attempting to utilize emergency funding, the LAA should try to first use a DVP to

secure energy service. If the DVP is not sufficient to reconnect the household, then a

combination of the DVP and RA funding can be used. RA funding can only be used if it

results in a reconnection of the household’s energy service. In the event RA funding is

not sufficient to reconnect the energy service, a DVP will not be made to reduce the total

amount owed by the household.

The amount of Reconnection Assistance will be the minimum amount needed to help

secure energy service to the household. Households are eligible for emergency payments

not to exceed a TOTAL of $750 per household per year. Eligible households are limited

to one Reconnection Assistance payment for the primary energy source and one for the

secondary. Both payments combined cannot exceed the applicable benefit limit.

Applications for primary and secondary emergency payments do not have to be done

simultaneously. The household is allowed to apply for emergency payment to one

vendor and then, if the need exists, return to the LAA at a later date and apply for an

II.5

emergency benefit to the other vendor. This is not to be interpreted to mean that the

household is entitled to the maximum benefit. The time of the application and the

availability of funding will determine if each household applying for emergency benefits

will receive the maximum.

Good Faith Effort

To be eligible for Energy Assistance (DVP and/or RA), a disconnected or imminently

threatened client must make a Good Faith Effort toward paying his/her utility bill(s),

including payment of all Client Portion Required balances.

If the applicant’s payment history does not demonstrate good faith, the applicant will be

required to pay a $75 Good Faith Effort (GFE) payment to the utility or utilities that

would receive LIHEAP payments(s). Applicants may owe additional past due amounts

above the required $75; this balance is the Client Portion Required (CPR). All GFE/CPR

payments must be made in full prior to receiving any Energy Assistance benefit (DVP or

RA).

The Department of Commerce and Economic Opportunity will implement the Good Faith

Effort (GFE) /Client Portion Required (CPR) requirement as follows:

DCEO and/or the LAA will look at the LIHEAP applicant’s payment history. If the

application includes both utilities or if the electric utility is the primary vendor, then the

client payments to vendor(s) in the previous 90 days (beginning with the application date)

must be at least 10% of the 30-day household gross income multiplied by 3. If the

payment history does not demonstrate the required percentage of payments has been

made, then the applicant will be required to pay a GFE and/or CPR.

The preferred method of payment for the $75 is cash or money order at the utility’s

authorized payment center, however receipts from other forms of payment should also be

accepted. If the applicant presents a receipt to verify his/her GFE/CPR payment, the

LAA will enter/save into LIHEAP.net: 1. the total amount paid, 2. the receipt

number/transaction number and date of the payment. The LAA will then continue

processing the application. Or, if a utility reports through LIHEAP.net that the GFE/CPR

payment has been made, the LAA can continue processing the application. The LAA

must enter the exact payment amount made by the client towards their GFE/CPR, instead

of entering only $75. LAAs must negotiate the restoration of service as much as

possible. Regulated utilities are required to comply with the Illinois Public Utilities Act

as amended (Illinois Administrative Code 280) regarding reconnection of service to

Energy Assistance Program households.

IMPORTANT NOTES:

1. If the utility has put the client’s deposit refund onto the final account - this is money

that would go back to the client, if they were still in good standing with the utility. If

the utility will agree to transfer the deposit amount onto the new, or reconnected

account, this may be used to satisfy the GFE/CPR payment requirement. The entire

II.6

amount of the deposit refund payment must be counted as the GFE/CPR payment

(i.e., if the refund is $250, that’s the GFE payment amount, not $75).

2. No GFE/CPR payment receipt should be dated prior to the application date.

At the discretion of the LAA, a client phone call to the LAA with the GFE/CPR

receipt number is acceptable, especially for electronically communicating utilities.

The applicant has 15 calendar days from the GFE/CPR notice to pay the required amount

or be subject to denial after the appropriate deadline (or will be denied if funds are

exhausted, whichever is sooner). A procedure letter to the LAAs in April or May of each

year will establish the last date LAAs may accept missing documentation at the end of

the program year (15 days may be shortened, due to other program year close-out

requirements).

The Good Faith Effort may be waived with written permission from the Office of

Energy Assistance only in cases of extreme economic hardship, or when the applicant

did not have any previous primary and/or secondary service accounts during the past

90 days (starting with the application date) or has paid such bills in full. Extreme

economic hardship exists when the household’s source of income (that income that

would have been used to determine income eligibility) has been permanently

terminated for at least 30 days and a new source of income has not commenced.

Documentation of this condition must be received and verified by the agency before

the Reconnection Assistance payment may be processed. The GFE may be waived in

these specific instances; the CPR may never be waived. The client should make other

arrangements for payment of the CPR.

In summary, the Energy Assistance Program Reconnection Assistance specifics are:

• The household must be disconnected or in imminent threat of disconnection or

a verified threat of disconnection with a medical certificate.

• A “Does not pay own bills” household is not eligible for RA Assistance.

• RA must be provided in 48 hours; if life-threatening, assistance must be

provided within 18 hours.

• A DVP should be used first to attempt reconnection. If not successful, a

combination of DVP and Reconnection Assistance can be used. LAAs are to

negotiate as much as possible the reconnection of energy service. An RA

payment is not to be made if it does not result in reconnection. A DVP is not

to be made if it does not result in reconnection in combination with an RA.

• Only one primary and/or secondary RA payment per year.

• A Reconnection Assistance payment is the minimum amount needed to

secure winter energy services.

• The total amount of emergency benefit any one household can receive in a

program year is $750.

• Failure to make GFE/CPR payments will result in a denial of benefits.

II.7

• If the household is required to make a GFE/CPR, then the household will be

allowed at least 15 days to make the payment(s) (or the appropriate deadline

at the end of the program year, or until funds are exhausted, whichever is

sooner).

• Emergency funds cannot be used for tampering, or theft of service.

• Tampering charges must be paid by the household separate, and in addition to,

good faith payment.

• If the vendor is unsigned, send the payment in the form of a two-party check

to either the applicant or directly to the vendor.

• Regulated utilities are required to comply with the Illinois Public Utilities Act

as amended (Illinois Administrative Code 280) regarding reconnection of

service to Energy Assistance Program households.

B. Furnace Assistance Component

The State of Illinois Low Income Home Energy Assistance Program includes a Furnace

Assistance benefit program – the Furnace Assistance Component (FAC). An LAA’s Energy

Assistance staff takes the application, determines eligibility and verifies the benefit. The LAA’s

IHWAP staff conducts a heating system assessment and delivers the Furnace Assistance

Component benefit.

If the heating system cannot be repaired or replaced within the 18/48-hours, the LAA will make

alternative arrangements for temporary heat or relocation of the household (friend or relative’s

home, shelter, etc.) to a temporary location. Each agency is required to develop specific

written procedures to implement this emergency provision in an equitable manner.

Funds allocated to the Furnace Assistance Component of the program are allocated 2.5% of the

Federal Direct Client Assistance cost category 0201, and this limit will be monitored by the

LIHEAP.net system. The Furnace Assistance benefit will only be available to approved Energy

Assistance households that receive a LIHEAP (or PIPP, when available) benefit and whose

existing heating systems are not operational or have been red-tagged by their utility company.

There is NO IHWAP SIR Requirement for Furnace Assistance. If the home doesn’t have an

existing heating system neither LIHEAP nor PIPP funds can be used to install a new heating

system.

To receive Furnace Assistance, the applicant must have an approved Energy Assistance

application. A Good Faith Effort (GFE) or Client Portion Required (CPR) payment is not

required for receiving the heating system portion of Energy Assistance benefits. However, when

a GFE/CPR is required for restoration of utility service no heating system repair or replacement

work will be allowed on that unit until the GFE/CPR is paid and utility service restored. For

example, if a client is disconnected from utility service and the heating system is also red-tagged,

then the standard GFE might still apply to get the service reconnected before the furnace work

would be done. However, if the client has a non-working furnace but is still connected to the

utility service, then a GFE/CPR payment might not be required.

II.8

If the utility service is not restored (e.g., too much is owed, no GFE/CPR is made, etc.), no

heating system work will be allowed on that unit. The utility should be contacted to ensure the

household is not disconnected for nonpayment or other reasons prior to initiating the Furnace

Assistance Component benefits.

The Furnace Assistance Component will be entered on the LIHEAP.net system. On the Furnace

Assistance date of application, the LAA must note client information on:

a. Client Information and Furnace Assessment Worksheet (form)

b. App Comments on LIHEAP.net

c. Furnace section on LIHEAP.net and enter date of application in the activity section:

During the dates the furnace job progresses (from initial client contact through LAA Paid status)

the LAA must make Activity History entries, so other LAA staff or GMs will know the job status

at all times.

The Furnace Assistance Component will only be operated from October 1

through March 31

–

no Furnace Assistance applications should be taken after March 31

or before October 1

. The

goal of this component is to restore the heating system to safe and effective operation. In some

cases, simple repair such as a replacement fuse or thermostat may be all that is needed to restore

heat. Other repairs may be more extensive, requiring the replacement of gas valves, electronic

controls, blower motors, etc.

A heating system may be replaced if the existing system is unsafe or the repairs exceed 50% of

the cost of a new unit. If the Assessor and contractor (including LAAs who use weatherization

crews instead of contractors) determine the furnace must be replaced, the file must contain the

Furnace Replacement Justification Form with the contractor’s (or LAA crew member’s) written

affirmation of needed repairs vs. the new furnace costs to compare and validate repairs exceed

the 50% requirement; this must also coincide with the itemized invoice. If the costs of the

replacement heating system exceed the IHWAP Mechanical cost limits, then a waiver from OEA

Weatherization is required. Any work completed exceeding the mechanical cost limits that does

not have prior authorization from OEA is considered a disallowed cost.

This component is for homeowners or income-eligible landlords residing in their rental property.

Since landlords have a legal responsibility to provide heat to their tenants during the winter

months, renters are not eligible.

Home Ownership and Household Eligibility Documentation Examples:

Example 1: An adult daughter’s name is on a mother’s proof of ownership, but the

daughter does not live in the home, according to the applicant.

1. The LAA must obtain proof the daughter is not in the home (signed, dated

statement from mother and daughter: an official document showing daughter’s

current address, etc.).

II.9

2. The daughter must also complete a Building Owner Certification and Work

Authorization form.

3. If proof of residency and/or Building Owner Certification and Work

Authorization form are difficult to obtain, LAA must document that all possible

efforts toward establishing Energy Assistance household residents.

Example 2: A living spouse’s (or ex-spouse’s) name is on the proof of ownership, but

the (ex-spouse) according to the applicant is no longer in the home:

1. The LAA must obtain proof the spouse/ex-spouse is not in the home (signed,

dated statement from applicant and non-resident spouse/ex-spouse; some official

document showing spouse/ex-spouse’s current address and/or legal

separation/divorce papers, etc.).

2. Have the spouse/ex-spouse complete a Building Owner Certification and Work

Authorization form.

3. If proof of residency and/or Building Owner Certification and Work

Authorization form are difficult to obtain, LAA must document all possible

efforts toward establishing Energy Assistance household residents.

Example 3: The home ownership is part of a trust: The LAA must obtain proof of

validity of the trust, and proof of physical occupancy of the residence (signed, dated

statements, mail, ID card(s), statement from a school regarding enrollment

status/residency).

