THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)Use of this model plan is optional. However, the information requested is required in order to receive a Low Income Home Energy Assistance Program (LIHEAP) grant.Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Section 1 Program Components Program Components, 2605(a), 2605(b)(1) - Assurance 1, 2605(c)(1)(C) 1.1 Check which components you will operate under the LIHEAP program. (Note: You must provide information for each component designated here as requested elsewhere in this plan.) Dates of Operation Start Date End Date Heating assistance 03/01/2026 09/30/2026 Cooling assistance 03/01/2026 09/30/2026 Summer crisis assistance Winter crisis assistance Year-round crisis assistance 10/01/2025 09/30/2026 Weatherization assistance 10/01/2025 09/30/2026 Provide further explanation for the dates of operation, if necessary LIHEAP Program TimelineLate September – Distribute policy and forms to Community Action Agencies (CAA) for new FFYOctober 1 - New LIHEAP year begins with year-round Weatherization and Crisis assistance. Weatherization is overseen by the Hawaii DLIR OCS and contracted to the CAA. LIHEAP Crisis assistance intake is done by CAA.February to March - Finalize training materials (presentations, handouts). CAA preparation begins including hiring seasonal staff.April - Training for year-round staff of CAA that elect to do early outreach in May. CAA contact resident managers at Senior and Public housing to schedule on-site application intake.May - Year-round CAA staff conduct early outreach for Heating and Cooling Assistance. Training done for seasonal staff hired by CAA to assist with Heating and Cooling application intake.June 1-30 - LIHEAP applications accepted from the general public for Heating and Cooling Assistance. Estimated Funding Allocation, 2604(C), 2605(k)(1), 2605(b)(9), 2605(b)(16) - Assurances 9 and 16 1.2 Estimate what amount of available LIHEAP funds will be used for each component that you will operate: The total of all percentages must add up to 100%. Percentage ( % ) Prior year totals Heating assistance 5.00% 5.00% Cooling assistance 50.00% 50.00% Summer crisis assistance 0.00% 15.00% Winter crisis assistance 0.00% 0.00% Year-round crisis assistance 15.00% 0.00% Weatherization assistance 10.00% 10.00% Carryover to the following federal fiscal year 10.00% 10.00% Administrative and planning costs 10.00% 10.00% Services to reduce home energy needs including needs assessment (Assurance 16) 0.00% 0.00% Used to develop and implement leveraging activities 0.00% 0.00% TOTAL 100.00% 100.00% Tribal grant recipients: direct-grant tribes, tribal organizations, or territories with allotments of $20,000 or less may use for planning and administration up to 20% of the funds payable. Grant recipients that are direct grant tribes, tribal organizations, or territories with allotments over $20,000 may use for planning and administration purposes up to 20% of the first $20,000 (or $4,000) plus 10% of the funds payable that exceeds $20,000. Any administrative costs in excess of these limits must be paid from non-federal sources. Alternate Use of Crisis Assistance Funds, 2605(c)(1)(C) 1.3 The funds reserved for winter crisis assistance that have not been expended by March 15 will be reprogrammed to: Heating assistance Cooling assistance Weatherization assistance Other (specify:) Categorical Eligibility, 2605(b)(2)(A) - Assurance 2, 2605(c)(1)(A), 2605(b)(8A) - Assurance 8 1.4 Do you consider households categorically eligible if at least one household member receives at least one of the following categories of benefits in the left column below? Yes No If you answered "Yes" to question 1.4, you must complete the table below and answer questions 1.5 and 1.6. Heating Cooling Crisis Weatherization TANF Yes No Yes No Yes No Yes No SSI Yes No Yes No Yes No Yes No SNAP Yes No Yes No Yes No Yes No Means-tested Veterans Programs Yes No Yes No Yes No Yes No 1.4a. Provide your definition of categorical eligibility. Please explain how households are categorically eligible (i.e, do all household members need to receive the benefits or just one member, is there a data exchange in place?) and how categorical eligibility streamlines the LIHEAP application process. “Categorical recipient” means those individuals who are in receipt of assistance under the Supplemental Nutrition Assistance Program (SNAP), Supplemental Security Income (SSI), and/or Temporary Assistance to Needy Families (TANF)/Temporary Assistance to Other Needy Families (TAONF) programs and shall include only:1. SSI recipients certified by the Social Security Administration (SSA) to be in SSI independent living arrangement and certified by the SSA to be eligible on the first day of the month of application.2. SNAP and TANF/TAONF recipients in the Department’s eligible computer files on the first day of the month of application.3. Households in receipt of Transitional Benefits Alternative (TBA) are not means-tested and are therefore not considered categorical recipients. 1.5 Do you automatically enroll households without a direct annual application? Yes No If Yes, explain: 1.6 How do you ensure there is no difference in the treatment of categorically eligible households from those not receiving other public assistance when determining eligibility and benefit amounts? Basic eligibility requirements are the same for all households. There is no differentiation in maximum benefits or point assignments amongincome-eligible households and categorically eligible households. No difference is made in payment amounts. In crisis assistance, payment is issued according to the alleviation amount as verified by the utility company to restore service, with the same maximum payment for income- eligible and categorical eligible households. SNAP Nominal Payments 1.7a Do you allocate LIHEAP funds toward a nominal payment for SNAP households? Yes No If you answered "Yes" to question 1.7a, you must provide a response to questions 1.7b, 1.7c, and 1.7d. 1.7b Amount of Nominal Assistance: $0.00 1.7c Frequency of Assistance Once Per Year Once every five years Other - Describe: 1.7d How do you confirm that the household receiving a nominal payment has an energy cost or need? Determination of Eligibility - Countable Income 1.8. In determining a household's income eligibility for LIHEAP, do you use gross income or net income? Gross Income Net Income Other - Describe 1.9. Select all the applicable forms of countable income used to determine a household's income eligibility for LIHEAP Wages Self - Employment Income Contract Income Payments from mortgage or Sales Contracts Unemployment insurance Strike Pay Social Security Administration (SSA ) benefits Including MediCare deduction Excluding MediCare deduction Supplemental Security Income (SSI ) Retirement / pension benefits General Assistance benefits Temporary Assistance for Needy Families (TANF) benefits Loans that need to be repaid Cash gifts Savings account balance One-time lump-sum payments, such as rebates/credits, winnings from lotteries, refund deposits, etc. Jury duty compensation Rental income Income from employment through Workforce Investment Act (WIA) Income from work study programs Alimony Child support Interest, dividends, or royalties Commissions Legal settlements Insurance payments made directly to the insured Insurance payments made specifically for the repayment of a bill, debt, or estimate Veterans Administration (VA) benefits Earned income of a child under the age of 18 Balance of retirement, pension, or annuity accounts where funds cannot be withdrawn without a penalty. Income tax refunds Stipends from senior companion programs, such as VISTA Funds received by household for the care of a foster child Ameri-Corp Program payments for living allowances, earnings, and in-kind aid Reimbursements (for mileage, gas, lodging, meals, etc.) Other Adoption Assistance WIC-exempt 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. 1.10 Do you have an online application process Yes No 1.10a If yes, describe the type of online application (Select all boxes that apply) A PDF version of the application is available online and can be downloaded, filled out and mailed in for processing. A state-wide online application that allows a customer to complete data entry and submit an application electronically for processing. One or more locally available online applications that allows a customer to complete data entry and submit an application electronically for processing. Online application that is also mobile friendly Other, please describe Please include a link(s) to a statewide application, if available: Benefit, Employment & Support Services | LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP)LOW INCOME HOME WATER ASSISTANCE PROGRAM (LIHWAP) (hawaii.gov) 1.10b Can all program components be applied for online? Yes No If no, explain which components can and cannot be applied for online. We do not have a means to submit an application online. Application must be printed or emailed for submission. 1.11 Do you have a process for conducting and completing applications by phone Yes No 1.12 Do you or any of your subrecipients require in person appointments in order to apply Yes No If yes, please provide more information regarding why in-person appointments are required and in what circumstances they are required. 1.13 How can applicants submit documentation for verification? Select all that apply: In-person Mail Email Portal application Other, please describe Drop-off Hidden for Section 1

