CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 1
PROGRAM OVERVIEW
In 2013, the City of Anaheim (City) established the Homelessness Assistance Pilot Program (HAPP) with the objective of assisting families with minor children who were experiencing homelessness transition into permanent supportive housing. To facilitate the delivery of HAPP services, the City published a Request for Proposals (RFP) and selected the Illumination Foundation to administer the program. The pilot program provided a combination of supportive services and housing assistance. Based on the success of HAPP, the City approved the removal of the pilot status of the program and continuation of HOME funds for the Homeless Assistance Program for Families (HAP -F). HAP-F follows a Tenant -Based Rental Assistance (TBRA) program model and complied by all the requirements of the HOME Program as set forth under Section 24, Part 92, of the Code of Federal Regulations (24 CFR 92).
Toward the end of FY 2024 -2025, City staff were notified by The Illumination Foundation of a change in desired programming direction which made it difficult for the City to continue contracting The Illumination Foundation for HAP -F services. To ensure continued services for HAP-F families and avoid a return to homelessness, City staff procured a proposal from City Net.
The procedures set forth herein establish the tenant selection guidelines for the TBRA program, provide the necessary operating structure for the program and clarify the roles and responsibilities of the Service Provider and the City.
I. MARKETING, OUTREACH AND APPLICATION PROCESS
A. Marketing and Outreach
• The Service Provider is responsible for marketing and outreach activities to find prospective eligible households interested in the TBRA Program. It is anticipated that the primary source of referrals will be received from the Anaheim Union High School District (AUHSD) McKinney Vento Liaison , the Community Care Response Team (CCRT) and the City’s Housing and Community Development Department.
B. Waiting List
• Once the program has reached maximum enrollment, the Service Provider shall maintain a waiting list of prospective eligible households. This list must be prioritized as follows:
▪ The client outcome matrix form; and
▪ Most urgent need;
▪ Date and time of referral to the Service Provider or initial direct contact with the Service Provider (if not a referral from another agency).
C. Intake Process
• AUHSD referrals will include a completed client vulnerability index form.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 2
• For referrals that are submitted by CCRT , the City’s Housing and Community Development Department and other community partners or received directly by the Service Provider, the Service Provider must complete the vulnerability index form and may coordinate with the AUHSD or verify ties to Anaheim, as applicable. • The Service Provider must attempt to contact the family within five (5) business days of receipt of the referral.
• As part of the intake process, the Service Provider will meet with the prospective eligible household to conduct a needs assessment and complete an Initial Qualification Form (Appendix A).
• If the program has reached maximum capacity, the Service Provider shall review the referral to assess if other services may be offered while the applicant is waiting for a slot to open in the HAP-F program.
• As part of the intake process, the Service Provider shall also request and/or assist the prospective eligible household with the completion of the following documents:
▪ TBRA Application (Appendix B)
▪ Declaration of Homelessness Status or At Risk of Homelessness Status (Appendix C)
D. Guidance for Eligible Households
• The Service Provider will meet with the prospective eligible households throughout the application process and will continue to meet with and counsel each eligible household regarding TBRA Program policies, the household's responsibilities as participants, and the goals and objectives of the TBRA Program.
E. HMIS Requirement
• The U.S. Department of Housing and Urban Development (HUD) and the federal partners, along with other planners and policymakers use aggregate Homeless Management Information System (HMIS) data to better inform homeless policy and decision making at the federal, state, and local levels. • The HEARTH Act, enacted into law on May 20, 2009, requires that all communities have an HMIS with the capacity to collect unduplicated counts of individuals and families experiencing homelessness.
• Through their HMIS, a community should be able to collect information from projects serving individuals and families experiencing homelessness to use as part of their needs analyses and to establish funding priorities.
• HMIS participation is not a statutory requirement for recipients of HOME funding but will be used for the HAP -F to collect client -level data and data on the provision of housing and services to individuals and families at risk of and experiencing homelessness.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 3
II. DETERMINATION OF ELIGIBILITY
The HAP-F program utilizes HOME funding for the delivery of the rental assistance component, and HOME-ARP funding for the delivery of the supportive services component. Eligibility for services offered by the HAP-F program shall adhere to all requirements of the HOME Program as set forth under Section 24, Part 92, of the Code of Federal Regulations (24 CFR 92).
