Medical Equipment Energy Usage Assistance Program (MEEUAP)

Medical Equipment Energy Usage Assistance Program (MEEUAP) is sponsored by Imperial Irrigation District (IID). This program provides reduced rates on electricity for individuals who rely on medical equipment at home. While not a direct grant for equipment, it assists with the ongoing cost of operating essential medical devices.

Imperial Irrigation District Energy Consumers Advisory Committee Agenda Report FROM: Robert N.

Fugett, general superintendent, Customer Service SUBJECT: Customer Assistance Programs - 2018 Changes to Income Guidelines and Program Materials ____________________________________________________________________ Staff Recommendation/Motion: Staff seeks the ECAC’s recommendation for board approval of the revised 2018 income guidelines and program materials for the customer assistance programs.

Customer assistance programs are funded by a 2. 85 percent Public Benefits Charge that is billed to all IID customers that consume electricity.

IID provides two residential income assistance programs for qualifying low-income customers: (1) Residential Energy Assistance Program, which provides income qualified customers with a discount on their energy bill; and (2) Emergency Energy Assistance Program, which offers financial assistance to customers facing disconnect for non-payment.

The income guidelines for IID’s low-income programs are based on 175 percent of federal poverty guidelines, which are updated and published each year in the Federal Register . Based on recent changes, staff has updated IID’s 2018 income guidelines and streamlined the application.

IID also provides one medically qualified customer assistance program: (3) Medical Equipment Energy Assistance Program (MEEUAP), which provides a discount for residential customers who use prescribed in-home medical equipment to sustain life or prevent deterioration of the person’s medical condition. 63 RESIDENTIAL ENERGY ASSISTANCE PROGRAM For more information on REAP, please contact IID or visit our website at www. iid.

com/reap. 1-760-339-9032 (REAP Representative) • 1-800-303-7756 (Customer Service) Imperial Irrigation District’s Residential Energy Assistance Program (REAP) provides income-qualifying customers with a 20 percent discount on their electric bill. IID also offers a 30 percent REAP discount to qualifying seniors age 65 or older.

Participants who are 65 or older will need to reapply for REAP every two years, while all other participants must reapply annually. It is the customer’s responsibility to renew the application. The income guidelines are as follows: To establish eligibility you must complete the enclosed application and return it, along with any supporting proof of income (such as pay stubs, Social Security statements or other income information).

This is required for each adult in residence. Applicants may receive the discount only after IID verifies the application. The applicant must be the customer of record with IID and cannot be claimed on another person’s Income Tax Return as a dependent.

1. Complete and sign application (also available for download at www. iid.

com/reap ). 2. Fill out IRS Form 4506-T for income verification (only for new applicants).

3. Provide proof of income verification (for each adult in residence). 4.

Submit completed application, along with supporting documents, to customerservice@iid. com or mail to IID (pre-paid mailer enclosed). You can also apply at the following Customer Service Centers: Maximum Household Income (Effective as of January 1, 2018) No. of Persons in Household Total Combined Annual Household Income Each additional person $7,315 # IID A century of service.

• To avoid interruption of your discount, it is recommended that you apply 6-8 weeks prior to your renewal application deadline. • Your primary residence must be in IID’s service area. • You must provide information requested within 10 working days or the application will be void.

• This program is subject to funding availability and may change • Account must be in good standing to qualify. You Do Not Qualify for REAP if: • You have multiple residential accounts. • You have a commercial account (except domestic water pumps).

• You do not meet the income guidelines. • Your account has been assigned for collection. • You have history of unauthorized and unmetered energy • Other restrictions may apply.

64 RESIDENTIAL ENERGY ASSISTANCE PROGRAM APPLICATION CUSTOMER INFORMATION (Entire application must be completed and signed. Please print clearly.)

IID Service Account Number (or name of mobile home park, if applicable): Name (as shown on your IID bill) Last Four Digits of SS# DOB Telephone Number Email Address (optional) Number of persons in my household (include yourself, other adults and children): Adults Children Total combined gross annual household income (total amount you receive before taxes): The definition of “gross annual household income” is all money and non-cash benefits, from all sources, both taxable and non-taxable, before taxes and all deductions for persons who live in my home.

This includes, but is not limited to, the following: Please check ( ) ALL sources of your household income. I certify under penalty of perjury under the laws of the state of California that the information I have provided in this application is true and correct. The IID bill is in my name.

I understand this application does not guarantee my participation in the program. I am not claimed on another person’s income tax return. I agree to provide proof of my household income if requested by IID.

I understand that IID may require me to submit a completed IRS 4506T form for income verification with the Internal Revenue Service. I, the account holder/applicant, live on the premises. I agree to inform IID if I no longer qualify to receive the discount.

