HOUSING ASSISTANCE POLICY

Transcription

1 HOUSING ASSISTANCE POLICY Subject: AFC Housing and Utility Assistance Application Date: September 1, 2009 PURPOSE: To set minimum eligibility criteria and standardize the process for distribution of multiple funding streams consistent with the guidelines established by those funding streams, which include the Illinois Department of Human Services (IDHS) State Homeless Prevention Funds, Housing Opportunities for People With AIDS / Short Term Rental Mortgage Utility Assistance (HOPWA STRMU), and Ryan White Part A, to clients participating in the Northeastern Illinois HIV/AIDS Case Management Cooperative with the AIDS Foundation of Chicago. It is at the discretion of AFC staff along with the guidelines established by the funding streams to determine which funding source, as previously mentioned, will be used in providing financial assistance to the client. POLICY: The AIDS Foundation of Chicago receives funding from a variety of sources to assist low income residents who reside in the following counties: Cook, DeKalb, DuPage, Grundy, Kane, Kendall, Lake, McHenry and Will. The principal purpose of this assistance is to stabilize individuals and families in their current home, to decrease the amount of time spent in shelters, and to help individuals and families secure and maintain affordable housing. Additionally, these funds are not intended to provide continuous or long-term assistance. These funds are defined as being a needs-based assistance program not an entitlement. Assistance from these funding streams is considered shortterm help that is intended to promote long-term housing stability. AFC Housing and Utility Assistance can only be used for up to 4 payments in a 24-month period. PROCEDURE: Eligibility criteria: 1. Households in imminent danger of eviction and/or, 2. Households in imminent danger of homelessness and/or, 3. Households in imminent danger of foreclosure (Note: they can t already be in the foreclosure process) and/or, 4. Households that are currently homeless. (Note: they need to be able to document the ability to afford rent and utilities in the future without this assistance) 5. For those households receiving funds from either HOPWA STRMU or Ryan White Part A, they must provide documentation showing that they are HIV+ ALL HOUSEHOLDS MUST BE ABLE TO DOCUMENT A TEMPORARY ECONOMIC CRISIS BEYOND THEIR CONTROL WHICH INCLUDES: Loss of employment Medical Disability or emergency Loss or delay of a public benefit Natural Disaster Substantial change in household composition Victimization by criminal activity (including Domestic Violence)

2 Illegal action by a landlord Displacement by government or private action Behind in one to three month s rent Behind in utility payments Client in need of assistance to remain in stable permanent subsidized housing Client is moving from Homelessness into permanent housing Types and Amounts of Assistance: o Any payment made cannot exceed $1, This is a cap. Actual payment amounts will always be determined by the documentation submitted on the applicant s lease, eviction notice, utility bill or mortgage statement as provided in the application. o Payments for security deposits must match the amount written on the client s lease. Any payment made, regardless of how much it may be below the cap amount, will be counted as one out of the four allowable payments in a 24-month period. It is allowable for a client to obtain both a rent payment and a utility payment in the same month with one application if the sum of both payments is still below the cap of $1, and there is adequate supporting documentation. This type of scenario, when properly documented, can be considered use of one out of the four allowable payments in a 24-month period. If there is documented need for assistance greater than $1, in the same month, it will be considered a separate payment and will require that an additional application be submitted. Therefore, if a client requires assistance in an amount greater than the cap of $1, in the same month in order to prevent homelessness, it will be considered use of two payments in their four allowable payments in a 24-month period. The second payment MUST resolve the balance and MUST come from a different funding stream. AFC staff will determine, based on the application provided by the Case Manager, which funding source will be used to assist the client. AFC will first determine if the client s application meets the requirements of IDHS in order to receive funds. If IDHS funds are determined to be an ineligible source or if IDHS funds have been exhausted for the given period, AFC staff will then review HOPWA STRMU as an alternate funding option. If the client s application does not meet the necessary requirements of HOPWA STRMU or if HOPWA STRMU funds have been exhausted for that period, AFC staff will then review Ryan White Part A funding requirements in order to assist the client s application. Process to Obtain Assistance: Clients must complete the application with their assigned Case Manager and submit to the AIDS Foundation of Chicago for assistance. Responsibilities of Client/Applicant: 1. All applicants for AFC Housing and Utility Assistance must be enrolled in the central client registry at AFC and currently working with an AFC-funded program. 2. Applicants must provide adequate documentation that they are experiencing a temporary 2