A. Income Eligible Households
• Income limits for extremely low, very low- and low-income households are established annually for the HOME Program by HUD for the Orange County income limit area.
• To receive supportive services under the HAP-F program, applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
• To receive rental assistance under the HAP-F program, applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
• On a case -by-case basis, exceptions may be granted to households with incomes between 60% and 80% of the AMI. The Service Provider must obtain written approval from the City before rental assistance is provided to households above 60% AMI. • Gross Annual Income shall be determined in accordance with 24 CFR part 5 (often referred to as the Section 8 definition), with the allowable inclusions and exclusions from income established at 24 CFR 5.611.
▪ Gross Annual Income includes all payments from all sources, whether in cash or in -kind, that are anticipated to be received by all adult members of the Participating Tenant Household during the 12- month period following the date of application and before any deductions are made.
• The Service Provider will determine and verify eligibility for assistance under the HAP-F TBRA Program through the review of income source documents outlined in the revised HOME rule published in July 2013, applicants must provide evidence of income for the two (2) most recent months. Acceptable source documents include wage statements, check stubs, entitlement verification from another government agency and bank statements. The definition of income for the purposes of the HAP -F TBRA program are located in 24 CFR 5.609.
▪ The Service Provider may also consider any likely changes in income when collecting income verification documentation.
• Initial income verifications are valid for 6 months. If admission into the HAP -F program takes longer than 6 months, income verifications must be updated and reevaluated. After initial verification, income re -certifications shall be conducted annually.
• Income verifications will be used for two purposes:
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 4
▪ To determine eligibility for services (HOME TBRA assistance). A determination of eligibility will be completed as part of the admissions process and thereafter annually.
▪ Income information will be used to establish the household’s initial contribution toward rent, which shall be set at 30% of the household income. The household's initial contribution will remain unchanged for the first 60 days of assistance under the HOME TBRA program. Thereafter, rent will be adjusted in accordance with section IV below.
B. Current residents of the City of Anaheim
Due to the nature of the population served by the HAP -F TBRA program it may not be possible to obtain traditional proof of residency documentation such as a previous lease agreement or utility bill. The following documentation can be accepted to establish that an applicant household qualifies for the program’s Anaheim live/work preference:
• Proof that the family's last place of stable residency was in the City of Anaheim. verification from a landlord is acceptable.
• Documentation from an Anaheim City School that the children in the household have been enrolled and attending a school for at least the last 90 days from the time of admission into the HAP-F TBRA program.
▪ Under this documentation verification, it is still a requirement that the last place of the family's stable residency be in the City of Anaheim. • Documentation from a partner agency in the Anaheim Homeless Collaborative evidencing that the family is known to be chronically homeless in Anaheim. • Proof that an adult member of the household is working or has been recently hired to work in Anaheim.
• Under no circumstances may a client solely submit a self -certification of Anaheim live/work preference to meet this requirement.
C. Current homelessness or at-risk of homelessness
• The HAP-F program abides by the definition of homelessness that has been established by the U.S. Department of Housing and Urban Development • The HAP-F program abides by the definition of at -risk of homelessness that has been established by the U.S. Department of Housing and Urban Development
D. Includes at least one child
• A child is defined by the HAP-F program as an individual who is 18 years of age or younger.
• The child must reside in the household at least 5l % of the time.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 5
E. Annual Eligibility Verification
• The Service Provider will re-qualify eligible household, including examination of source documentation, on an annual basis.
• The Service Provider may request that a participating eligible household provide Verification(s) more often than annually, as reasonably necessary to confirm continued qualification and eligibility for the TBRA Program.
• The Service Provider will provide a written notice to each applicant stating whether the Applicant was determined eligible for assistance under the TBRA Program.