I understand that when I receive any discount or benefit without meeting the qualifications for it, I may be required to pay back the discount I received. o Wages, Salaries & Commission o Alimony/Spousal/Child Support o W-2 or 1099M Form(s) from Employers > THIS IS A LEGAL DOCUMENT # IID A century of service. Status Discount Amount Initials Date FIRST-CLASS MAIL PERMIT NO. 2 IMPERIAL, CA # IID A century of service.

> Please fold on the dotted lines, seal and mail the completed application to IID. > No postage is necessary . Use tape to seal –no staples!

66 This page is intentionally left blank . FOR OFFICE USE ONLY Customer Account Number Qualifying Medical Equipment Usage kWh per month Effective Dates Approved/Denied By: Any incomplete or false information on this application may cause IID to postpone, deny or stop the Medical Equipment Energy Usage Assistance Program (MEEUAP) rate to customer.

Applicants will receive the program rate once the application is approved by IID, no retroactive benefits will be afforded to the customer. IID reserves the right to visit your home (or your tenant’s home) during reasonable hours to verify the information on this application.

If you refuse to allow IID to visit your home (or your tenant’s home) to verify the information on this application, IID may not grant, or may discontinue, the Medical Equipment Energy Usage Assistance Program allocation.

You must agree to let IID Energy know if any of the following occur: • The person with the qualifying illness no longer lives with you (or your tenant) • The equipment or hours of use change • The equipment is no longer used in your home (or your tenant’s home) • You move to another address and want the program applied to your new address When complete, please mail this application to: Imperial Irrigation District, Medical Equipment Energy Usage Assistance Program P.

O. Box 937 Imperial, CA 92251 PART 1: TO BE COMPLETED BY CUSTOMER. (Entire application must be completed and signed.

Please print clearly.) Name (as shown on your IID bill) Customer Account # Name of Patient Relationship to Customer Name of Tenant Telephone Number Name of equipment Full name of manufacturer A/C Tonnage Watts Volts Amps Hours/Days of use For electricity paid by property owner (master meter accounts): Provide the following information for each piece of equipment (found on the manufacturer data plate).

Please do not abbreviate the name of the equipment or its manufacturer. Please use an additional sheet if you need more space. # IID A century of service.

Do you have a backup generator, battery pack or other equipment for life support or mobility in case of a power outage? Although Imperial Irrigation District will make every effort to supply uninterrupted service, continuous service cannot be guaranteed. In the event of a power outage, patients requiring the use of life-support equipment are responsible for providing their own backup power system.

Program participation does not guarantee service on delinquent or past due accounts. Yes -- How many hours of backup will it provide? No 67 PART 2.

TO BE COMPLETED BY LICENSED MEDICAL DOCTOR OR DOCTOR OF OSTEOPATHY The patient medically requires increased heating and/or cooling and has one of the following: During a service interruption, if your patient did not have a backup system, how long could your patient survive without using the life-support equipment that you describe?

Paraplegia Hemiplegia Quadriplegia Multiple Sclerosis Scleroderma Life-Threatening Illness Compromised Immune System Electric Nerve Stimulator Heating Device for Respirator Infusion Pump/Hyperalimentation Motorized Wheelchair (Battery Charging Unit) Portable Volume Ventilator What life support equipment does your patient need to use regularly?

Is this equipment neccesary to sustain, restore, or supplant a vital function, or permit mobility? How long (months/years) do you think patient will need equipment? Hours -- How many?

Days -- How many? Why is the use of this equipment essential to sustain life or enhance mobility? Name, address, telephone and license number of physician: Name M.

D. /D. O.

(Circle One) Business Telephone Number Business Address City State Zip Code I hereby certify that the above information reflects my medical judgement regarding this patient’s needs for equipment necessary for life support or mobility. Signature of M. D.

/D. O. Date California Doctor’s License Number or Military License Number 68 www.

iid. com # Customer Assistance Programs # 2018 Income Guidelines and Applications ## General Superintendent, Customer Service ## October 2, 2017 69 www. iid.

com # IID Public Benefits Charge # Program Budgets Customer Assistance Programs 2018 Budget ## REAP 4,900,000 $EEAP 1,300,000 $MEEUAP 84,000 $Admin Cost 453,000 $ 1) 38 percent of REAP customers are seniors (30 percent discount). 71 www. iid.

com # Changes to Income Guidelines # Streamlined Application & Web Page # • EEAP is available to REAP participants facing disconnect ##  Customers must be a REAP participant ##  IID pledges available once per quarter • Up to $75 74 www. iid.

com # • Discount percentage based on life -sustaining medical # • Requires annual medical certification # • HVAC discount is currently seasonal (summer / winter) # • Moving forward 12 -month discount for 2018 This page is intentionally left blank .