3 economic crisis beyond their control. Responsibilities of Case Manager: 1. The Case Manager will work with the clients to submit all required forms and documentation. 2. If the client is deemed eligible for Ryan White Part A funds, the case manager will obtain approval and an Authorization Number on a Request for Reimbursement form from an AFC Housing Associate. This approval will allow the Case Manager s agency to cut a check to assist the client. 3. The Case Management agency must make the approved payment within 5 business days. The Case Manager must then return the Request for Reimbursement form along with a copy of the check within 5 business days of the expenditure of funds. 4. The AFC Housing and Utility Assistance Program requires that, if services are provided during AFC s fiscal year (July 1 st through June 30 th ), the Case Manager must attempt to contact the household to determine if they are still housed. This contact MUST be made during the month of September or October in the following fiscal year. In the event no one in the household can be contacted, the Case Manager must attempt to contact the landlord. For example: Client X received assistance anytime between July 2009 and June The Case Manager will attempt to make contact in either September or October of Responsibilities of AFC: 5. No payments will be made directly to the client; all payments will be made directly to a third party/vendor (property management company, utility company, building owner or mortgagor). 6. AFC will inform the case manager where the payment will be made from. Depending on the eligible funding stream, the payment may be cut out of the case manager s agency. In this case the case manager will receive a reimbursement form from AFC with an Authorization Number. The payment may also get cut from The Emergency Fund or from AFC. In all cases, copies of the checks will be kept in the client s file at AFC and sent to the client s case manager. 7. Clients who are dissatisfied with the process or results of their application for the AFC Housing and Utility Assistance Program will be provided the name and number of the AFC Housing Assistance Manager, Ric Martel, FORMS: AFC Housing and Utility Assistance Application (Nine Pages) 3

4 Documentation Overview Subject: AFC Housing and Utility Assistance Overview Date: September 1, 2009 Page 1 of 4 PURPOSE: The AFC Housing and Utility Assistance application requires up to 16 forms to be included. This document will provide a brief overview of each form, assisting the Case Manager in helping their clients gather and complete all needed forms when submitting an AFC Housing and Utility Assistance application. These forms include: Application Checklist Client Service Form Narrative and Housing Plan with Client Signature Temporary Economic Crisis Checklist (with supporting documentation) IDHS Supportive Services From IDHS Documentation Checklist Documentation of Need Current Lease, Letter of Residence, Mortgage Payment Coupon Proof of Ownership from Landlord Copies of Past Due Utility Bills/Shut-off Notices Documentation of Current Income Signed Release of Information Form Budget Form Follow-Up Requirement Form AFC Medical Assessment Form Federal W9 and Landlord Tax ID Number Application Checklist This form is to be used as a cover sheet to the entire application indicating the client who is requesting assistance and the case manager who is submitting the application. It also serves as a checklist to confirm that all of the necessary application forms have been gathered. Please leave the bottom portion of the form blank where it states: DO NOT WRITE BELOW THIS LINE: AFC OFFICE USE ONLY. This is where AFC staff will internally keep track of the funding stream that the client is eligible for and how many payments the client may have received so far in a 24 month period. Client Service Form This form provides AFC needed demographic information on the client, including current address, race, household income as well as reason for assistance. It is important that clients along with their Case Managers review other funding streams as options in providing them assistance as warranted. This will include funding from CEDA / LIHEAP. It is up to the case manager to verify that the client has tried every resource possible before submitting this application. 4