2026 CATEGORICAL INCOME *Income limits are current federal projections, pending official release of FY 2026 charts

HH Size Annual Income HH Size Annual Income 1 $17,990 11 $81,290 2 $24,320 12 $87,620 3 $30,650 13 $93,950 4 $36,980 14 $100,280 5 $43,310 15 $106,610 6 $49,640 16 $112,940 7 $55,970 17 $119,270 8 $62,300 18 $125,600 9 $68,630 19 $131,930 10 $74,960 20 $138,260

DETERMINING CATEGORICAL ELIGIBILITY

Household Calculation HH is receiving SNAP, SSI, TANF, GA or AABD Assign income from the Categorical Income Chart No one has SNAP, SSI, TANF, GA or AABD Calculate income **Income is assigned based on eligible household members**

SSI = Supplemental Security Income is NOT Social Security Disability Benefits.

BENEFIT MATRIX FOR HAWAII H-HEAP 2026 09/2024

H-HEAP HEATING AND COOLING ENERGY CREDIT (EC)

Non-Subsidized Households (PD) Private Dwelling EC PD households are awarded points based on household’s situation. Available EC funds are distributed amongst points, resulting in a Value Per Point (VPP). VPP and household’s benefit amount varies annually depending on points awarded and available funds. Example: Available funds and points collected statewide result in a VPP of $140. A household is approved for EC and awarded 4 points. The household’s EC benefit will be $140 X4 = $560 Category Factors Possible Points Income Level Refer to the Points for Income Chart 0, 1, 2,or 3 Household Size 1-2 3-5 6 or more 1 2 3 Regional Difference O`ahu Hawai`i Island, Maui, Lāna`i, Kaua`i, Moloka`i 1 2 Vulnerability Elderly (60+), disabled, and/or children under age 5 1 Energy Burden 30% of income or greater 1 Minimum points available: O`ahu Hawai`i Island, Maui, Lāna’i, Moloka`i, Kaua`i 2 3 Maximum points available: O`ahu Hawai`i Island, Maui, Lāna’i, Moloka`i, Kaua`i 9 10

H-HEAP ENERGY CRISIS INTERVENTION (ECI) MAXIMUM AMOUNT: $700 ECI payment is based on past due amount, not to exceed maximum.

*Benefit amount is subject to change in the event of federal appropriation increase or decrease. Subsidized Households (RS) Public Housing, Rent Subsidy, or Photovoltaic (PV) Households Flat rate benefit based on eligible household size Household size 1-2 $375 Household size 3-5 $425 Household size 6 or more $475