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 11/01/2025 09/30/2026 Cooling assistance Summer crisis assistance Winter crisis assistance 11/01/2025 09/30/2026 Year-round crisis assistance Weatherization assistance 11/01/2025 09/30/2026 Provide further explanation for the dates of operation, if necessary An application received on April 30 must be completed by the applicant no later than May 31. If April 30 falls on a weekend, the last business day in April will serve as the final date to apply for home energy assistance. After consideration of the circumstances, which may include a particularly inclement winter, increases in energy prices, lower than expected application numbers, an extension of the statewide moratorium, etc., the Commonwealth of Massachusetts may extend the application date from the end of April into the month of May. An online portal is offered in addition to the hard copy application, and includes the options of online appointment booking, prescreening tools, and submitting the application online. 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 70.00% 73.00% Cooling assistance 0.00% 0.00% Summer crisis assistance 0.00% 3.00% Winter crisis assistance 1.00% 0.00% Year-round crisis assistance 0.00% 0.00% Weatherization assistance 15.00% 10.00% Carryover to the following federal fiscal year 0.95% 0.95% Administrative and planning costs 10.00% 10.00% Services to reduce home energy needs including needs assessment (Assurance 16) 3.00% 3.00% Used to develop and implement leveraging activities 0.05% 0.05% 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 eligibility exists only through the H-EAT. To be eligible for the H-EAT HEAP benefit, Applicants must be Supplemental Nutritional Assistance Program (SNAP) recipients, not receive a HEAP benefit in the last 12 months, have a limited energy burden, and a recorded shelter cost. Eligibility is determined by household. This streamlines the application process by reducing the paperwork for eligible households that already have had their eligibility verified by a state agency. It also reduces the administrative burden on the Subgrantees and the involved state agencies. 1.5 Do you automatically enroll households without a direct annual application? Yes No If Yes, explain: SNAP recipient households’ income and utility information are collected by the Massachusetts Department of Transitional Assistance (DTA) and data matched with HEAP households. DTA determines those SNAP households with limited energy burden eligible to receive an annual benefit of $21 based on their residential energy cost and affordability threshold as determined by Commonwealth of Massachusetts, and issues notices accordingly. Income eligible households with no energy cost (i.e., excluding heat included in rent tenants) are not eligible to receive a H-EAT benefit. 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? All applicant households, including H-EAT recipients, must have their eligibility for regular HEAP assistance determined separately through one of the 20 local administrating agencies. The Commonwealth of Massachusetts has specific program eligibility criteria that must be met. 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: $21.00 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? Through the established agreement between the Commonwealth of Massachusetts and DTA, it is determined that the SNAP households receiving the H-EAT benefit have energy costs/needs. Further the notice that DTA issues with the H-EAT benefit explains that the benefit is to pay towards home energy expenses and must be returned if certain criteria are not met (e.g., ineligible dwelling types). 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 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: www.toapply.org/MassLIHEAP 1.10b Can all program components be applied for online? Yes No If no, explain which components can and cannot be applied for online. 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 at intake sites. Hidden for Section 1

Fiscal Year 2026 Home Energy Assistance Program (HEAP) Income Eligibility and Benefit Levels Number of People in a Household 100% of Federal Poverty Level 125% of Federal Poverty Level 150% of Federal Poverty Level 175% of Federal Poverty Level 200% of Federal Poverty Level 60% of Estimated State Median Income 1 15,650 $ 19,563 $ 23,475 $ 27,388 $ 31,300 $ $ 51,777 2 21,150 $ 26,438 $ 31,725 $ 37,013 $ 42,300 $ $ 67,709 3 26,650 $ 33,313 $ 39,975 $ 46,638 $ 53,300 $ $ 83,641 4 32,150 $ 40,188 $ 48,225 $ 56,263 $ 64,300 $ $ 99,573 5 37,650 $ 47,063 $ 56,475 $ 65,888 $ 75,300 $ $ 115,504 6 43,150 $ 53,938 $ 64,725 $ 75,513 $ 86,300 $ $ 131,436 7 48,650 $ 60,813 $ 72,975 $ 85,138 $ 97,300 $ $ 134,423 8 54,150 $ 67,688 $ 81,225 $ 94,763 $ 108,300 $ $ 137,410 9 59,650 $ 74,563 $ 89,475 $ 104,388 $ 119,300 $ $ 140,397 10 65,150 $ 81,438 $ 97,725 $ 114,013 $ 130,300 $ $ 143,385 11 70,650 $ 88,313 $ 105,975 $ 123,638 $ 141,300 $ $ 146,372 12 76,150 $ 95,188 $ 114,225 $ 133,263 $ 149,360 $ $ 149,360 13 81,650 $ 102,063 $ 122,475 $ 142,888 $ 152,347 $ $ 152,347 14 87,150 $ 108,938 $ 130,725 $ 152,513 $ 155,334 $ $ 155,334 15 92,650 $ 115,813 $ 138,975 $ 158,321 $ 158,321 $ $ 158,321 16 98,150 $ 122,688 $ 147,225 $ 161,308 $ 161,308 $ $ 161,308 17 103,650 $ 129,563 $ 155,475 $ 164,295 $ 164,295 $ $ 164,295 Homeowners and Non-Subsidized Housing Tenants Deliverable Fuel (Oil, Propane, Kerosene & Other) $600 $550 $510 $470 $470 $430 Utility and Heat- Included-in-Rent $500 $460 $425 $390 $390 $355 High Energy Cost Supplement TBD TBD TBD TBD TBD TBD Subsidized Housing Tenants Deliverable Fuel (Oil, Propane, Kerosene & Other) $420 $385 $355 $325 $325 $300 Utility and Heat- Included-in-Rent $350 $325 $300 $275 $275 $250 High Energy Cost Supplement TBD TBD TBD TBD TBD TBD High Energy Cost Supplement (HECS) Thresholds - TBD Note: Contact EOHLC to determine eligibility for a household of 18 and above. Sources (Income Level): "Annual Update of the HHS Poverty Guidelines, Federal Register, January 17, 2025 (90 FR 5917-5918) and "Federal Poverty Guidelines and State Median Income Estimates ... Mandatory Use in FY26 LIHEAP", USHHS, OCS, DEA, LIHEAP-IM-2025-02 6/2/2025 The Benefit Amount awarded to eligible households is based on several household factors reflected on this chart. Those include the number of people in a household, their gross income, the energy source, and the housing situation. The High Energy Cost Supplement is an additional benefit provided only to qualifying, eligible HEAP households whose previous year's heating source costs exceed the above listed HECS thresholds.