1. A representative of the trust should complete a Building Owner Certification and

Work Authorization form.

2. If proof of residency and/or Building Owner Certification and Work

Authorization form are difficult to obtain, LAA must document all possible

efforts toward establishing Energy Assistance household residents.

Notes: (1) A quitclaim deed is acceptable as proof of ownership as long as it is

notarized and filed with the county. (2) A Contract for Deed purchase is

acceptable as proof of ownership as long as it is notarized and filed with the

county.

Assessment/Final Inspection Fee:

The LAA may charge an assessment fee to the Energy Assistance Furnace Assistance component

to cover the costs of its weatherization staff’s Furnace Assessment and Final Inspection related to

administration of the Furnace Assistance Component. This fee will only be the actual costs of

salary, fringe benefits, travel expenses, and other related costs of the assessment and final

inspection. The assessment fee must not be based on comparable services by area contractors, or

designed so the agency can make a profit on the assessment and inspection, after expenses. The

Energy Assistance and IHWAP Coordinators must work with the LAA’s Fiscal Officer to

determine the hourly burdened wage. A folder containing these calculations for all applicable

LAA staff must be kept current, and must be easily accessible for OEA review.

II.10

The Assessor/Final Inspector Cost Allocation Worksheet must be used to specify what the LAA

is charging:

• The hourly burdened wage for time attributed to the Assessment or Final

inspection,

• The mileage to/from the furnace location at the Internal Revenue Service (IRS)

Business Standard rate (currently .57 cents per mile – When calculating mileage

round to the nearest whole number: .4 or less round down, .5 or greater round up.)

• Mileage is between LAA headquarters and the furnace job, or between

one home and another if more than one furnace is evaluated during a

work day.

• A separate worksheet must be used for each Furnace Assistance

job/application to calculate the allowable assessment fee and the final

inspection fee.

• Necessary lodging, if applicable, and/or

• Other costs directly associated with Furnace Assistance Assessment/Final

Inspection.

An Assessment and a Final Inspection must be completed on all Furnace Assistance households

receiving Furnace Assistance Component benefits. The LAA Assessor should attempt to

review the heating system jointly with the contractor. In the event the LAA Assessor cannot

meet with the contractor onsite, the LAA must provide justification in the client file. Trained

individuals with the equivalent level of IHWAP certified staff will conduct the Final Inspection.

There should always be a separation of duties, to ensure proper checks and balances. LAAs with

staffing issues must follow IHWAP procedures to request waiver of the requirement that

different staff perform the assessment and the final inspection. This includes describing the issue,

proposing the short-term solution, and including a staffing plan to achieve a permanent solution.

In order to meet the 18/48 hour requirement, a contractor may conduct the Assessment. The

reasons for using a contractor to conduct the Assessment must be documented in the client file.

This Assessment must include all IHWAP equivalent tests using flue-gas analyzers and

appropriate testing for carbon monoxide, fuel leaks, draft and spillage testing etc., Refer to

IHWAP Standards Manuals for additional testing requirements. All IHWAP documentation

(Contractor Checklist, Sizing Charts, etc.) must be included in the Energy Assistance client file.

All Furnace Assistance invoices must be date-stamped by the LAA on the day they are received.

After receipt of the invoice, a Final Inspection to ensure that all work was completed in a safe

and effective manner will be conducted within 15 working days from the date of receiving the

completed Work Order and Invoice from the contractor. All costs (labor, materials, assessment,

and inspection fees) will be charged to line 0201 in the Energy Assistance budget. Budget flex

may be utilized for this line in accordance with LIHEAP HHS Grant Agreement. Payment of

invoices for Furnace Assistance should not be disbursed until after the Final Inspection has been

signed indicating the work is complete and the job is closed.

II.11

Replacement Heating Systems:

If a replacement furnace is required, a 90% plus “two pipe” (sealed combustion) system must be

installed. These systems are the same specification as the current IHWAP guidelines. An 80%

plus system can be installed only when 1) there is sufficient reason as to why a 90% plus system

could not be installed, 2) the LAA has provided sufficient documentation as to why a 90% plus

system cannot be installed and 3) OEA Weatherization has approved its installation.

If an 80% plus system is installed in a location that uses a masonry chimney, a metal flue liner

must also be installed. A flue liner will also need to be installed for the water heater if a 90%

system is installed, and the water heater remains as a stand-alone (orphaned) unit. The heating

contractor must complete a heating system sizing calculation to ensure that a properly sized

heating system is installed. Copies of these calculations are to be contained in the Energy

Assistance file.

Health and Safety:

The Furnace Assistance Component benefit is funded at the minimum amount necessary to

restore heat and to ensure all combustion appliances operate safely in accordance with IHWAP

Health and Safety procedures.

An IHWAP Health and Safety review shall be done in conjunction with the assessment. All

Health and Safety problems that would normally be corrected with IHWAP funds to safely

restore heat, including gas leaks and improper venting of any combustion appliances, must be

corrected with Furnace Assistance funds. This would include gas leaks or venting adjustments

or correction to the water heater if needed. IHWAP approved smoke detectors and carbon

monoxide detectors will be installed as a part of the Furnace Assistance Component. All

allowable Energy Assistance Health and Safety work must be installed in compliance with the

current IHWAP Standards. However, IHWAP Health and Safety items such as moisture

reduction measures, ASHRAE 62.2 ventilation and the replacement of a water heater will not be

done with Energy Assistance Furnace Assistance funding. Fire extinguishers are not a LIHEAP

allowable Health and Safety expenditure

Mechanical Measures and Costs Limits:

The maximum costs limits have increased. The new guidelines and limits are as follows:

General Heating System $3,000 +90% EFE required

General Heating System w/AC (combo system) $5,500

Boiler/Conversion/Steamer $3,500

Boiler/Conversion/Steamer w/AC $6,000

Heat Pump $4,500 8.0 HSPF/14 SEER*

Mini-Split System $2,500 8.2 HSPF / 14.5 SEER*

* must be Energy Star Rated

When replacing a natural gas or propane furnace, a 90% efficient must be used whenever

possible. In residential building or mobile home installations where a 90% efficient unit is not

possible, a waiver must be requested and OEA must approve of an 80% efficient furnace.

II.12

In certain instances such as a home with no existing ductwork, special venting problems, or an

existing boiler system with complete radiator and pipe replacement, a case-specific cost waiver

may be applied for through your Weatherization Specialist with a Waiver form (Furnace

Assistance, Waiver Request form). The waiver request needs to include a description of why the

Furnace Assistance cost limits are not adequate, a detailed listing of the work that needs to be

done, a computerized heating system sizing calculation of the Manual J Type, and digital

photographs of the existing heating system, or problem.

Mechanical costs include all associated material and labor costs of cleaning, tuning, repairing,

retrofitting, or replacing a heating system. This would include but not be limited to labor and

material for: heating systems; distribution systems; parts; transitional plenums; ductwork; shut-

off valves; sediment traps; black pipe; black pipe connectors; HVAC electrical work; chimneys;

flues; flue liners; etc. Retrofits and repairs to a heating appliance shall not exceed 50% of the

cost to replace it. If the costs of the replacement heating system exceed the IHWAP Mechanical

cost limits, then a waiver from OEA is required (Waiver Request form).

Emergency HVAC work may be more expensive, especially, during weekends, holidays, or after

hours. If a measure exceeds the IHWAP costs, the agency will document the reason for the

charge, and attach it to the contractor’s invoice. The contractor’s invoice must clearly itemize

the labor and material costs by item.

The cost of the Health and Safety items (for example, smoke detectors, carbon monoxide

detectors, and water heater repairs such as correction/repair of gas leaks, damaged fuel lines, and

ventilation problems) needed for the safe restoration of heat are not included in the cost limit.

The cost of the Furnace Assessment and Final Inspection are not included in the cost limit.

There is a maximum cost limit of $600 for Health and Safety work. Health and Safety costs that

exceed the Energy Assistance maximum limit of $600 may be submitted for a review and

approval process on a case-by-case basis. ASHRAE 62.2 Ventilation Fans are

not an allowable

expenditure with Furnace Assistance Component funds.

Dual Heating Systems:

In rare circumstances individual LIHEAP (and PIPP, when applicable) homes may have multiple

heating systems. In an effort to restore heat to the home, if both heating systems can be made

operable with minor repairs, LIHEAP funds should be allocated for those repairs. If one heating

system can be made operable with minor repairs and one heating system requires replacement

due to 50% rule or the second system is in such a state of disrepair it requires replacement,

LIHEAP funds should be allocated for the repair and replacement. In instances where both

heating systems require replacement due to 50% rule or are in such state of disrepair only one

heating can be replaced utilizing LIHEAP funds, the heating system chosen for replacement

should be the one which is most advantageous to the client. Great care should be taken when

choosing the proper system to replace. Dependent on the dual heating zones, the appropriate

zone to be chosen would be the one that provides heat to an area that protects the client and other

utilities that may be compromised due to freezing temperatures, i.e., water.

II.13

When a multiple heating system is discovered and only one system can be made operational with

LIHEAP/PIPP funds, a priority referral and assignment should be made for IHWAP services.

Based on SIR driven requirements and structural need, IHWAP may be able to complete the

furnace needs and tighten the building shell to reduce the energy burden to the client.

All questions should be directed to your assigned LIHEAP Grant Manager or IHWAP Field

Specialist. All LIHEAP/PIPP/IHWAP heating system rules apply with exception to the IHWAP

SIR requirements for LIHEAP/PIPP furnace component.

All heating system work must be guaranteed for a period of one year. A Final Inspection of the

work performed is required and the Final Inspector must give a copy of the Final Inspection form

to the client, which is signed and dated. The original which contains post flue gas analyzer tape

attached, is kept in the client file. The completed Final Inspection form sets the date for the

guarantee and assurance period of one year from the date of Final Inspection or (one year from

the work complete date listed on the Assurance and Guarantee of Work form, if the Final

Inspector did not require any call-back work which must be documented with Weatherization

Callback/Rework Notice). The Final Inspector will insert the appropriate one-year date range,

signature, and Final Inspection date on the Assurance and Guarantee of Work form which was

received from the contractor; the original Guarantee goes to the homeowner and a copy is

retained for the LAA Furnace Assistance file.

NOTE: If the client remains inaccessible after repeated and well documented attempts to

conduct the Final Inspection, the “Final Inspection Attempt Letter” should be mailed to the

client. Sometimes this needs to be done to set a Final Inspection Date and close the job.

After Final Inspection, but within the same Program year, sometimes a client will report an

unforeseen problem with the Furnace Assistance job. Issues regarding the furnace that may not

necessarily be a contractor call-back or be covered under the contractor’s Assurance and

Guarantee of Work might involve some additional costs to a closed (LAA Paid) Furnace

Assistance job. This type of cost is rare, but is has happened that something was not assessed

properly or the repairs were not enough to keep an old furnace in safe operating condition (as

two examples). In this type of situation the Grant manager and IHWAP Specialist must be

notified and give consent prior to sending the LAA staff person back to the home (keep

documentation of consent in the client file). If needed, the Furnace portion of the application on

LIHEAP.net can be placed back into Pending Status for further data entry (up to the allowable

amounts and following the repair vs. replace guidelines, etc.).

