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Eligibility, 2605(b)(2) - Assurance 2 2.1 Designate the income eligibility threshold used for the heating component: Add Household size Eligibility Guideline Eligibility Threshold 1 All Household Sizes HHS Poverty Guidelines 150.00% 2.2 Do you have additional eligibility requirements for Heating Assistance? Yes No 2.3 Check the appropriate boxes below and describe the policies for each. Do you require an Assets test? Yes No If yes, describe: Do you have additional/differing eligibility policies for: Renters? Yes No If yes, describe: Renters Living in subsidized housing? Yes No If yes, describe: Renters with utilities included in the rent? Yes No If yes, describe: Do you give priority in eligibility to: Older Adults (60 years or older)? Yes No If yes, describe: Vulnerable households are identified at the time of application. Vulnerable households have early application periods and designated times for which only they may apply for assistance. A household is considered vulnerable if its members include someone aged 60 or older (elderly), someone who has a medically documented disability, or someone under the age of 18. Individuals with a disability? Yes No If yes, describe: Vulnerable households are identified at the time of application. Vulnerable households have early application periods and designated times for which only they may apply for assistance. A household is considered vulnerable if its members include someone aged 60 or older (elderly), someone who has a medically documented disability, or someone under the age of 18. Young children? Yes No If yes, describe: Vulnerable households are identified at the time of application. Vulnerable households have early application periods and designated times for which only they may apply for assistance. A household is considered vulnerable if its members include someone aged 60 or older (elderly), someone who has a medically documented disability, or someone under the age of 18. Households with high energy burdens? Yes No If yes, describe: Other? Yes No If yes, describe: Explanations of policies for each "yes" checked above: Vulnerable households are identified at the time of application. Vulnerable households have early application periods and designated times for which only they may apply for assistance. A household is considered vulnerable if its members include someone aged 60 or older (elderly), someone who has a medically documented disability, or someone under the age of 18. Determination of Benefits 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 2.4 Describe how you prioritize the provision of heating assistance to vulnerable populations, e.g., benefit amounts, early application periods, etc. Administering agencies allow early application periods, which includes conducting appointments for the elderly on specific days of the week at Senior Centers. Also, vulnerable households are identified at the time of application. 2.5 Check the variables you use to determine your benefit levels. (Check all that apply): Income Family (household) size Home energy cost or need: Fuel type Climate/region Individual bill Dwelling type Energy burden (% of income spent on home energy) Energy need Other - Describe: Income eligibility is determined based on the household’s gross income for the month prior to the month of application. Our benefits matrix is included in this State Plan as Attachment A – PY2026 LIHEAP Payment Assistance Chart. For example, if a household applies for assistance any time in August, they must provide verification of the gross monthly income each household member received in July. Each year, ADECA will update the Payment Assistance Chart when the federal poverty guidelines are issued to revise the income ranges. To calculate the income levels on the PY2026 Payment Assistance Chart, the HHS Poverty guidelines mandatory for 2025 from the following website: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines are used. However, ADECA will adopt 2026 Federal Poverty Guidelines upon release. The Payment Assistance Chart will be updated when the 2026 Federal Poverty Guidelines are released and subrecipients will be notified. For a one-person household, the maximum annual income based on 100% of HHS Poverty Guidelines is $15,650. To calculate the maximum income for a one- person household at 150% poverty, we multiplied $15,650 by 1.5 = $23,475. To determine the maximum monthly amount as shown on our benefits matrix, we divided $23,475 by 12 = $1,956. Our benefits matrix contains three income categories for each household size. The following is an example of how we calculated the income categories: For a one-person household, we divided $1,956 by 3 = $652. The lowest income category (which receives the highest benefit) has a range of $0 - $652. The formula to calculate the next highest income category for a one-person household (which receives a slightly lower benefit) is $653 + $652 = $1,305. Therefore, the range for that income category is $653 - $1,305. The highest income category for a one-person household starts at $1,306 and the maximum monthly income is $1,956 as described above. The same method is used to complete the benefit matrix for households with two to fifteen people. As stated on the matrix, households with more than four people will receive benefits in the same amount as shown for a household of four. If a household has a high energy need (including, but not limited to, those with children under 18, elderly members, or members with a disabling condition), subrecipients may award an additional $50. *The same Payment Assistance Chart is used to determine income eligibility to receive a supplemental benefit from the Infrastructure Investment and Jobs Act fund. Each time a household receives a Heating benefit, the household also receives a $100 supplemental benefit at the same time if funding is available. Benefit Levels, 2605(b)(5) - Assurance 5, 2605(c)(1)(B) 2.6 Describe estimated benefit levels for the fiscal year for which this plan applies. Please note: the maximum and minimum benefits must be shown in the payment matrix. Minimum Benefit $280 Maximum Benefit $580 2.7 Do you provide in-kind (e.g., blankets, space heaters) and/or other forms of benefits?2 Yes No If yes, describe. If any of the above questions require further explanation or clarification that could not be made in the fields provided, attach a document with said explanation here.