Utility assistance intake questions for healthcare advocates

Quick summary

Maintaining essential utilities such as electricity, heating, water, and phone service is more than a financial concern. For many individuals, it is critical to health and safety. Loss of service or unsafe indoor temperatures can quickly increase risk, particularly for those who rely on power for medical equipment, refrigerated medications, adequate lighting, or reliable communication.

For healthcare advocates, targeted intake questions can help identify urgent risk, collect the necessary documentation upfront, and connect individuals to the most appropriate utility assistance options. For patients and caregivers, this guide outlines what to expect during the intake process so they can prepare in advance and access support more efficiently.

Introduction

Utility costs are a common source of stress, especially for older adults, people with chronic conditions, and families on fixed incomes. Research and federal reports describe “energy insecurity” as situations like struggling to pay an energy bill, receiving a disconnection notice, keeping the home at unhealthy temperatures to reduce costs, or having to cut back on other necessities to cover energy expenses.

A strong intake does two things at once:

• It protects health by flagging immediate danger early.
• It improves outcomes by collecting the details and documentation assistance programs typically require.

This article gives you a practical intake framework and question bank you can use in healthcare advocacy settings.

Why utility stability is a health issue

Utilities support basic conditions for health at home:

• Safe indoor temperature. Extreme heat can lead to heat illness. Cold exposure can lead to hypothermia. Older adults and people with certain health conditions are often at higher risk.
• Electricity-dependent care. Some home medical devices rely on electricity. A power outage can interrupt treatment, oxygen delivery, breathing support, feeding support, mobility devices, or communication access.
• Medication and food safety. Some medicines and medical supplies must be stored within specific temperature ranges. Many people also rely on refrigeration for safe food and specialized nutrition.
• Water access and hygiene. Safe water supports hydration, sanitation, hand hygiene, wound care, and safe food preparation. Losing water service or having unsafe water can create urgent health concerns.

If you uncover immediate health risk during intake, your first priority is safety planning and escalation.

How to use this intake guide

Use this structure in order:

1. Quick safety screen to identify urgent risk in minutes.
2. Core intake questions to understand the household, the account, and the barrier.
3. Documentation checklist so applications do not stall.
4. Program matching so you pursue the highest-impact option first.
5. Follow-up questions to confirm progress and reduce repeat crises.

This guide is intentionally general because utility rules and program requirements vary by state, locality, and utility provider.

Step 1: Quick safety screen

Start with direct, time-sensitive questions. Keep these short and easy to answer.

Immediate safety and urgency

Ask:

• Are any utilities off right now (electricity, gas, water, heating fuel delivery, phone or internet)?
• Do you have a shutoff notice, or is shutoff scheduled within the next 72 hours?
• Is your home currently too hot or too cold to stay safe?
• Do you have access to a safe place to go today if the home becomes unsafe?
• Are there infants, older adults, or people who are pregnant in the home?

If yes to any, shift to urgent planning and same-day action steps.

Electricity-dependent medical needs

Ask:

• Do you use any medical device that requires electricity (for example oxygen equipment, breathing devices, suction, feeding equipment, mobility charging, home monitoring)?
• Do you have backup power (battery, generator, alternate location) for that device?
• Would you be at risk if the device stopped for even a short time?
• Do you have a written plan for what to do during a power outage?

If electricity is required for health-sustaining equipment, treat this as high priority and coordinate a rapid plan.

Heat illness and cold exposure red flags

Ask if anyone currently has symptoms such as:

• Confusion, fainting, severe weakness, or very high body temperature in heat
• Shivering that will not stop, confusion, extreme sleepiness, or very low body temperature in cold

If you suspect severe heat illness or hypothermia, advise urgent medical evaluation based on your organization’s protocol.

Step 2: Core utility assistance intake questions

Use the categories below as a reusable question bank. You can tailor wording for your setting and time.

Household basics

Ask:

• What is your name and the best phone number to reach you?
• What is the service address, and is it the same as your mailing address?
• Who lives in the home, and what are their ages?
• Who should be contacted if we cannot reach you?
• What language do you prefer for calls and documents?