The LAA must use approved IHWAP contractors and procure prices for this component without

reestablishing new bidding procedures or Energy Assistance may procure their own contractors

and prices separate from the Weatherization Program. In the event that IHWAP contractors

cannot be used due to the timelines for necessity of restoring heat to the client’s home, the LAA

can pay current market rate and select local licensed contractors to perform the work as long as

emergency procurement procedures are met.

Furnace Assistance Restrictions - No Furnace Assistance applications will be taken after

March 31

. No furnace work will be performed on any furnace in a household that has been

condemned or otherwise deemed uninhabitable by the State or any unit of local government or

by any department or subdivision of the State or local government. In addition, no work will be

II.14

done on any furnace in any household that is pending foreclosure or for sale within 90 days of

application date. The Furnace Assistance Component is limited to homeowners only. Central

heating systems in multi-family buildings are not eligible for the Furnace Assistance Component.

These situations can be referred to IHWAP.

Only one furnace replacement benefit per dwelling is allowed for a period of 10 years. An

example of this would be if a client received a new replacement furnace on November 12, 2005,

they would not be able to get an additional replacement furnace at the same address until after

November 12, 2015. The dwelling of an eligible household may receive furnace repairs once

each program year.

Agencies will need to keep a file listing the address of households receiving a furnace. It does

not matter if the home has previously received IHWAP assistance. In cases where the home has

not been previously weatherized, the Energy Assistance household should be immediately

referred to IHWAP for weatherization services. They will receive a special Energy Assistance

priority that will allow them to be weatherized ahead of other existing IHWAP clients if the

client has not received prior IHWAP services.

Deferral/Walk-Away Policy: The decision to defer Furnace Assistance or, in extreme cases,

provide no Furnace Assistance services, is difficult but necessary in some cases. The Deferral or

Walk-Away policy for a Furnace Assistance application will also follow IHWAP policy, as long

as it is Not SIR Related. As part of this Deferral or Denial process, the “Denial of Furnace Work

Letter,” and/or “Notice of Hazardous Condition Form” must be submitted to the client and a

copy must be included in the client file.

The Furnace Assistance section of the client file must contain the original document or a copy of

the following forms and documents:

• The Client Information and Furnace Assessment Worksheet (original)

• The home ownership documentation which may include, but is not limited to: a copy of

the deed; the property tax bill; mobile home title; a mortgage payment book coupon; an

authorization statement from the executor of a blind trust; a contract for deed; a quitclaim

deed, or other legal documentation on home ownership that has been filed with the

County Clerk.

• A Building Owner Certification and Work Authorization, signed by all owners (original)

• For furnace replacements, a Furnace Replacement Justification Form must be in each file.

This form is documentation and affirmation that comparison of the costs of needed repairs

exceed by 50% the cost of a new furnace costs –that the 50% rule is met. It is signed with

both the LAA Authorization and the Contractor/Crew member as affirmation (original).

• For furnace jobs that had an addition or deletion of work after initial assessment, there

must be a Change Order Request Form approved (signed) by the LAA and agreed to

(signed) by the contractor/crew member (original).

• A Manual J (or equivalent) sizing chart for all furnace replacements (original)

II.15

• If an 80% plus furnace was installed, the file must contain sufficient written explanation

as documentation of why a 90% plus system could not be installed, together with a copy

of approved Furnace Wavier Form (original).

• The contractor’s itemized invoice (original)

• The Mechanical Contractor Checklist (original)

• The Contractor Release of Lien (original)

• The Contractor Assurance & Guarantee of Work (copy with original to client)

• A completed IHWAP Inspection Detail Form (original, with copy to client)

• The final status Furnace page from LIHEAP.net, with “Activity history” details of job

assignments, Assessment/Final Inspection dates/staff, the check number for LAA Paid,

etc. (screen print)

• Energy Assistance Furnace Assistance Waiver Request form, if applicable (original)

• Notice of Hazardous Condition Form, if applicable (copy, original to client)

• Assessor/Final Inspector Cost Allocation Worksheet (original)

• Denial of Furnace Work Letter, if applicable (copy)

• Final Inspection Attempt Letter, if applicable (copy)

C. Cooling Assistance

LAAs will not operate a Summer Energy Assistance Program in the 2016 program year.

SECTION II

ENERGY ASSISTANCE PROGRAM BENEFITS

EXHIBITS

Map of Local Administering Agencies (LAAs) ........................................II.16

Map of Six Regions ...................................................................................II.17

Map of North/South Benefit Areas ..........................................................II.18

Energy Assistance Program Matrix North ................................................II.19

Energy Assistance Program Matrix South ...............................................II.20

Client Information and Furnace Assessment Worksheet ..........................II.21

Furnace Replacement Justification Form ..................................................II.22

Final Inspection Summary Report .............................................................II.23

Contractor Assurance and Guarantee of Work ..........................................II.24

Contractor Checklist ..................................................................................II.25-26

Contractor Release of Lien ........................................................................II.27

Building Owner Certification and Work Authorization ............................II.28

Energy Assistance Program Furnace Assistance Waiver Request ............II.29

Change Order Request Form .....................................................................II.30

Assessor/Final Inspector Cost Allocation Worksheet ...............................II.31

Denial of Furnace Work ............................................................................II.32

Notice of Hazardous Condition Form .......................................................II.33

Final Inspection Attempt Letter Sample ...................................................II.34

Callback/Rework Notice ...........................................................................II.35

II.16

II.17

II.18

0 % TO 50 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS NAT. GAS/OTHER PRIMARY $448 $448 $466 $501 $512 $530

SIZE INCOME INCOME SECONDARY $211 $211 $241 $270 $293 $315

1 $0 $490 TOTAL $659 $659 $707 $771 $805 $845

2 $0 $664

3 $0 $837 ALL ELEC. TOTAL $553 $553 $607 $666 $709 $758

4 $0 $1,010

5 $0 $1,184 PROPANE PRIMARY $546 $546 $568 $612 $625 $646

6 $0 $1,357 SECONDARY $315 $315 $378 $436 $470 $518

7 $0 $1,530 TOTAL $861 $861 $946 $1,048 $1,095 $1,164

8 $0 $1,704

9 $0 $1,877 FUEL OIL PRIMARY $546 $546 $568 $612 $625 $646

10 $0 $2,050 SECONDARY $315 $315 $378 $436 $470 $518

TOTAL $861 $861 $946 $1,048 $1,095 $1,164

CASH $130 $130 $140 $150 $160 $170

51% TO 100 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS NAT. GAS/OTHER PRIMARY $358 $358 $372 $401 $410 $424

SIZE INCOME INCOME SECONDARY $169 $169 $193 $216 $235 $252

$491 $981

TOTAL $527 $527 $565 $617 $645 $676

$665 $1,328

$838 $1,674

ALL ELEC. TOTAL $442 $442 $487 $533 $568 $605

$1,011 $2,021

$1,185 $2,368

PROPANE PRIMARY $437 $437 $453 $489 $500 $517

$1,358 $2,714

SECONDARY $252 $252 $302 $348 $376 $414

$1,531 $3,061

TOTAL $689 $689 $755 $837 $876 $931

$1,705 $3,408

$1,878 $3,754

FUEL OIL PRIMARY $437 $437 $453 $489 $500 $517

$2,051 $4,101

SECONDARY $252 $252 $302 $348 $376 $414

TOTAL $689 $689 $755 $837 $876 $931

CASH $104 $104 $112 $120 $128 $136

101 % TO 150 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS NAT. GAS/OTHER PRIMARY $269 $269 $279 $301 $308 $318

SIZE INCOME INCOME SECONDARY $127 $127 $145 $162 $175 $188

$982

$1,471 TOTAL $396 $396 $424 $463 $483 $506

$1,329

$1,991

$1,675

$2,511 ALL ELEC. TOTAL $331 $331 $364 $400 $425 $454

$2,022

$3,031

$2,369

$3,551 PROPANE PRIMARY $327 $327 $341 $366 $375 $388

$2,715

$4,071 SECONDARY $188 $188 $227 $261 $282 $312

$3,062

$4,591 TOTAL $515 $515 $568 $627 $657 $700

$3,409

$5,111

$3,755

$5,631 FUEL OIL PRIMARY $327 $327 $341 $366 $375 $388

$4,102

$6,151 SECONDARY $188 $188 $227 $261 $282 $312

TOTAL $515 $515 $568 $627 $657 $700

CASH $100 $100 $100 $100 $100 $102

2016 LIHEAP MATRIX - North

II.19

0 % TO 50 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS

AT. GAS/OTHER PRIMARY $391 $391 $407 $439 $451 $466

SIZE INCOME INCOME SECONDARY $178 $178 $204 $230 $249 $268

1 $0 $490 TOTAL $569 $569 $611 $669 $700 $734

2 $0 $664

3 $0 $837 ALL ELEC. TOTAL $459 $459 $508 $561 $597 $639

4 $0 $1,010

5 $0 $1,184 PROPANE PRIMARY $477 $477 $497 $536 $549 $568

6 $0 $1,357 SECONDARY $270 $270 $327 $376 $407 $449

7 $0 $1,530 TOTAL $747 $747 $824 $912 $956 $1,017

8 $0 $1,704

9 $0 $1,877 FUEL OIL PRIMARY $477 $477 $497 $536 $549 $568

10 $0 $2,050 SECONDARY $270 $270 $327 $376 $407 $449

TOTAL $747 $747 $824 $912 $956 $1,017

CASH $110 $110 $115 $125 $135 $140

51% TO 100 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS

AT. GAS/OTHER PRIMARY $312 $312 $326 $352 $360 $372

SIZE INCOME INCOME SECONDARY $143 $143 $164 $183 $199 $214

$491 $981

TOTAL $455 $455 $490 $535 $559 $586

$665 $1,328

$838 $1,674

ALL ELEC. TOTAL $367 $367 $407 $449 $476 $510

$1,011 $2,021

$1,185 $2,368

PROPANE PRIMARY $381 $381 $398 $429 $439 $455

$1,358 $2,714

SECONDARY $216 $216 $261 $301 $326 $359

$1,531 $3,061

TOTAL $597 $597 $659 $730 $765 $814

$1,705 $3,408

$1,878 $3,754

FUEL OIL PRIMARY $381 $381 $398 $429 $439 $455

$2,051 $4,101

SECONDARY $216 $216 $261 $301 $326 $359

TOTAL $597 $597 $659 $730 $765 $814

CASH $100 $100 $100 $100 $108 $112

101 % TO 150 % FUEL TYPE 123456 OR MORE

FAMILY 30 DAY 30 DAYS

AT. GAS/OTHER PRIMARY $235 $235 $246 $264 $270 $280

SIZE INCOME INCOME SECONDARY $106 $106 $122 $137 $149 $161

$982

$1,471 TOTAL $341 $341 $368 $401 $419 $441

$1,329

$1,991

$1,675

$2,511 ALL ELEC. TOTAL $275 $275 $304 $336 $357 $383

$2,022

$3,031

$2,369

$3,551 PROPANE PRIMARY $286 $286 $298 $322 $330 $341

$2,715

$4,071 SECONDARY $162 $162 $196 $225 $244 $269

$3,062

$4,591 TOTAL $448 $448 $494 $547 $574 $610

$3,409

$5,111

$3,755

$5,631 FUEL OIL PRIMARY $286 $286 $298 $322 $330 $341

$4,102

$6,151 SECONDARY $162 $162 $196 $225 $244 $269

TOTAL $448 $448 $494 $547 $574 $610

CASH $100 $100 $100 $100 $100 $100

2016 LIHEAP MATRIX - South

II.20

II.21

ENERGY ASSISTANCE PROGRAM FURNACE ASSISTANCE

CLIENT INFORMATION AND FURNACE ASSESSMENT WORKSHEET

CLIENT INFORMATION – COMPLETED BY LAA STAFF TAKING FURNACE APPLICATION

Energy Assistance Program Application #______________________

Client’s Name SSN

Address Date Time

Phone (____) ______ -________ Temperature at time of application: _______(qF)

Furnace Problems _________________________________________________________

________________________________________________________________________

Date All Documentation Received

Date Heat Restored

Is client the homeowner? Yes No

Ownership documentation

(attach to worksheet) ______________________________________________________

ASSESSMENT OF FURNACE CONDITION – COMPLETED BY ASSESSOR

NOTE: If a contractor is utilized to conduct the Assessment, the reasons must be documented in the client file.