5 Below is an explanation of the race codes on the Client Service Form: AI/AN=American Indian/Native Alaskan A=Asian B/AA=Black/African American NH/OPI=Native Hawaiian/Other Pacific Islander W=White AI/NA&W=American Indian/Native Alaskan and White A&W=Asian and White B/AA&W=Black/African American and White AI/NA&B/AA=American Indian/Native Alaskan and Black/African American Other Multi Racial=also includes Hispanic and anyone who doesn t classify themselves Narrative and Housing Plan The Case Manager must write a detailed description of the client s situation and what impact the assistance will have on the client s long term stability. It should include a Housing Plan that describes how the client will take steps to increase their income and reduce their expenses. Everything in the narrative must match the temporary economic crisis and must have supporting documentation. This form MUST be signed and dated by the client ONLY. Temporary Economic Crisis Checklist The Temporary Economic Crisis checklist requires the Case Manager to identify the emergency and/or crisis that the client is currently facing. Documentation must be included that supports the crisis. If the type of crisis the client is experiencing is not on the list, it is the responsibility of the Case Manager to then describe the crisis thoroughly in the narrative. Both the client and Case Manager MUST sign this document. IDHS Supportive Services Form Case Managers must complete this form as part of the AFC Housing and Utility Assistance Application to indicate the kind of services and referrals the client is receiving through case management. The first five categories are mandatory in completing this document. Use the column that best describes the household and check the appropriate boxes, then total the number of checks at the bottom of the page. Regardless of whether or not the client receives funding from IDHS, this form must be completed and provided to AFC when applying for assistance to demonstrate the supportive services that are being provided. IDHS Documentation Checklist Like the previous IDHS document, this one goes into greater depth on the current status facing the client. Each category should be checked so that it corresponds to the information provided in the narrative. Like the IDHS Supportive Services Form, this document MUST also accompany each AFC Housing and Utility Assistance Application. Documentation of Need Documentation of Need might include an eviction notice, a letter from the landlord that states how much the client is past due, default or late payment notice, verifiable evidence of loss of job or other source of income, verifiable evidence from a healthcare professional of a hospitalization or inability to work. A sample Landlord Statement is provided if necessary. If the Landlord has already provided a notice with the same information, the sample Landlord Statement does not need to be used. 5

6 Current Lease, Letter of Residence, Mortgage Payment Coupon Each client is responsible for providing a copy of their current written lease agreement, letter of residence, or mortgage payment coupon when applying for assistance. Even if the client is only applying for utility assistance, the client must still submit a copy of their written lease agreement or mortgage. A sample rental agreement form is provided if necessary. It is required that the written lease agreement include the length of lease, the amount of monthly rent, and both the client and the landlord signatures. Proof of Ownership Payments for housing assistance will only be made to the owner of the building where the client lives, the Property Management Company or the mortgagor. If the payment check is to be made out to an individual person, proof of ownership in the form of a current property tax statement, a water bill or a mortgage statement must be obtained. If the payment check is to be made out to a property management company or a mortgagor, proof of ownership is not needed. Copies of Past Due Utility Bills/Shut-off Notices Each client is responsible in providing their Case Manager copies of the past due or shut-off notices from their utility companies in which funds are being requested. Payments for utilities will be made directly to the utility company. Please make sure the client s account number is clearly visible. These documents are only required if the client is applying for utility assistance. A Utility Statement is included to serve as Documentation of Need. If the client is requesting utility assistance, this form must accompany the copy of the utility bill. Note that you must fill out the top and the bottom of the form and AFC staff will complete the rest if the application is moving forward. Documentation of Current Income Case Managers must obtain documentation of the client s current income. Clients with no income will not be eligible for AFC Housing and Utility Assistance. This is short term needs based assistance and the client must be able to pay bills on their own for the future months after assistance is received. Income documentation may include the current year s SSI or SSDI award letter, the current year s DHS award letter, or copies of recent pay stubs. It is important that Case Managers verify prior to submitting these documents that they are current for the year in which assistance is being requested. Signed Release of Information Form All client applicants must complete and sign the Release of Information form that indicates where their information will be sent. This includes the case management agency and the AFC administrative office. Depending on the funding stream the client is approved for, it may also include The Emergency Fund administrative office. Budget Form The purpose of this document is to show the client s total income versus their total expenses. The client must show that they DO NOT have a deficit. Additionally, the client must be able to show they can afford their bills in the future. The Case Manager should complete this form with their client to verify accuracy. 6