Utility services and accounts

Ask:

• Which services are you responsible for: electricity, gas, heating oil or propane, water, sewer, trash, phone, internet?
• Which services are included in rent or paid by someone else?
• Who is the account holder for each utility?
• Do you have the account number(s) and the most recent bill(s)?
• Are you in a multi-unit building, and does the account cover more than one unit?

Current status and timeline

Ask:

• Are services currently on, reduced, or disconnected?
• If there is a shutoff notice, what is the shutoff date?
• What is the amount past due, and what is the total balance?
• Have you already set up a payment plan? If yes, what are the terms?
• Has the household received a final notice, disconnection warning, or reconnection fee estimate?

Health risk and medical vulnerability

Ask questions that connect the utility issue to health, without requiring the person to “prove” their illness to you.

Ask:

• Does anyone in the home have a condition that makes extreme heat or cold more dangerous (for example heart disease, lung disease, kidney disease, diabetes, or mobility limitations)?
• Does anyone use electricity-dependent medical equipment at home?
• Does anyone need refrigerated medications or temperature-sensitive supplies?
• Does anyone have home health services, dialysis schedules, oxygen needs, or limited ability to leave home quickly?
• Who is the prescribing clinician or primary clinician who could verify medical need if required?

Housing and home environment

Ask:

• Do you rent or own?
• If you rent, is the utility in your name, the landlord’s name, or bundled into rent?
• What is the primary heat source and how is it powered?
• Is the home weatherized adequately (drafts, broken windows, poor insulation, unsafe heating methods)?
• Are there building issues that affect health (mold, leaks, broken heating or cooling equipment)?

Income and benefits snapshot

Keep this respectful and practical. Explain that many programs use income and household size to determine eligibility.

Ask:

• What is your approximate monthly household income?
• What are the sources (work income, Social Security, SSI, SSDI, pension, unemployment)?
• Has your income changed in the last 60–90 days?
• Do you receive any benefits that often support eligibility (for example Medicaid, SNAP, SSI, TANF)?
• Do you have any recent pay stubs, benefit letters, or award notices?

Previous assistance and barriers

Ask:

• Have you applied for energy assistance or weatherization before? If yes, when and what happened?
• Have you been denied in the past? Do you know why?
• What has made it hard to apply or follow through (transportation, internet access, disability, caregiving demands, language)?
• Do you need help uploading documents, mailing forms, or attending appointments?
• Are you comfortable with us contacting agencies or the utility company with you or on your behalf?

Communication access and safety planning

Ask:

• What is the best way to contact you (phone, text, email, mail)?
• Do you have reliable phone and internet access right now?
• If the power goes out, do you have a plan to charge your phone or reach help?
• Is there anyone in the home who would need an accessible format (large print, hearing support, interpretation)?

Consent and coordination

Ask:

• Do you give permission for your advocate to speak with the utility provider, community agencies, or your clinician’s office about this issue?
• Is there anyone else you want included in calls (caregiver, family member, case manager)?

Step 3: Documentation checklist

Many programs move faster when documents are ready at the start. Requirements vary, but these are commonly requested.

Identity and household

• Photo ID for the applicant
• Proof of address (lease, mail, recent bill)
• Household member list (names and ages)

Utility information

• Most recent bill(s) for each utility
• Account number(s)
• Shutoff notice or disconnection letter if applicable

Income and benefits

• Recent pay stubs or income statements
• Social Security, SSI, SSDI, pension, or unemployment documentation if applicable
• Proof of enrollment in benefits that may support eligibility

Medical documentation when relevant

Some households benefit from medical documentation when utilities affect health. In certain settings, “medical certification” processes may exist to support shutoff protection or restoration in medically vulnerable households.

If appropriate, prepare:

• Clinician contact information
• A brief summary of why the utility is medically important (for example electricity for a device, temperature sensitivity, mobility limitations)

Step 4: Match needs to program pathways

Once you have the intake data, map the household to the right pathway. This prevents wasted time and reduces the risk of disconnection while paperwork is pending.

Crisis pathway

Use when there is a shutoff notice, disconnection, or unsafe home temperature risk.

Common advocate actions:

• Prioritize same-day calls to the utility provider to request options such as payment arrangements, temporary holds, or restoration steps.
• Identify local crisis energy assistance options in the household’s area.
• Coordinate rapid medical documentation if electricity is required for health-related equipment and the utility requests verification.