Assessor Name Date

What is wrong with furnace?

Is the furnace operational? Yes No Comments:

Is the furnace red-tagged? Yes No Comments:

NOTE: If Furnace cannot be repaired, and it must be replaced, the “Furnace Replacement Justification Form” must be

thoroughly completed by the Assessor (or Contractor/Crew), including the cost comparison showing justification for

replacement. When additional parts or labor need to be added to the furnace job after the initial furnace Assessment, the

Change Order Request Form must be used in the same manner as with Weatherization jobs.

ASSESSOR’S DETAILED COMMENTS:

__________________________________________________________________________________________________

______________________________________________________________________

FURNACE COST

Repair $__________ (attach contractor’s Itemized Invoice)

Replacement $ ________ (attach Furnace Replacement Justification Form, including justification for

replacement, and contractor’s Itemized Invoice)

Furnace Contractor: ________________________________________________________

Agency Staff Signature:___________________________________________Date: ______________

II.22

FinalInspectionSummaryReport

ප

YesපNoප

PreWxCFMͲ50Reading:

CAZ1:

CAZ2:

CAZ3:

CFMͲ50TargetNumber

(ASHRAE62.2):

IntermediateReading:

FinalCFMͲ50Reading:

AtticZoneReading:

CrawlZoneReading:

OtherZoneReading:

RatedInput

AllrequiredTestingDone?:

Measured

If"No"explainwhy:

Draft/IWC

C/Oppm

FlueC/O2

Efficiency

 Date AdditionalSignature

Date

IamsatisfiedwiththeWeatherizationorEAFurnaceworkcompletedonthisdwelling?

Smoke

DetecͲ

tors:

FinalInspectorSignature

YesපNoප

Arealllaborhours,materialsused,andactualcostsaccountedfor?

ILLINOISHOMEWEATHERIZATIONASSISTANCEPROGRAM

&ENERGYASSISTANCEFURNANCECOMPONENT

Lite

Blubs:

CO

DetecͲ

tors:

Fire

ExtinͲ

guishers:

IhavebeenprovidedtheAssuranceandGuaranteeofWork by:

Ihavebeeninstructedinuseandmaintenanceofallitemsandmeasuresinstalledincluding

SmokeDetectors,C/ODetectors,andExhaustFans(ifapplicable)andprovidedwithequipment

manuals?

whichguaranteesthecompletedWeatherization/EnergyAssistanceFurnaceWorkforoneyearfromthe

FinalInspectionDate .Problemsthatoccuraftertheguaranteeexpiresorthatareunrelatedthe

Weatherization/EAFurnaceworkareacknowledgedastheresponsibilityoftheClient/Homeowner.

ToBeCompletedWiththeClient/Homeowner

YesපNoප

CheckhereifclientRefusedRemovalofStandͲAloneElectricSpaceHeater(s).Checkingthisboxservesasawaiverthat

theclientisacceptingpotentialhazardsresultingfromcontinueduseoftheelectricspaceheater.

Client'sSignature:_______________________________________________

Yesප Noප

WaseachbuildingsectionproperlyassessedandaddressedontheInputDocument?(N/AEAFurnace)

WaterHeater: HeatingSystem:

IsalloftherequireddocumentationintheClientFileandhasitbeenreviewed?

WasallweatherizationorEAfurnaceworkcompletedinaccordancewiththequalitycontrolstandardsand

specificationsassetforthintheIHWAPManuals?

Yesප Noප

YesපNoප

YesපNoප

WaterHeaterSystem:

Seconds

toDra

Seconds

toDraft:

HeatingSystem:

PostͲWeatherizationDiagnosticReadings(@FinalInspection)

Date:_________________________________

SpillageTestͲOut

Worse CaseDepressurization

FlueGasTestin

Number

Installed:

Comments:

Blower DoorReadings

N/AtoEAFurnace

ZoneReadings

Client Name:

obAddress:

IHWAP Jobnumber

orEAAppNumber:

Contractor(s)Name(s)

Other:(describe)

II.23

II.24

ENERGY ASSISTANCE - FURNACE ASSISTANCE

CONTRACTOR ASSURANCE AND GUARANTEE OF WORK

(to be given to the client at Final Inspection & a copy in the client file)

I, of the following firm,

Name

Guarantee the workmanship for installation of:

at ___________________________________________________________________________for

one year, beginning _____________________ and ending ________________________ in

accordance with manufacturer’s instruction and the American National Standards Institute (ANSI)

procedure.

Contractor’s Signature _______________________________

Work Complete Date _______________________________

Final Inspector’s Signature __________________________

Final Inspection Date ______________________________

NOTE: If the workmanship passed the Final Inspection, then the Work Complete Date starts the one

year guarantee. However, if there is a call back issue, the one year guarantee starts with the Final

Inspection date. The one-year period must be filled in by the Final Inspector. The original should be

given to the client/owner (mailed or hand-delivered, after a copy is made for the client’s furnace file).

II.25

II.26

II.27

ENERGY ASSISTANCE PROGRAM

FURNACE ASSISTANCE

CONTRACTOR RELEASE OF LIEN

WHEREAS, we the undersigned have installed materials and furnished labor and/or equipment for the

Furnace Retrofit project for:

________________________________________________________________

(Client’s Name & Address)

WHEREAS, all materials were installed and labor was furnished according to a written agreement

dated ____________________ between ______________________________

_______________________________________ (herein referred to as the LAA) and

_________________________________ (hereafter referred to as the contractor); WHEREAS, we the

undersigned have agreed to release any and all claims and liens which we have, or might have, against

the owner of said property, the occupier of said property, and the LAA by reason of the labor,

materials, and equipment furnished by us in connection with said Weatherization Project.

NOW THOSE PRESENT WITNESSETH that we, the undersigned, in consideration for the sum listed

on the contract and any attached change Work Orders, the receipt whereof we do hereby acknowledge,

do hereby release, remiss, and forever quit any or all manner of liens, claims, and demands whatsoever

which we now have, or might have in the future against the owner and occupier of said property and

the LAA.

_______________________________ _______________________________

(Company Name) (By)

Date Job Started: ____________________

Date Job Completed: ____________________

Failure to complete this form correctly could result in delay of payment.

II.28

ENERGY ASSISTANCE PROGRAM

FURNACE ASSISTANCE

BUILDING OWNER CERTIFICATION and WORK AUTHORIZATION

I, ____ , certify that I am the owner/authorized agent

(print name)

indicated (Documentation) for the property at

I further certify that I have given my permission to the weatherization agency or its

designated agent to allow work on the dwelling and/or primary heating system at the property listed

above in accordance with the following provisions (and such other particulars as may be attached to

this agreement).

I understand that all work that may be done to the primary heating system will be guaranteed for a

period not to exceed one year. After that time, I agree to be responsible for any related costs to the

primary heating system.

____________________ ______________________________

Signature Date

Homeowner Phone # ____________________

Landlord/Authorized Agent Phone # ____________________

Illinois Home Weatherization Assistance Program / Low Income Home Energy Assistance Program

Office of Energy Assistance State of Illinois Department Of Commerce and Economic Development

Check one:

___ Weatherization Mechanical Cost Waiver Request ___ Furnace Assistance Mechanical Cost Waiver Request

Costs exceeding mechanical cost limits without prior authorization from OEA will be disallowed.

Complete this request form in its entirety. An agency making an incomplete submission will be required to resubmit which will delay processing.

Agency:

Assessor: Date

Assessed:

IHWAP Job #:

Application #:

Funding

Source:

Contractor:

Contractor's

Address:

Client Name:

Client's Address:

Detailed Reason For Replacement

Please be clear, concise and thorough on the reason for replacement. This expedites the approval process. A detailed

cost breakdown of material and labor descriptions is required. Use your procured IHWAP approved catalog mechanical

prices. Include heating system make, model, and size and detailed work to be performed -no general classifications.

Detailed color digital photos of the existing conditions, clearly showing why the request is being submitted, are

mandatory. If duct work is required take photos of the existing ducts and/or lack of ducts. If no furnace is present, state

what was previously used to heat the home. LIHEAP funds cannot be used if there is no existing furnace/heating

system. A computerized Manual J heat load calculation is also required with this submittal.

Material / Labor Description QTY Material Labor

Total

Complete and Thorough description of Why waiver is needed:

Other Weatherization Measures to be completed:

R – September 2014

II.29

II.30

ENERGY ASSISTANCE PROGRAM

FURNACE ASSISTANCE

CHANGE ORDER REQUEST FORM

(for addition or deletion of work)

CLIENT NAME: ____________________ APPLICATION ID #: __________________________

The goal of Furnace Assistance is to restore the heating system back to safe and effective operation.

This is not a “furnace replacement program.”

NOTE: If the furnace must be replaced, a Furnace Replacement Justification Form (not a Change

Order Request Form) must be completed by the individual conducting the assessment.

THIS CHANGE ORDER REQUEST IS AN AGREEMENT BETWEEN THE UNDERSIGNED

CONTRACTOR AND _____________________________

(NAME OF LAA) TO APPROVE AND CARRY OUT

WORK THAT IS SUBSTANTIALLY DIFFERENT THAN THE ORIGINAL PROJECT SCOPE. BOTH

PARTIES UNDERSTAND THAT THE REQUESTED MATERIAL/LABOR CHANGES, AS

SPECIFIED BELOW, MAY ALTER THE PROJECT'S PRICE AND SCHEDULE. IT IS ALSO

UNDERSTOOD THAT ANY DIFFERENCES IN ESTIMATED COSTS DUE TO THIS CHANGE

ORDER WILL BE ACCOUNTED FOR IN THE REGULAR PAYMENT SCHEDULE.

EXPLANATION FOR ADDITION OR DELETION OF WORK:

Changes either adding or deleting material/Labor from the home will change the estimated total costs

on the work order. The Contractor (or Crew member) will contact the Agency and receive

authorization before making changes. The Contractor will manually calculate new costs at bottom of

this form to reflect the requested changes. The Contractor will provide all labor and material for the

following work:

__________________________________________________________________________________________

_____________________________________________________________________

Labor Costs: ______________ (Add/Deduct) Material Costs: _______________ (Add/Deduct)

Does Change Affect Schedule?