7 Follow-Up Requirement Form Whenever assistance is given to a client, the Case Manager MUST perform follow-up with the client in the following September or October to determine if the client has remained housed. In instances when the Case Manager can not contact the client, they must then attempt to make contact with the emergency contact or the landlord. This form must be included at the time of application to confirm that this requirement will be done in the future. Both the client and Case Manager MUST sign this form and submit with the application. Only the top and the bottom portions of the form must be completed at the time of application. The middle will be completed during the follow up period. AFC Medical Assessment Form If the applicant is HIV positive, this form MUST be completed by the client s medical provider. This form indicates the client s HIV status. This form must be signed AND dated by the medical provider. Federal W9 and Landlord Tax ID Number In order to be in compliance with IRS requirements, AFC requires that the Case Manager obtain the landlord s Tax ID number on a W9 Form. If the landlord is an individual, this would be a Social Security number. If the landlord is a property management company they will have a Tax ID number for the business. This information is required for payments to be made by AFC. If the assistance check will not be paid out of AFC, this form may not be required. 7

8 AFC HOUSING AND UTILITY ASSISTANCE APPLICATION CHECKLIST (Please use this as a cover sheet) CLIENT INFORMATION: Last Name First Name SS# - - Date of Birth / / DOCUMENTATION CHECKLIST Client Service Form Narrative with Client Signature Temporary Economic Crisis Checklist with supporting documentation IDHS Supportive Services Form IDHS Documentation Checklist Current lease, letter of residence, or proof of ownership (i.e., water bill) from landlord Copies of past due utility bills/shut-off notices (gas, electric) Documentation of current income Signed Release of Information Form Budget Form Follow Up Requirement Form AFC Medical Assessment Form Federal W9 Form with landlord tax ID number Case Manager (print) (signature) Agency Date DO NOT WRITE BELOW THIS LINE: AFC OFFICE USE ONLY Client application meets the eligibility for: IDHS HPF HOPWA/STRMU Ryan White Part A None Reason for Eligibility: Including this application how many assistance payments has the client received in the past 24 months: One Two Three Four 8

9 Client Service Form Date: / / Partner Agency: AFC 1. Client Information Last Name First Name Date Of Birth Hispanic Race Sex Disability Y N AI/AN A BL/AA NH/OP W AI/AN & W A&W B/AA&W AI/AN & B/AA Other/Multi-racial M F Physical Psychiatric Street Address Zip Code Phone # 1 Phone # 2 Monthly Household Income Referral Source 2. Household Information (include everyone else living in the household) $ HPCC External Internal Last Name First Name Age Hispanic Race Sex Y N AI/AN A BL/AA NH/OP W AI/AN & W A&W B/AA&W AI/AN & B/AA Other/Multi-racial M F Y N AI/AN A BL/AA NH/OP W AI/AN & W A&W M F B/AA&W AI/AN & B/AA Other/Multi-racial AI/AN A BL/AA NH/OP W AI/AN & W A&W Y N B/AA&W AI/AN & B/AA Other/Multi-racial M F Y Y N N AI/AN A BL/AA NH/OP W AI/AN & W A&W B/AA&W AI/AN & B/AA Other/Multi-racial M F AI/AN A BL/AA NH/OP W AI/AN & W A&W B/AA&W AI/AN & B/AA Other/Multi-racial M F 3. Program Eligibility 4. Coordination of Additional Services a. Have you received these funds in the last 24 months? Y N b. Reason for assistance (check all that apply): Natural disaster Medical disability or emergency Illegal landlord action Loss of delay of public benefit Substantial change in household composition Displacement by private or government action Victimization by criminal activity Loss of employment Other: 5. Prevention Services a. LIHEAP Coordination Already receiving LIHEAP Not receiving LIHEAP and helped to apply Not eligible for LIHEAP b. Food Stamp Coordination Already receiving food stamps Not receiving food stamps and helped to apply Not eligible to receive food stamps c. Did this household require assistance with enrolling in or maintaining public benefits? Yes No Reason for assistance Security Deposit Rent Mortgage Utility 1. To maintain current residence. $ $ $ $ 2. To move from residence to other permanent housing. 3. To move from a shelter to permanent housing. $ $ $ $ $ $ $ $ 9

