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 11/03/2025 04/07/2026 Cooling assistance 04/15/2026 06/22/2026 Summer crisis assistance Winter crisis assistance 01/02/2026 04/07/2026 Year-round crisis assistance Weatherization assistance Provide further explanation for the dates of operation, if necessary Regular benefits under the Heating Assistance component will operate from 11/3/2025 through 4/7/2026 or until funding allocated to this benefit is exhausted, whichever comes first. Benefits under the Regular component may be extended beyond the proposed 4/7/2026 closing date if New York State receives additional funding. This Plan is based on an assumption of flat Federal funding. NYS will offer a 1st Emergency benefit under Winter Crisis Assistance, which will operate from 1/2/2026 through 4/7/2026. New York State will operate a Cooling Assistance Component (CAC) from 4/15/2026 through 6/22/2026, or until funding allocated to this benefit is exhausted, whichever comes first. If additional funds are made available, NYS will consider the operation of Weatherization assistance, emergency Heating Equipment Repair and Replacement (HERR), and/or heating equipment Clean & Tune (C&T). 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 74.00% 51.00% Cooling assistance 4.00% 4.00% Summer crisis assistance 0.00% 0.00% Winter crisis assistance 13.00% 20.00% Year-round crisis assistance 0.00% 0.00% Weatherization assistance 0.00% 15.00% Carryover to the following federal fiscal year 0.00% 0.00% Administrative and planning costs 9.00% 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. Households containing a member in active receipt of ongoing Supplemental Nutritional Assistance Program (SNAP), federally funded Public Assistance (PA), or Code A Supplemental Security Income (SSI) (state and federal living arrangement code of “A”) are considered Categorically Income Eligible (CE) for HEAP. Not all household members need to be in receipt of federally funded PA, SNAP, or Code A SSI. If one household member is in receipt of one of these programs, the entire household is considered categorically income eligible. There is no outside data exchange in place. Receipt of PA and SNAP is verified through OTDA’s system of record, the Welfare Management System (WMS), and Code A SSI is declared by the applicant and verified by the social service district (district). Categorical Eligibility streamlines the application process by allowing households in receipt of PA, SNAP and Code A SSI to apply for HEAP without providing additional income documentation. 1.5 Do you automatically enroll households without a direct annual application? Yes No If Yes, explain: Federally funded PA and SNAP recipient households who are in receipt of ongoing benefits are considered CE, but these recipients must also meet all other eligibility criteria in order to be eligible for a Regular HEAP benefit. These recipients consent to have their eligibility determined through the HEAP Autopay process when they complete and submit a NYS Application for Certain Benefits and Services (LDSS- 2921), Recertification Application for Certain Benefits and Services for PA or SNAP (LDSS-3174), or Supplemental Nutrition Assistance Program (SNAP) Application/Recertification (LDSS-4826). The consent language is found in the consent section of each application. PA, and SNAP recipient households who are CE or have income at or below the maximum allowable for HEAP based on household size, meet all other eligibility criteria, and are in receipt of ongoing benefits at the time the Autopay is run are not required to complete a separate HEAP Application (LDSS-3421). OTDA uses the PA, and SNAP recipient household eligibility information and budget found in WMS at the time of the Autopay run to determine the household's income eligibility for HEAP, as well as other eligibility criteria. If all HEAP eligibility factors, including vendor information, can be collected from WMS, a Regular eligibility determination is made and a payment amount is electronically issued, as appropriate, to either the vendor or to the recipient through their Electronic Benefits Transfer (EBT) card. Households approved for a Regular benefit via the Autopay process receive a notice of approval containing the eligibility factors used to determine their eligibility, the amount of the benefit and their fair hearing rights. Regular heat-included benefits may be paid directly to a recipient’s domestic electric utility account or directly to the household through their EBT card if the household does not pay a utility directly for domestic electric. Heat-included households are households that do not make payments directly to a vendor for their primary heating but make undesignated payments for heat as a portion of their rent and are in an eligible living arrangement. All Regular heater HEAP benefits through the Autopay must be paid directly to a vendor. If required HEAP eligibility factors beyond income eligibility cannot be retrieved from WMS, the case appears on an exception report for districts to review. If missing information can be obtained by 12/31/2025, a Regular benefit may be approved by the eligibility examiner. To enhance participation and benefits for those households enrolled in SNAP, NYS will obligate FFY 2026 funds to the FFY 2027 program and continue issuing nominal assistance benefits to SNAP households. 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? Eligibility criteria for each program component are applied uniformly to all applicant 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: $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? OTDA and districts confirm that a household that receives a nominal HEAP payment has an energy cost or need based on information contained in the case record and in WMS. Clients must provide documentation of direct or indirect responsibility of incurred energy costs. A direct energy burden must be documented through vendor fuel bill or fuel bill receipt, a statement from the vendor or collateral contact with the vendor specifying who pays the bill and to whom the bill is paid. Households that pay energy costs indirectly, in the form of rent, must document their energy cost in the form of a landlord statement or a signed lease agreement between the applicant and the landlord. 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: myBenefits (ny.gov), ACCESS HRA (nyc.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. Outside of New York City, only the Regular benefit can be applied for through myBenefits (ny.gov). Applicants must contact their local social services district to obtain and submit an application for any other HEAP component. In New York City, the Human Resource Administration (HRA) allows HEAP applicants to apply for Regular and Cooling benefits online through the HRA customer portal ACCESS HRA (nyc.gov). Applicants must contact NYC HRA to obtain and submit an application for any other HEAP component. 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 Documentation can be faxed to the social service districts Hidden for Section 1