Ŀ Yes Ŀ No

New Estimated Completion Date, if applicable: _________________

Approved: __________________________________________ __________________________

Signature of Agency Staff Approving Change (Date)

Agreed: __________________________________________ __________________________

Contractor Signature or Crew Member Signature (Date)

II.31

ENERGY ASSISTANCE PROGRAM

FURNACE ASSISTANCE

Assessor/Final Inspector Cost Allocation Worksheet

Instructions: A separate worksheet must be used for each Furnace Assistance job/application to

calculate the allowable Assessment fee and the Final Inspection fee.

Complete each line or write N/A if not applicable:

Date: ___________________________

Assessment or Final Inspection (circle one)

Assessor/Final Inspector Name(s): _____________________________________________

Application Number: ___________________________

Burden Wages: ___________________________

Round trip Mileage ___________________________

Lodging: ___________________________

Other: ___________________________

Total fees: ___________________________

Comment or Description: _____________________________________________________

___________________________________________________________________________

Authorized by Agency Staff: _______________________________, _______________________

Name Title

Date

Enter this amount

on LIHEAP.net

II.32

DENIAL OF FURNACE WORK

Date

Applicant's Name

Applicant's Address

Dear

Your application for Furnace Assistance through the Energy Assistance Program has been

considered and determination was made that:

Heating system work cannot be done because repair, retrofit or replacement costs exceed the

allowable limits for our program. If you can obtain funding by _____________________

(date),

you will receive furnace assistance.

A required matching contribution for the cost of a replacement heating system was not made by

your landlord therefore no furnace work will be performed. If another source of funding can

be located for these activities by __________

(date), you will receive heating system

assistance.

Your heating system was determined unsafe and a required matching contribution for the cost of

a replacement system was not made by you or your landlord. It is the policy of the

weatherization program that no weatherization work be performed on housing units with unsafe

heating systems. If your landlord agrees to make the necessary matching contribution or

you can obtain another source of funding for these activities by ________ ,

(date)

you will receive weatherization assistance. Remember, you have a right to reapply for

assistance.

You have a right to appeal this decision by requesting an informal conference at our agency

within 30

days of this letter by contacting ________________________________________________.

Agency Representative

Sincerely,

(Agency Representative)

cc: Applicant's File

Enclosure: "Your Rights" brochure

II.33

II.34

SAMPLE FINAL INSPECTION ATTEMPT LETTER

Date:

Dear Mr./Mrs._______________:

Enclosed please find a final inspection form for the Weatherization Assistance or Energy

Assistance Furnace - Heating System work that was done to your home. We have made several

attempts to contact you to perform the final inspection on your home, but have not been able to

find you home.

Enclosed you will find a copy of the final inspection sheet; this form must be signed by you next

to the "X", and returned to our agency. If you wish, please make comments about the work that

was done. Please mail the signed form to our office in the enclosed self-addressed stamped

envelope. If the signed final inspection sheet is not returned by , we will

consider the work to be satisfactory and your file will be closed.

Thank you for your assistance and if you should have any questions, please contact the

Weatherization Office at ________________________________________________________.

Sincerely,

II.35

SECTION III

OUTREACH

SECTION III - OUTREACH

Outreach Responsibilities .................................................................................III.1

Outreach Plan ....................................................................................................III.2

Coordination and Referral Procedures ..............................................................III.2

Consumer Education .........................................................................................III.4

Publicity ............................................................................................................III.4

III.1

SECTION III

OUTREACH

Outreach is the agency’s first contact with a potential client. This contact may be as direct

as a walk-in client who has questions about energy assistance or as indirect as a person

reading an agency’s program flyer posted on the bulletin board at the local grocery store.

Agencies perform many outreach activities during the course of a normal day.

Outreach Responsibilities

Required by the grant agreement, agencies must carry out the following responsibilities

with regard to outreach:

• General information brochures and/or posters that include the agency name,

address, and telephone number will be disseminated throughout the service

area.

• Local offices of other energy-related agencies and low-income service

providers will be contacted to coordinate outreach/publicity efforts and to

implement referral mechanisms.

• Other groups, clubs, churches, schools and local units of government will be

contacted to coordinate outreach/publicity efforts.

• The offices of State and U.S. Senators and Representatives and other

officials such as township supervisors will be contacted to coordinate

referrals and publicity efforts.

• A news release about the program, which contains a program description,

eligibility criteria, and application procedures including a list of the

documentation that the applicant is expected to provide, will be developed

and utilized. Prior to sending press releases about the program, all LAAs

must submit a DRAFT to Maria.Gallardo@illinois.gov

, with a copy to your

Grant Manager. OEA staff will review the DRAFT and contact the LAA.

• Other local service agencies will be contacted to arrange sites for intake that

are preferably transportation accessible to disabled persons and visible at the

community level (i.e., senior centers, nutrition sites, etc.).

• Local resources such as DHS and community colleges will be contacted to

arrange for interpreters as needed.

• Where appropriate, door-to-door canvassing will be conducted to identify

potential applicants.

• Top priority will be placed on outreach efforts to seniors, disabled and low-

income minority heads of households, but without discrimination against any

other population groups.

To summarize, the agency must develop outreach procedures that ensure the eligible

population is aware of and has access to Energy Assistance Program benefits. It is

important that each agency develop a positive working relationship with groups in the

community that have regular contact with low-income populations.

III.2

Outreach Plan

Because proper outreach is so critical, agencies should devote time and effort to developing

an Outreach Plan. The plan should include the number and time commitments of outreach

staff employed by the agency, as well as, volunteers and other staff not employed by the

agency. An intake schedule should be devised that lists the sites, dates and times each site

will be taking applications. Also, a list of resources that can be contacted to arrange for

interpreters should be included. Training procedures for all outreach workers must be

devised and delineated in the Outreach Plan. Training guidelines should include times, size

of groups, handout materials, etc.

Coordination and Referral Procedures

The Illinois Energy Assistance Program is only one of several residential energy assistance

programs. Often a client who is not eligible for Energy Assistance may be eligible for a

utility-sponsored program such as “Add a Dollar,” “Share the Warmth,” “Rate Relief” or

“Dollar More”. The agency needs to be aware of these other energy assistance programs

and include such information in outreach materials.

In addition to making referrals to energy assistance programs, the agency should determine

other needs of the household and make the appropriate referrals to other low-income

service providers. For example, does the household know about and utilize

benefits/programs such as Circuit Breaker tax relief, SNAP (Supplemental Nutrition

Assistance Program), CSBG, IHWAP, Supplemental Security Income (SSI), senior

services such as Homemaker and Chore Service, nutrition programs, Head Start or other

local discount programs?

Adequate information should be available for agency staff to coordinate services and refer

clients responsibly at the local level. It is strongly advised that a directory of services be

compiled and routinely updated. The Service Directory should be developed for

distribution to both the outreach worker and the client. At a minimum it should include the

information below:

• program title

• program components

• eligibility criteria

• limitations on availability

• contact agency/person and phone number

III.3

A possible entry in the Service Directory could resemble the following:

PROGRAM NAME: Jaycees Neighborhood Repair Program

Contact Person: John Brown

Agency: Jaycees

Address: 2714 W. Elm, Center City, Illinois 60000

Telephone: 312/555-5678

Effective date: Ongoing

Eligibility criteria: Age 60 or over, must reside within Maple Grove

subdivision

Program description: At request of individual, Jaycees (volunteers) make

repairs/improvements on homes (interior and/or exterior);

up to $400 in materials may be used.

Finally, as a low-income service provider, the agency will regularly receive inquiries and

referrals from various agencies, hotlines and clients. The service directory will assist in the

proper routing of these calls. The following toll-free hotlines can be of assistance to you

and your clients.

HOTLINE

AGENCY

PURPOSE

800/252-8966

Illinois Department on

Aging

Senior Help Line

800/843-6154

DHS

Help Line-Cash, Medical &

SNAP

800/447-4278

HFS

Child Support Services

800/252-2873

DCFS

Child Abuse Hotline

800/524-0795

ICC - Consumer Service

Division

Concerns about ICC

regulated utilities

312/663-1522

Illinois Migrant Council

Assistance to migrant and

seasonal farmworkers

(MSFW) & their families

217/522-7016 (V/TTY)

CCDI – Coalition of

Citizens with Disabilities

Advocacy for disabled

individuals

800/669-5556

CUB – Citizens Utility

Board

Assistance in regards to utility

companies

877/411-WARM

(9276)

Keep Warm Illinois

• Households needing

home energy

assistance and

weatherization

• Energy cost savings

tips and tips to stay

warm, healthy and

safe during winter

III.4

Consumer Education

Consumer education should be predicated upon raising the Energy Assistance Program

applicant’s awareness about energy conservation by providing energy-saving tips and

related brochures; providing information about community-based resources; securing

affordable energy-saving appliances; referring Energy Assistance Program applicants to

community-based workshops and energy-related educational program sites; and

organizing energy conservation workshops.

It is recommended that agencies provide a consumer education packet for each Energy

Assistance Program applicant. Consideration should be given to developing materials

which explain/demonstrate energy conservation techniques. Furthermore, information to

help strengthen the Energy Assistance Program applicant’s financial literacy should also be

provided. This includes, but is not limited to, information on spending habits, priorities,

budgeting, and saving. This education effort could make the difference between the client

being able to pay the bill or being disconnected.

It is strongly advised that information about agencies such as the Citizens Utility Board

(CUB) which works for lower rates and better service from the state’s investor-owned

electric, gas and telephone companies be shared with the Energy Assistance Program

applicant. CUB’s website offers a wealth of information on the services they provide

and can be accessed by logging on to: http://www.citizensutilityboard.org.

In addition to CUB, information and frequently asked questions about Alternative Retail

Energy Suppliers (ARES) and Alternative Retail Gas Suppliers (ARGS) can be accessed

by logging on to: http://www.pluginillinois.org/faq.aspx

and

http://www.icc.illinois.gov/ags/faq.aspx.

Publicity

Good program publicity is critical. Whether your agency expends its funds in a month or

still has money left at the end of the year, a good publicity effort lets all potential clients

know when and where to apply for Energy Assistance. Furthermore, publicity aimed at the

general public lets the communities you serve know the good things you are doing— bad

news travels fast; good news takes an effort!

Agencies are encouraged to participate in activities that will educate the public and

publicize the program such as writing newspaper articles, giving presentations before

local organizations, doing presentations for children during classroom sessions or

assemblies, and participating in local cable television public service programs and

announcements.

SECTION IV

INTAKE

SECTION IV - INTAKE

Intake Strategy ..................................................................................................IV.1

Home Visits/Mail-In Applications ....................................................................IV.2

Special Accommodations..................................................................................IV.3

Locations for Outreach/Intake ..........................................................................IV.3

Scheduling Outreach/Intake ..............................................................................IV.4

Application/Eligibility ......................................................................................IV.4

Authorization to Apply .....................................................................................IV.4

Client Confidentiality Rights ............................................................................IV.5

Client Appeals Rights .......................................................................................IV.5

Section IV – Exhibits ........................................................................................IV.6

IV.1

SECTION IV

INTAKE

Each agency must establish an intake system that can collect the data needed to certify

that each applicant (i.e., each individual in the Energy Assistance Program household) is

eligible for energy assistance. The importance of the intake process cannot be

overemphasized. Agencies should examine different methods of taking Energy

Assistance Program applications so that a logical, systematic approach to serving clients

is developed. A well-handled intake system improves the efficiency of the program and

results in good public relations.