10 Please write a narrative about the client s situation and the impact of the assistance. Be sure to include any case management or referrals you provided to the client and steps the client will take to increase their income and reduce their expenses. (Note: This information will be shared with staff of the Emergency Fund. I have received the services and financial assistance described in this document. I understand that I will be contacted in 09/10 or 10/10 and asked about the impact of this assistance. X Client signature and date 10

11 AFC HOUSING AND UTILITY ASSISTANCE Temporary Economic Crisis Checklist Client Name: Person Completing Form: All Households Must Be Able to Document a Temporary Economic Crisis. These funds are not intended to provide continuous or long-term assistance. These funds are defined as being needs-based assistance, not an entitlement. Assistance from these funding streams is considered short-term help that is intended to promote long-term housing stability. If the client s temporary economic crisis does not appear below, please use this form to describe the situation and provide supporting documentation. Description of Emergency/Crisis: (check all that apply) Loss of Employment (termination letter from employer, unemployment application/documentation that shows date of final day of employment) Loss or delay of Public Benefit (with documentation PA, VA or SS letters) Medical disability or emergency (hospital bills, doctor s bills, or a doctor s note) Domestic violence situation (with police report) Natural Disaster (fire or flood report, etc) Substantial change in household composition (for example, proof of death of a household member) Victimization by criminal activity (with police report) Illegal action by a landlord Displacement by government or private action (letter from landlord informing the individual/household that they need to move) Client is moving from Homelessness into permanent housing Client is in need of assistance to remain stable in permanent subsidized housing I verify that the above information is accurate to the best of my knowledge. Client Signature: Case Manager Signature: Date: 11

12 IDHS Supportive Services Form Supportive Services Case Management* Single Male Single Female Couple-no child Couple w/ child Male w/ child Female w/ child Counseling-Financial* Food Stamp Screening* LIHEAP Screening* Six month follow-up* Advocacy Alcohol Abuse Services Child Care Children s Services Counseling-Life Skills Counseling-All Others Education Employment Services ESL Health/Dental Services HIV/AIDS Related Services Housing Placement/Inspection Legal Services/Referrals Mental Health Services Substance Abuse Services Transportation Children s Services Housing location/inspection Other: Total: *These 5 categories are mandatory for all clients receiving state prevention funds! 12

13 IDHS Homeless Prevention Program Documentation Checklist Initial Client Assessment The household must fall into one of these categories in order to be eligible: Imminent danger of eviction Imminent danger of foreclosure Imminent danger of homelessness Currently homeless The household must document a temporary economic crisis beyond its control, evidenced by at least one of the following conditions: loss of employment medical disability or emergency loss or delay of some form of public benefit natural disaster substantial change in household composition victimization by criminal activity illegal action by a landlord displacement by a government or private action some other condition which constitutes a hardship comparable to the one listed above: 2-year Eligibility Requirement The household is eligible to access assistance once every 2 years. All exceptions must be submitted to and approved by IDHS Homeless Prevention Program staff. Does the household meet the 2 year eligibility requirement? Yes No, but exception approved by IDHS program staff Income Verification The household must be able to demonstrate an ability to meet its future rental/utility obligations after assistance has been granted based on current or anticipated income: Employer verification/copy of Pay Stubs SSI/disability verification Unemployment Benefits Other: Rental (or Mortgage) Assistance/Arrearage Landlord agreement/lease Eviction/Five-Day/Past-Due Notice Mortgage Documentation/Repayment plan Records of payment Copy of check issued by agency Security Deposit Assistance Lease or rental agreement Receipt of payment or partial payment towards security deposit Copy of check issued by agency Utility Assistance/Arrearage Utility statement showing arrearage Shut-off notice or past due bills Copy of check issued by agency Follow-up Requirement Six months after the end of the fiscal year, the household must be followed-up with to determine their housing status. At the time of intake did you: Thoroughly explain your follow-up process to the household Collect adequate contact information, including a secondary number, to ensure a successful follow-up Wrapping Up the Client File Am I collecting the necessary client data to ensure accurate reporting to the Department of Human Services? (ie household composition, gross monthly income, type of prevention assistance granted, food stamp status, LIHEAP status, supportive services). 13