Ongoing bill support pathway

Use when services are on but unaffordable and shutoff is likely.

Common advocate actions:

• Screen for income-based assistance programs that help with heating or cooling costs.
• Ask about budget billing, arrears management programs, or reduced payment plans if available through the provider or state programs.
• Build a monthly affordability plan that aligns with the person’s fixed expenses and medical needs.

Home weatherization and energy efficiency pathway

Use when the underlying problem is high bills due to housing conditions.

Common advocate actions:

• Screen for weatherization support.
• Ask about home improvements that reduce energy use and stabilize indoor temperature.
• Coordinate with housing support resources if accessibility or home safety issues are part of the problem.

Water affordability pathway

Use when water or sewer bills are unaffordable or service is threatened.

Common advocate actions:

• Ask the local utility whether a customer assistance program, discount rate, or payment plan is available.
• Screen for local or state affordability programs where they exist.
• Provide a basic emergency water safety plan if service disruption is possible.

Phone and internet affordability pathway

Use when communication access is at risk, especially for older adults, people who need telehealth, or households coordinating complex care.

Common advocate actions:

• Screen for federal phone or internet discount programs.
• Confirm identity documentation and address consistency early, since these programs often require verification.

Step 5: Follow-up questions after you apply

A strong follow-up prevents repeated crises.

Ask:

• Did you receive confirmation that the application was submitted?
• Was a case number issued, and who is the contact person?
• What is the expected decision timeline?
• If there is a shutoff date, what action is needed to prevent disconnection before the decision?
• Do you need help responding to requests for more documents?

Power outage preparedness for medically vulnerable households

If the household relies on electricity for health needs, follow up with a basic preparedness check.

Ask:

• Do you have a written list of medical devices, model numbers, supplier contact info, and clinician contacts?
• Do you know how long each device can safely be off?
• Do you have backup batteries, charging options, or an alternate location plan?
• Do you know who to notify when power is lost and restored?

Special considerations for older adults and people with chronic conditions

As you complete intake, keep risk in mind:

• Older adults are often at increased risk from heat and cold.
• People with chronic conditions and certain medications may be more vulnerable to temperature extremes.
• People with disability, limited mobility, or cognitive impairment may have more difficulty relocating quickly, staying hydrated, or accessing cooling or warming resources.

Your intake questions should make it easy for someone to describe their needs without feeling judged. You can say: “These questions help us understand what will keep you safest at home.”

When to escalate for urgent medical help

Utility insecurity can become a medical emergency. If someone has severe symptoms of heat illness or hypothermia, or if loss of electricity threatens a health-sustaining device, treat it as urgent according to your organization’s protocol.

If you are a patient or caregiver and you think someone is in immediate danger, seek emergency help right away.

How Understood Care advocates can support utility assistance navigation

If you are managing utility insecurity alongside health needs, you should not have to do it alone. A healthcare advocate can help you:

• Organize bills, notices, and documentation
• Identify which pathway to pursue first based on urgency and health risk
• Coordinate with clinicians when medical documentation is needed
• Track deadlines and follow up so applications do not stall

Learn more:

• Financial help https://understoodcare.com/uc-articles/financial-help
• Housing help for people with disabilities who need accessibility features https://understoodcare.com/uc-articles/housing-help-for-people-with-disabilities-who-need-accessibility-features
• Home safety and accessibility https://understoodcare.com/uc-articles/home-safety-and-accessibility
• How healthcare advocates help with nutrition and food security https://understoodcare.com/uc-articles/how-healthcare-advocates-help-with-nutrition-and-food-security
• Disability benefits made simple https://understoodcare.com/uc-articles/disability-benefits-made-simple‍