No applications are to be solicited, completed, or appointments scheduled prior to

the program start date.

Intake Strategy

The agency may develop its own procedures, but must meet the first come, first serve

criteria. In order to serve the client quickly and efficiently, and, paper applications must

be minimized accordingly. For the 2016 Energy Assistance Program, it will be even

more important to take on-line applications.

One or more of the following intake methods should be used:

• Taking applications at several sites

Different sites may be located throughout the county where applications are taken

three or four days a week. The site(s) may then be closed for the remainder of the

week to verify applications and reconcile the amount of funds remaining. This

procedure may be repeated until all dollars are obligated/authorized.

• Rotating sites around the county

Only one site would be open on any particular day. Continue rotating sites until all

funds are obligated/authorized. Under this system, the agency may elect to take

applications in its central office every day in addition to the other locations.

• Using a walk-in number system

The agency may elect to hand out numbers when a site is open for intake to

applicants as they enter. Applications are then taken in order. If applicants are not

present when their number is called, they will be bypassed and may pick up a new

number when they return. The agency may determine that a set number of

applications (e.g., 20) can be taken at a particular site on a given day, handing out

just that number. Or, the agency may continue handing out numbers as potential

IV.2

applicants continue to arrive, scheduling their application on the next day the site is

open.

• Take applications on an appointment basis

Applicants are assigned the first available appointment time convenient for them.

NOTE: The Department encourages LAAs to use two intake systems (appointment

and walk-ins) but it is at the discretion of the LAA to use their preferred method.

APPOINTMENTS MUST BE GIVEN WITHIN 60 CALENDAR DAYS OF THE

DATE THE APPOINTMENT IS REQUESTED. AGENCIES THAT UTILIZE

APPOINTMENT SYSTEMS MUST, AT A MINIMUM, TAKE APPOINTMENTS

AT LEAST FOUR DAYS PER WEEK AND ALLOW FOR WALK-IN CLIENTS

AT LEAST ONE DAY PER WEEK.

It is strongly recommended that the agency consider using an appointment system for at

least a percentage of their applications. It is especially useful in situations where there

are many applicants waiting to be served and in less populated areas where temporary

sites and periodic scheduling are used. In the first case, an appointment system reduces

the waiting time and provides better service for the applicants. In the second situation,

the agency knows the exact number of applicants it will serve and can predict the amount

of time and number of staff needed. The agency may also wish to use an optional

Appointment Form to assist in the application process. Agencies should also move to

automate their intake using LIHEAP.net to enter applications on site.

Home Visits/Mail-In Applications

Sites must be accessible to persons with disabilities in accordance with the Americans

with Disabilities Act (ADA); however, there are times when a home visit or the mail-in

application procedure may be necessary to serve an applicant. A home visit must be

made when:

• a relative or friend cannot make application on behalf of the applicant at a regular

site,

• the individual has stated the need for a special accommodation because of a

disabling condition, or

• all other methods for getting the individual to the site have been exhausted.

Home visits should be arranged on an appointment basis. Remember to telephone the

applicant an hour prior to the appointment to ensure the individual is prepared to have an

application taken.

If an applicant is homebound and has previously completed an Energy Assistance

Program application in the program year, no signature is needed for a subsequent

emergency application.

IV.3

CLIENTS WHO REQUEST HOME VISITS MUST BE SERVED WITHIN 60

CALENDAR DAYS OF THE REQUEST.

Mail-in applications occur when the LAA completes an application via telephone for the

homebound applicant. The LAA completes the top part of the application and a

documentation request form. Both forms, plus a self-addressed envelope, are sent to the

applicant who then signs and returns the application and documentation to the LAA for

verification. If the applicant cannot copy the documentation, refuses to send the

originals, or is not capable of understanding the mail-in procedure, a home visit will be

required.

Special Accommodations

Details for serving applicants with special needs must be worked out prior to the start of

the program. No application should be delayed because resources to assist the applicant

are not available. The following resources may be useful:

Deaf and Hard of Hearing Commission

217-557-4495 V/TTY

877-455-3323 V/TTY

Division of Rehabilitation Services

1-800-843-6154 English or Español

1-800-447-6404 TTY for callers who are

deaf or hard of hearing

IL Migrant Council

312-663-1522

Governor’s Constituent’s Assistance

Office

312-814-2121

Locations for Outreach/Intake

Permanent or temporary outreach sites should be located in all sections of the LAA’s

service area. They should be visible at the community level and be transportation and

building accessible to persons with disabilities. Possible outreach/intake sites may

include the LAA’s central and satellite offices, senior centers, nutrition sites, government

offices, churches or community facilities. Preference should be made for sites that

accommodate automated intake with LIHEAP.net.

If any organization other than the grant recipient provides outreach/intake services, it

must perform intake responsibilities according to the instructions in this manual. If these

services are free of charge, a Non-Financial Agreement must be signed by the Energy

IV.4

Assistance Program agency and the other organization. (Secure two signed copies of

every Non-Financial Agreement – one for the agency file and one for the vendor’s file.)

If the agency has to pay for these services, a subcontract should be established and noted

in the agencies grant application; or if added later, reported to the Department in writing.

Scheduling Outreach/Intake

The agency must determine a time schedule for each outreach/intake site. The agency

must have this on file for review. Additions or changes should also be put in the file.

This schedule must demonstrate that clients of the agency’s entire service area have equal

access to program benefits.

Application/Eligibility

When all documentation is not presented at the time of application, this further delays the

application process. LAAs should stress in press releases and other contacts with

potential applicants that all documentation needs to be available at the time of the

appointment, including the actual or utility projected budget bill amount. However, all

households must be given the opportunity to apply, whether or not applicants have all the

necessary information with them at the time of application. Furthermore, the applicant

has 15 calendar days from the Documentation Request notice to provide the missing

documentation or be subject to denial after the Documentation Request notice due date

(or will be denied if funds are exhausted, whichever is sooner). A procedure letter to the

LAAs in April or May of each year will establish the last date LAAs may accept missing

documentation at the end of the program year (15 days may be shortened, due to other

program year close-out requirements).

The standard LIHEAP/IHWAP application should be used. The application includes a

page for additional household members’ information. If there are additional members in

the household besides the applicant, this sheet must be completed for the applicant, and

each additional household member, and each household member’s information must be

entered into the LIHEAP.net system.

WITHIN 3 DAYS OF APPLICATION DATE, ALL APPLICATIONS

MUST BE ENTERED INTO THE LIHEAP.net APPLICATION

SYSTEM.

Authorization To Apply

For households with a bill, an adult household member or emancipated minor must be the

Customer of Record with the energy vendor. If the Customer of Record cannot make

application, another household member may make application on his/her behalf. If the

person making application is not a member of the immediate household, the applicant

must provide a written statement to the agency designating the person to apply on his/her

behalf, and giving permission for the application to be signed by that person. If the

IV.5

person providing the application information is not the applicant, that person shall sign

the applicant’s name, then his/her own name and indicate his/her relationship.

In the case of an eligible household with no bill, the applicant should be the head of

household and should sign the application. If the head of household cannot make the

application in person, the same rules outlined above apply.

In child custody issues (a child is claimed in one household and the other parent

subsequently comes in to apply stating the child resides with him/her), the first family

member that claims the child and provides proof of the child’s social security card at the

point of intake – the child shall remain on this application.

Eligibility for Energy Assistance Program is limited to households at or below 150% of

the federal poverty income level. The income test is based on the household’s gross

income for the past 30 days, beginning with the date of application. Applicants are

required to show proof of the household’s gross income through various documents

and/or affidavits. A discussion of acceptable documentation to substantiate gross income

follows in Section V.

Client Confidentiality Rights

Agencies are reminded that information provided and secured about applicants is

confidential and obtained only for use by the Energy Assistance Program.

Client Appeals Rights

Federal and State rules require that every applicant be educated on their right to appeal.

Appellant rights for LIHEAP are printed on the reverse side of the client’s copy of the

application and agencies should review this section with the applicant. A copy of these

rights can be found in Section VI – Exhibits, along with the client application. Appeal

rights are exclusive to the definition of applicant household.

SECTION IV

INTAKE

EXHIBITS

Non-Financial Agreement Form .................................... IV.6

IV.6

ENERGY ASSISTANCE PROGRAM

Non-Financial Agreement

This letter of understanding is effected between the ___________________,

Local Administering Agency for the Energy Assistance Program, hereinafter

known as the “LAA” and _______________________, contributing agency,

hereinafter known as the “agency” on this day of ___________, 20___.

The agency agrees to provide the following as a public service to the LAA:

_____________________________________________________________

___________without expectation of compensation.

This agreement is in effect until: __________________________________

Signature __________________ Signature _________________

Date ______________________ Date _____________________

LAA __________________________ Agency __________________

SECTION V

DOCUMENTATION

SECTION V – DOCUMENTATION

Income Documentation .................................................................................... V.1

Other Types of Documentation ........................................................................ V.9

Section V – Exhibits ......................................................................................... V.15

V.1

SECTION V

DOCUMENTATION

Income and component-specific documentation are required to determine a client’s

eligibility for assistance. Intake staff should be aware of all required documentation. The

Application File Checklist form is a double check system for all applicant files because it

clearly lists the documentation required in the file. This form helps guide the intake

process. Using this Application File Checklist is optional. The Local Administering

Agency may choose to create their own checklist, or they may manage their files without

one.

The receipt of all required documentation determines the start date for the Energy

Assistance Program time frames. Therefore, all documents should be dated upon receipt

(handwritten or date-stamped) and the date must be entered on the appropriate line of the

LIHEAP/IHWAP application form, or in the documentation section on LIHEAP.net, as

documentation is received.

Income Documentation

For a complete application, gross income documentation and/or affidavits must be

provided for each person in the household who has received income during the previous 30

days (beginning with the date of application). Gross income (before taxes or any other

deductions) must be used to verify income with limited exceptions. The main exception is

Social Security checks that have a Medicare deduction.

For income documentation (wages, Unemployment Compensation Benefits, SSA, SSDI,

etc.) which clearly indicates Child Support garnishment, the gross minus the garnishment

amount should be used as countable income. In addition, households with documented

Child Support payments (such as cancelled checks, a statement from the recipient, other

documentation showing the payments were made, etc.) will have these amounts deducted

from gross household income. In situations where a fixed income has recoupment, for

Child Support, Internal Revenue Service (IRS), or other garnishment, net income should be

budgeted; use net income with the exception of included taxes (if applicable). If the LAA

ever questions whether gross or net income should be used for the Energy Assistance

Program application the Grant Manager should be contacted.

If a household is on a fixed income (income that does not change), it is preferable to verify

the income using the award letter if dated within the same calendar year. If a fixed

monthly income amount does not fall within the specific 30-day timeframe, do not enter

the client as a zero income applicant: the amount of the regular fixed income must be

included with the application (in STARS/LIHEAP.net, and/or in the applicant file).