14 HOUSING STABILITY LANDLORD STATEMENT (to be filled out by the landlord) DATE: TENANT INFORMATION: Last Name First Name Tenant s Address: City: State: Zip: Amount of PAST DUE Rent: $ LANDLORD INFORMATION: Owner s Name or Management Company Name: Mailing Address: City: State: Zip: Contact Person (Owner or legal representative of property): Phone Number: I agree to accept a Housing Stability payment for this past due rent which will guarantee an additional 30 days of residence. By signing below I certify that I am the owner or legal representative of the owner, of the property listed under Tenant s Address above and that the information provided is true and accurate to the best of my knowledge. Signature: Property Owner or Legal Representative of Property 14

15 RENTAL AGREEMENT FORM This is a formal rental agreement between the Tenant and Landlord. The tenant shall be responsible for rent in the sum of $ per month, on a month-to-month basis, for the apartment listed below. A security deposit of $ has been paid on the apartment. Address of apartment: Printed Name of Tenant Printed Name of Landlord Signature of Tenant Signature of Landlord Landlord s Address Landlord s City, State, Zip Code DATE: (Lease Valid for 12 months from date above) 15

16 Utility Statement Date: *Utility Bill cannot be more than two months older than payment date. CLIENT INFORMATION: Last Name First Name SS# - - Date of Birth / / DO NOT FILL OUT THE INFORMATION IN BOX: AFC OFFICE USE ONLY UTILITY INFORMATION: Company Name: Mailing Address: City: State: Zip: Amount Due: Payment Date: Account Number: Client (print) (signature) Case Manager (print) (signature) Agency Date 16

17 AFC HOUSING AND UTILITY ASSISTANCE RELEASE OF INFORMATION I am requesting rental/mortgage/utility assistance from the AIDS Foundation of Chicago (AFC). In order to administer this request and be awarded my assistance, I authorize (case management agency) to release information regarding my housing, finances, case management services, and HIV status and related disabilities to AFC, 200 W. Jackson, Chicago, IL, I further authorize that if my application for assistance is approved, this information may be shared with the administer of IDHS Homeless Prevention Funds for the City of Chicago, the Emergency Fund, 651 W. Washington Suite #504, Chicago, IL This consent is valid for one year from the date indicated below. I understand that I may revoke this consent at any time by providing written notice of my intent to revoke this consent to Provider. This consent cannot be revoked to the extent that action has already been taken based on this consent. (Client name - print) (Signature) (Date) (Witness-print) (Signature) (Date) 17

18 AFC HOUSING AND UTILITY ASSISTANCE BUDGET HOUSEHOLD INCOME (per month) HOUSEHOLD EXPENSES (per month) Employment $ Rent/Mortgage $ Unemployment $ Electricity $ SSI $ Heat $ SSDI $ Water $ VA Benefits $ Phone $ Child Support $ Food $ Family Support $ Child Care $ TANF $ Car expenses $ LINK benefits $ Other: $ Other: $ Other: $ Total Income $ Total Expenses $ 18

19 CLIENT INFORMATION: AFC HOUSING AND UTILITY ASSISTANCE FOLLOW UP REQUIREMENT Last Name First Name SS# - - Date of Birth / / Circle One: Single Male Single Female Couple: No Child Couple w/child Male w/child Female w/child Client received AFC Housing and Utility Assistance on: / / The program requires that if services are provided during the fiscal year (July 1, 2009 June 30, 2010) the case manager must attempt to contact the household to determine if they are still housed. This contact MUST be made during September or October of If rental assistance was provided and nobody in the household can be contacted, the case manager must attempt to contact the landlord. Please describe the results of the contact with the landlord Please describe the results of the contact with the client or the attempts at contact: Still housed in the same location Housed in a different location Homeless Deceased Unable to locate I authorize and understand that if my application for assistance is approved, my case manager will contact me, my emergency contact (below) or my landlord to determine if I am still housed. EmergencyContactName: Phone: Client (print) (signature) Case Manager (print) (signature) Agency Date 19

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