FAQ

• What are utility assistance intake questions for healthcare advocates?
  They are a structured set of questions you use to identify shutoff risk, health vulnerability, eligibility factors, and required documents so you can connect someone to energy, water, or communication assistance efficiently.
• What should I bring to a utility assistance intake call to speed up help?
  Bring your most recent utility bill, any shutoff notice, your account number, proof of address, proof of income or benefits, and contact information for anyone who helps manage your care.
• What are the most important “first questions” to prevent a utility shutoff?
  Ask whether utilities are already off, whether there is a scheduled shutoff date, what the past-due amount is, and whether anyone in the home relies on electricity for medical equipment or needs safe indoor temperatures for health.
• How do LIHEAP intake questions differ from other energy assistance questions?
  LIHEAP-style screening commonly focuses on household size, income, energy costs, and crisis status. Your healthcare intake should also add health-risk questions, like electricity-dependent devices and temperature vulnerability.
• What is “medical certification” for utility shutoff protection?
  In some settings, there may be a process where a clinician confirms that a household member has a medical need tied to utility service, which may support shutoff protection or restoration options. Requirements and availability vary.
• What intake questions help identify heat-related health risk at home?
  Ask about indoor temperature, access to cooling, older age, chronic health conditions, medications, mobility limits, hydration barriers, and whether anyone has symptoms that could indicate heat illness.
• What intake questions help identify cold-weather risk and hypothermia risk?
  Ask whether the home can maintain safe heat, whether anyone is older or has conditions that increase cold vulnerability, whether heating is unsafe, and whether anyone has confusion, severe sleepiness, or uncontrolled shivering.
• What utility assistance questions are important for older adults on fixed income?
  Ask about Social Security or other fixed income sources, recent changes in expenses, past-due amounts, eligibility-related benefits, disability or mobility needs, and whether the home is safe during temperature extremes.
• What if the patient does not have internet or reliable phone service to complete applications?
  Ask about preferred contact methods, whether mail is reliable, whether a caregiver can assist, and whether a phone or internet affordability program could stabilize communications for ongoing care.

References

• Heat Illness (MedlinePlus) https://medlineplus.gov/heatillness.html
• Hypothermia (MedlinePlus) https://medlineplus.gov/hypothermia.html
• Hot Weather Safety for Older Adults (National Institute on Aging) https://www.nia.nih.gov/health/safety/hot-weather-safety-older-adults
• Cold Weather Safety for Older Adults (National Institute on Aging) https://www.nia.nih.gov/health/safety/cold-weather-safety-older-adults
• People at Increased Risk for Heat-Related Illness (CDC) https://www.cdc.gov/heat-health/risk-factors/index.html
• Power Sources and Backup Planning (CDC Prepare Your Health) https://www.cdc.gov/prepare-your-health/take-action/power-sources.html
• Home Use Devices: How to Prepare for and Handle Power Outages for Medical Devices that Require Electricity (FDA PDF) https://www.fda.gov/media/80782/download
• Electric Utility Disconnections (Congressional Research Service PDF, Jan 31, 2023) https://www.congress.gov/crs_external_products/R/PDF/R47417/R47417.2.pdf
• Energy Insecurity and Mental Health Symptoms in US Adults (JAMA Network Open, published Oct 27, 2025) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840540
• State-Level Household Energy Insecurity and Diabetes Prevalence Among US Adults, 2020 (CDC Preventing Chronic Disease) https://www.cdc.gov/pcd/issues/2024/24_0087.htm
• Medical Certification for Utility Shut-Off Protection and Health-Related Social Needs (PubMed Central) https://pmc.ncbi.nlm.nih.gov/articles/PMC9647589/
• Get help with energy bills (USAGov) https://www.usa.gov/help-with-energy-bills
• Weatherization Assistance Program (U.S. Department of Energy) https://www.energy.gov/scep/wap/weatherization-assistance-program
• Get help paying for phone and internet service (USAGov) https://www.usa.gov/help-with-phone-internet-bills
• Lifeline Get Started (Universal Service Administrative Company) https://www.usac.org/lifeline/get-started/
• Water Affordability Resources for Consumers (U.S. EPA) https://www.epa.gov/waterfinancecenter/water-affordability-resources-consumers
• Water, Sanitation, and Hygiene (WASH)-related Emergencies and Outbreaks (CDC) https://www.cdc.gov/water-emergency/index.html
• How to Create and Store an Emergency Water Supply (CDC) https://www.cdc.gov/water-emergency/about/how-to-create-and-store-an-emergency-water-supply.html‍