Examples of fixed income include:

• SSI

• SSA

V.2

• VA Benefits

• DHS Payments (TANF, AABD, RRA)

• Pensions

Acceptable types of documentation are:

• Check(s) or copy of the check(s) for above described examples of fixed income

• Check stubs (covering the 30 day period) that indicate payee, source, time period

and amount

• Statement of a person who cashes the checks i.e., currency exchanges, banks,

grocery stores

• Statement or affidavit from the source of the income such as employer, Social

Security Administration, Department of Human Services (or any State office),

Veterans’ Administration, Department of Labor, Township, etc.

• Proof of electronic deposit or on-line verification by Intake Worker using Intake

Worker’s Documentation Affidavit

• For SSA documentation, on the occasion when a benefit award letter and a current

bank statement don’t match, the bank statement amount should be used as the

countable income.

If an applicant does not have proof of gross income for the full 30 days, have the applicant

go to the source of the income(s) and have the source complete an Income Statement.

Provide forms for each source of income and have them returned directly to the agency by

the income source. Agencies may consider providing self-addressed stamped envelopes

for this purpose. If it is determined that the documentation, such as a check, cannot be

kept on file, either a copy should be made of the documentation or an Intake Worker’s

Documentation Affidavit should be filled out by the Intake Worker if it is not possible to

make a copy.

Multiple Applications

Verified income documentation will remain valid for 90 days. This policy is relevant if a

client returns to apply for additional Energy Assistance Program benefits. Additional

benefits are possible in the situations below:

• A client, who previously received a DVP, returns for RA benefits.

• A client, who previously received a DVP and a partial RA benefit, returns for

additional RA benefits to be paid to the other vendor.

• A client, who previously received a DVP and/or RA, returns for Energy Assistance

Program Furnace Assistance.

If the client’s first application was made within the previous 90 days, income eligibility

will not need to be redetermined. However, the Intake Worker will need to sign and

include a copy of the Eligibility Verification form and/or a copy of documents from the

first application attached to the current application in the client’s file. The agency files

V.3

and/or LIHEAP.net are to be checked and the record of income duplicated on the current

application.

NOTE: At the discretion of the LAA, a client phone call to the LAA to report Imminent

Disconnection or Disconnection, with a dated affidavit from the LAA staff on the

Eligibility Verification Form, may suffice as an RA application. The client does not need

to reapply in person within the 90-day income eligibility period if the household situation

is unchanged since initial application date.

Zero Income Adult vs. Zero Income Household

Zero Income Adult - If there is any income in the home (child support, a child's Social

Security or Supplemental Security Income, etc.), one Zero Income Affidavit, which lists

each adult without income, must be completed by the applicant. The standard expectation

is the applicant will thoroughly complete the Zero Income Affidavit form his/herself. If

the client has vision, literacy and/or comprehension challenges, he/she may request the

LAA Intake Worker complete the form on his/her behalf. If the LAA Intake Worker

completes the form, the signature and initials of both client and Intake Worker are

required. If the adult(s) state(s) they are living off the child's income plus SNAP (Food

Stamps), subsidized housing, etc., then a written statement on the Zero Income Affidavit is

sufficient.

Zero Income Household - Households where every member included on the application

is claiming zero income must provide supporting documentation (for each adult claiming

zero income). The applicant will be required to complete and sign the Zero Income

Affidavit form for household members age 18 or older. Supporting documentation

examples include, but are not limited to at least one of the following:

• Denial letter for Social Security benefits

• Denial letter for Unemployment Compensation benefits

• Denial letter for Workers’ Compensation benefits

• Proof of application for Department of Human Services program(s) such as Cash

(AABD/ TANF/GA), Medical Assistance, and/or SNAP (Food Stamps)

• The Verification of Assistance with Paying Household Bills form has been created

to facilitate consistent statewide efforts in documentation

• Proof of Subsidized Housing

Note: The LAA Intake Worker and/or Verifier must consider the composition of each

household as unique and ask how that household lives on zero income. The head of

household and any other adult applicants need to explain how the family is meeting its

needs and what efforts there are to rectify the situation other than the Energy Assistance

Program.

• If the zero income adult applicant states s/he cannot work because of disability, ask

if s/he has applied for disability and perhaps has a pending appeal and/or a denial

letter for benefits to provide as documentation. The LAA can recommend, or

V.4

require (if there is no other substantiating documentation), proof of application for

Social Security benefits.

• If there is work history based on the last date of employment and the last check

date on the Zero Income Affidavit, inquire about the receipt of or application for

Unemployment Compensation Benefits (UCB). The adult may need to apply and

provide proof of application for UCB, or can give documentation of being denied

benefits, or can provide proof the benefits have recently been exhausted.

• For an applicant stating s/he has been injured on the job and can't work, the LAA

can recommend, or require (if there is no other substantiating documentation), a

Workers' Compensation document for denied, exhausted, or ongoing benefits. A

doctor's statement within the past 90 days (beginning with the date of application)

that the client is not released for work may be appropriate substantiating

documentation.

• Always inquire and recommend an application for DHS benefits (Medical, SNAP,

Cash assistance) if the household contains children. The LAA may require the

adult to prove application for benefits, provide proof of ongoing benefits, or

provide DHS denial letter.

• Letter(s) of Support: If a Zero Income Household reports financial assistance with

bills from family members or friends, a “Letter of Support” may be provided by the

client to corroborate the statement. The Verification of Assistance with Paying

Household Bills form may be issued by the LAA for as many supporters from

whom the client receives assistance. For households who rely solely on such

support, the Verification of Assistance with Paying Household Bills form MUST

be received in a thoroughly completed status, or the application will be denied.

The LAA should also question the adult(s) about working for cash, doing odd jobs, yard

work, etc. Receiving cash for work performed is income. If the applicant attests to

receiving cash income, s/he can complete the Income Affidavit form. If the adult(s)

state(s) they are living on savings, the LAA may request a bank statement to show the bank

balance.

Department of Human Services

Cash payments from TANF, AABD supplemental payments, Transitional Assistance and

Refugee/Repatriate Assistance (RRA) are considered income. SNAP (Food Stamps),

medical assistance and cash payments made to providers on behalf of clients are not

income.

Recipients of TANF receive a Medical Eligibility Card. This card may be used to

determine the number of recipients in a family. However, an applicant should not be

denied if they cannot provide a copy of their medical card(s). Medical card(s) are not

required for Energy Assistance eligibility.

The DHS case ID number is divided in the following manner:

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Category DHS Local Office Basic Number

00 000 000000

The type of aid received is indicated on the medical card by the category codes:

Cash Assistance Medical Assistance Only

00 RRA 90

01 AABD 91

02 AABD 92

03 AABD 93

04 TANF 94

06 TANF 96

07, P3 GA – Chicago Only P# Outside City of Chicago

Due to the DHS change to an annual medical card (which no longer contains the DHS case

numbers, but it does contain each person’s “Recipient Identification Number”, or “RIN”),

the applicant must complete the Income Affidavit. In addition, LAAs must use one or more

of the following resources to verify receipt of income from DHS:

1-Table of Monthly Allowances-

Use the Table of Monthly Allowances to compute the 30-day income figure for TANF and

RRA recipients who do not have any other income. If there is other income claimed by a

TANF or RRA recipient, the monthly income allowances charts alone cannot be used to

verify income.

If the TANF or RRA recipient states s/he is not receiving the amount indicated on the

Table of Monthly Allowances charts, the agency must obtain verification from the

Department of Human Services using the DHS Verification of Income form, toll-free

phone number in Section VII, the DHS website, and/or the client’s statement. For further

information see Section VII.4 “Contacting DHS to verify income.”

2- DHS Verification of Income-

Due to the fact that AABD cash recipients may receive a different amount each month,

LAAs must have the client complete the Income Affidavit. If the recipient does not know

how much they received, a DHS Verification of Income form (or other means of

verification) must be used.

3- DHS Website-

The following DHS website links http://www.dhs.state.il.us/page.aspx or https://ebt-

link.illinois.gov/ilebtclient/login.recip may be utilized to verify a limited amount of DHS

benefit recipient information.

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Unemployment Compensation Benefits (UCB)

When an applicant has made an effort but is unable to provide all check stubs necessary to

document his/her unemployment compensation income for the 30-day period, use the

following procedure:

• Copy the existing unemployment check stub(s) as documentation.

• Ask the applicant to sign an Income Affidavit. Use this affidavit as documentation

for the missing check stub(s).

Do not count any Federal Supplement amount. Count and budget net UCB with the

exception of included taxes. Do not budget UCB “Deductions” (see UCB stub).

Use “Paydate” on UCB stub as check date for paper check, or add two days to allow for

funds availability on a UCB debit card.

Interest

The preferred documentation is a statement for the previous 30 days (beginning with the

date of application) using either a bank statement or the Income Statement. If an applicant

can obtain only an annual statement, divide the income amount on the statement by 12 and

use it as the 30-day documented amount.

Self-Employment

Self-employed applicants who want to use expenses as part of their income calculation

should complete the Self-Employed Income Worksheet that will calculate net income.

Ledgers, check stubs, receipts or other verification shall be used as documentation, and

copies must be kept in the client’s file. Expenses should be counted at the time they are

paid. A Net Loss on the Self-Employed Income Worksheet may not be used to off-set

income from other sources within a household.

Other Income

The following are also considered income and require 30-day documentation:

• Alimony

• Strike benefits

• Child Support

• Rental income

• Worker’s Compensation

• Sick pay

• Armed Forces allotments & allowances for housing, food and clothing (BAH on

paystub)

• Tips and gratuities; money received over and above payment due for a service

• Federal Black Lung Benefits

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• Annuities (a fixed sum of money paid to someone each year, typically for the rest

of their life; divide by the appropriate number to get a monthly amount when

applicable)

• Cash gifts (may be verified via Income Affidavit)

• Any income received for support of guardian and/or adopted child(ren)

• Educational Stipends (a periodic payment, especially a scholarship or fellowship

allowance granted to a student)

• Regular payments of an IRA (Individual Retirement Account) should be considered

income just like a pension

• Gambling proceeds and/or annual gross income should not exceed the annual 150%

income eligibility

• A one-time lump sum payment of lottery winnings must be divided by 12 months

to equal the 30 day income requirement

• Rental income is counted if applicant rents property outside his/her own household

or applicant shares his/her home, i.e., one household unit with a boarder, lodger

and/or renter who is NOT related



DO NOT DEDUCT ANY EXPENSES THE APPLICANT MAY CLAIM

FOR OPERATING THE PROPERTY, e.g., HEATING COSTS,

MAINTENANCE, etc.



DO NOT COUNT RENTERS AS HOUESHOLD MEMBERS OR

INCLUDE THEIR INCOME IN THE HOUSEHOLD’S INCOME

• Social Security income received for a spouse that resides in a nursing

home/assisted living facility that is not paid directly and completely to the facility

is countable income for the LIHEAP household"

• Other income, such as income from selling farm crops or livestock or similar bulk

product once a year, must be divided by 12 months to equal the 30 day income

requirement

• Commission checks that cover more than one month should be divided by the

appropriate number of months to equal the 30 day income requirement

The following are not considered income:

• Payments for Vocational Rehabilitation transportation and maintenance

• Reimbursement for other expenses incurred (such as for medical expenses)

• Payments made to others on the household’s behalf provided that such payments

were not directed by the household i.e., bills paid or purchases made by others

• Scholarships, subsistence amounts (BAS on paystub; an allowance paid to

Veterans while they pursue an educational or training program), GI Bill benefits

• Federal student aid (Grants or loans to undergraduate students made or insured

under programs administered by the Department of Education)

• Assets drawn down as withdrawals from a bank (or other financial institution);

such as, individual savings accounts, Reverse Mortgage, etc.

• Loans (including Student Loans)

• Sale of property

• Sale of house or car

V.8

• Sale of household items/assets at yard sales, on E-Bay, etc. is not income but is

proof of how all or part of the household’s monthly expenses were paid

• Tax refunds, including Earned Income Tax Credit (EITC) payments, whether

received as an advance payment with wages or as part of an income tax refund

• Gifts – in the form of non-cash assistance, i.e. food, clothing, rent, etc.

• One time insurance payments or compensation for injury

• Non-cash income

• One time payments e.g., Death Benefits, Circuit Breaker Benefits, Jury Duty,

retroactive child support, SSI, SSA, UCB, etc.

• Foster Grandparents/Senior Companion Stipend (Note: Do not count children as

household members); any payment to volunteers in programs under Title II of the

1973 Domestic Volunteer Services Act. Examples of these programs include RSVP

and Foster Grandparents

• Title V Senior Temporary Training Program; payments received from the

Community Service Employment Program funded under Title V of the Older

Americans Act (such as the Experience Works Program, formerly called Green

Thumb)

• Foster Parent Reimbursement (Note: Do not count children as household

members)

• Payments made under Title I of the 1973 Domestic Volunteer Services Act

(AmeriCorps VISTA, University Year for Action and Urban Crime Prevention

Program) are exempt if the person was receiving SNAP or cash benefits from

TANF, GA, or AABD at the time they joined AmeriCorps VISTA. (A temporary

interruption in SNAP/Food Stamps does not change the status of exempt

AmeriCorps VISTA payments.)

• SNAP benefits (Food Stamps)

• Income from employment through Title I, Workforce Innovation and Opportunity

Act (WIOA), including Job Corps

• Women, Infants, and Children Supplemental Nutrition Program (WIC) benefits

• Earned Income of dependent minors (children under 18 years of age)

• Reimbursements from the Uniform Relocation Assistance and Real Property

Acquisition Policy Act of 1970

• Earnings, allowances, and payments received under Title I of the National and

Community Service Act of 1990 are exempt. The programs in the act are:



Serve America,



Higher Education Innovative Projects,



American Conservation and Youth Corps Programs,



Community Service Programs, and



AmeriCorps State/National

• Any disaster relief payment made by federal, state, or local government, or by a

disaster assistance group

• Utility payments from a Public Housing Authority, whether paid directly to the unit

or to the utility company

• Payments to certain United States citizens of Japanese ancestry and resident

Japanese aliens and certain eligible Aleuts made under P.L. 100-383

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• Payments under P.L. 103-286 to persons due to their status as victims of Nazi

persecution

• Payments made to Veterans who receive an annual disability payment or to the

survivors of deceased Veterans who receive a onetime, lump sum payment from the

Agent Orange Settlement Fund or any other fund referring to Agent Orange

product liability under P.L. 101-201

• Money received from the Social Security Administration under a Plan to Achieve

Self-Support (PASS)

• Payments received under the Alaska Native Claims Settlement Act

• Additional payments received by military personnel for serving in a combat zone

• Monetary allowances for certain children of Vietnam War veterans (children born

with the congenital defect spina bifida and with certain birth defects)

• Tribal per-capita payments up to $2000 per person, per year, including payments

made out of income from tribal lands, payments made out of tribal judgment trust

funds, and any other source except gaming revenues

• Income derived from certain submarginal land of the United States that is held in

trust for certain Indian tribes

• Income received from the disposition of funds to the Grand River Band of Ottawa

Indians

• Payments by the Indian Claims Commission to the Confederated Tribes and Bands

of the Yakima Indian Nation or the Apache Tribe of the Mescalero Reservation

• Payments to the Passamaquoddy Tribe and the Penobscot Nation or any of their

members made under the Maine Indian Claims Settlement Act of 1980

• Payments of relocation assistance to members of the Navajo and Hopi Tribes made

under P.L. 93-531

• Matched funds that are deposited into an Individual Development Account (IDA)

from a unit of state or local government or through contributions made by a not-

for-profit entity are exempt income - funds deposited into the IDA remain exempt

as long as the IDA is maintained

• Payments made through the Victims of Crime Act of 1984

• Payments made under the YouthBuild Program (P.L. 102-550)

• Veteran’s Administration Pension Benefits for Aid and Attendance

• Life insurance proceeds (whether made in installments OR paid upfront)

• Money received from a Reverse Mortgage (but it can be used as proof of “regular

monthly support” for Zero Income applicants)

• One time withdrawal from 401K or retirement funds

• Income from work study programs

• National School Lunch Program (NSLP) free or discounted lunches

Other Types of Documentation

All applicants must provide a valid Social Security Number (SSN) in addition to income

documentation. A valid SSN is defined as a nine-digit number issued to U.S. citizens,

permanent residents, and qualified temporary residents by the Social Security

Administration.

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Three different types of Social Security cards are issued. The most common type contains

the cardholder’s name and number. There are also two other valid types of Social Security

cards used with the original purpose of tracking individuals’ accounts within the Social

Security program:

• One reads “NOT VALID FOR EMPLOYMENT”

• The other reads “VALID FOR WORK ONLY WITH DHS AUTHORIZATION”

(DHS – Dept. of Homeland Security)

Depending on the situation and type of benefit applied for, various other kinds of

documentation will also be needed. A description of the types of documentation used for

Energy Assistance Program intake follows. Head of household clients’ applications with

invalid Social Security numbers will be denied. Household members over the age of one

will also be required to have a valid SSN to qualify. NOTE: Each applicant must be a

resident of Illinois and either a U.S. citizen or a “qualified alien” as detailed in Section I of

this manual. LIHEAP HHS Information Memorandum published December 12, 2014

states: The income of all household members – regardless of eligibility – must be

documented, verified, and included in the calculation of the LIHEAP benefit amount.

Child Custody/Energy Assistance Application

When a child is claimed in one household and the other parent or family member

subsequently makes application stating this child lives in his/her household, the child shall

remain on the application of the first family member that claims the child as long as they

have provided proof of the child’s Social Security card at the point of intake.

Legal Names

For a new applicant or existing customers whose name does not match the Social Security

card and/or the utility customer of record, any of the following documents are acceptable

documentation for verification of a legal name:

• Social Security cards

• Driver’s License or Government-issued Photo ID

• Court documents

• Divorce papers

• Certificate of Marriage

The Affidavit of Legal Name(s) should be used to document a client’s use of more than

one name. This form links together a person with multiple variations of the same name.

All names (variations thereof) belong to the same person.

Social Security Numbers

The Intake Worker must ask the applicant for the Social Security numbers for all

household members. Hard copy proof must be obtained and may include a copy of the

Social Security card itself, a letter or print out from Social Security Administration, or any

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other form of government-issued identification that shows both name and Social Security

number. A TIN (Temporary Identification Number) is not an acceptable form of Social

Security documentation.

Social Security numbers of household members other than the applicant are to be collected

for data entry into LIHEAP.net; copies of Social Security number verification must be

included in the application file.

If the applicant does not have a social security number:

1. complete the application,

2. issue a Documentation Request Form for the missing Social Security number, and

3. encourage and assist the client in obtaining a Social Security number.

A documented Social Security number is required. For situations, such as I-360

PETITION, contact your Grant Manager so applicant eligibility can be arranged, when

possible.

LAAs must refer applications with fraudulent SSN(s) to the OEA Grant Manager. After

review, if enough evidence to support the suspicion of fraud is provided, the Energy

Assistance Program Manager may disqualify the household or individual members and

begin the recoupment process as described in Section VII, Correction of Client Benefit

Errors.

Proof of Responsibility for Energy Consumption

All applicants who pay their energy bills directly to the vendor must have a copy of one of

the following:

• Most recent primary and/or secondary energy bill

• Most recent bill stub/receipt

• Statement from the primary and secondary vendor

• An affidavit by the Intake Worker that one of the above materials has been

examined

The above must include Customer of Record name (adult household member or

emancipated minor name), address, account #, and rate code (if applicable). Only

residential, not commercial, accounts are eligible to receive Energy Assistance Program

benefits.

Good Faith Effort

To be eligible for Energy Assistance (DVP and/or RA), a disconnected or imminently

threatened client must make a Good Faith Effort toward paying his/her utility bill(s),

including payment of all Client Portion Required balances.

If the applicant’s payment history does not demonstrate good faith, the applicant will be

required to pay a $75 Good Faith Effort (GFE) payment to the utility or utilities that would

V.12

receive LIHEAP payments(s). Applicants may owe additional past due amounts above the

required $75; this balance is the Client Portion Required (CPR). All GFE/CPR payments

must be made in full prior to receiving any Energy Assistance benefit (DVP or RA).

The Department of Commerce and Economic Opportunity will implement the Good Faith

Effort (GFE) /Client Portion Required (CPR) requirement as follows:

DCEO and/or the LAA will look at the LIHEAP applicant’s payment history. If the

application includes both utilities or if the electric utility is the primary vendor, then the

client payments to vendor(s) in the previous 90 days (beginning with the application date)

must be at least 10% of the 30-day household gross income multiplied by 3. If the

payment history does not demonstrate the required percentage of payments has been made,

then the applicant will be required to pay a GFE and/or CPR.

The preferred method of payment for the $75 is cash or money order at the utility’s

authorized payment center, however receipts from other forms of payment should also be

accepted. If the applicant presents a receipt to verify his/her GFE/CPR payment, the LAA

will enter/save into LIHEAP.net: 1. the total amount paid, 2. the receipt

number/transaction number and date of the payment. The LAA will then continue

processing the application. Or, if a utility reports through LIHEAP.net that the GFE/CPR

payment has been made, the LAA can continue processing the application. The LAA must

enter the exact payment amount made by the client towards their GFE/CPR, instead of

entering only $75. LAAs must negotiate the restoration of service as much as possible.

Regulated utilities are required to comply with the Illinois Public Utilities Act as amended

(Illinois Administrative Code 280) regarding reconnection of service to Energy Assistance

Program households.

IMPORTANT NOTES:

1. If the utility has put the client’s deposit refund onto the final account - this is money

that would go back to the client, if they were still in good standing with the utility. If

the utility will agree to transfer the deposit amount onto the new, or reconnected

account, this may be used to satisfy the GFE/CPR payment requirement. The entire

amount of the deposit refund payment must be counted as the GFE/CPR payment (i.e.,

if the refund is $250, that’s the GFE payment amount, not $75).

2. No GFE/CPR payment receipt should be dated prior to the application date.

At the discretion of the LAA, a client phone call to the LAA with the GFE/CPR receipt

number is acceptable, especially for electronically communicating utilities.

The applicant has 15 calendar days from the GFE/CPR notice to pay the required amount

or be subject to denial after the appropriate deadline (or will be denied if funds are

exhausted, whichever is sooner). A procedure letter to the LAAs in April or May of each

year will establish the last date LAAs may accept missing documentation at the end of the

program year (15 days may be shortened, due to other program year close-out

requirements).

V.13