III. SELECTION OF HOUSING
Eligible households may elect to rent any housing unit in the City of Anaheim so long as the unit meets federal Housing Quality Standards (HQS) or such other standards as may be made applicable to the TBRA Program by HOME Program statues and/or regulation, specially including Uniform Physical Condition Standards (UPCS) and passes a rent reasonableness test. Due to the nature of the population served by the HAP-F program, it is expected that the Service Provider will assist eligible households with finding a nd selecting an appropriate housing unit that meets all program requirements.
While the Service Provider can refer eligible households to appropriate housing units, households may not be required to select a particular housing unit.
Rental assistance under the HAP-F program is only provided for housing units located in the City of Anaheim. Unincorporated area of Anaheim is excluded.
A. Occupancy Standards
• The number of people in each eligible household will determine the required unit type. • Each household must comply with the two per bedroom plus one occupancy standard. • The following table provides1hco.ccupancy standards by unit type:
Unit Type Number of People in Household
One-Bedroom Unit 1 to 3 People
Two-Bedroom Unit 3 to 5 People
Three-Bedroom Unit 5 to 7 People
Four-Bedroom Unit 7 to 9 People
B. Lead – Based Paint (LBP)
• All HOME Recipients are required to follow the HUD Lead Safe Housing Rule as listed in 24 CFR Part 35 in implementing their activities. Part M relates to Tenant Based Rental Assistance.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 6
▪ See Exhibit F – Lead in Your Home Pamphlet.
▪ See Exhibit G - Disclosure of Information on Lead -Based Paint and or Lead- Based Paint Hazards Form.
• Recipients and sub -recipients of HOME funds that fail to comply with HUD’s LBP requirements are subject to available sanctions under the HOME program and may be subject to other penalties authorized by law. Giving notice of a possible LBP hazard does not relieve a property owner of the responsibility for evaluating and reducing lead hazards.
C. Property Inspections
• Prior to the occupancy of any housing unit by an eligible household, and again during the annual verification process, the Service Provider must inspect each housing unit to ensure the unit complies with Housing Quality Standards (HQS) as set forth in the HOME Program (24 CFR 982 401(a)) as well as all applicable state and local codes and ordinances, including zoning ordinance.
• Each HQS inspection will include the following:
▪ Verification of property ownership.
▪ Verification of the age of the housing unit.
▪ Complete HQS Inspection Form (HUD – 52580).
▪ Lead-based paint hazard assessment, dissemination of lead -based paint information pamphlet and disclosure form and lead -based paint reduction activities, if required.
▪ Adequate opportunity for landlord to correct any deficiencies indicated in the HQS Inspection form to bring the housing unit into compliance. ▪ Verification that occupancy by the eligible household will comply with occupancy standards.
• Housing occupied by a family receiving HOME Investment Partnerships Program funds under the Tenant Based Rental Assistance component must meet both performance and accountability HCV (Housing Choice V oucher) Program Housing Quality Standards requirements.
▪ These requirements include but are not limited to providing a Notice of Inspection to property owners and program participants prior to a unit’s Housing Quality Standards initial inspection and annual reinspection.
D. Rent Reasonableness
• Rental assistance paid on behalf of TBRA household mu st be in compliance with federal rent reasonableness requirements which require that rent paid by or on behalf of HOME assisted household be similar to rents paid by non-assisted households. • Rent reasonableness reviews will be performed by the Service Provider.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 7
▪ The factors listed below shall be considered when determining rent comparability.
▪ Location and age
▪ Unit size, including th e number of rooms and square footage of room.
▪ The type of unit , including construction type (e.g., single family, duplex, garden, low-rise, high-rise).
▪ The quality of the unit (e.g., building construction, maintenance and improvements).
▪ Amenities, services, and utilities included in the rent. • The Service Provider will follow both the rent reasonableness regulations established for the Housing Choice V oucher (HCV) program at 24 C FR 982.507 and the methodology described in Chapter 8, Part III of the Anaheim Housing Authority Administrative Plan for the HCV program to evaluate rents. • In the event that a rent request does not meet rent reasonableness requirements, the Service Provider shall attempt to negotiate lower rent with the property owner. If the owner is not willing to accept the lower rent, the household must be instructed to search for another unit.
▪ Unless previously approved by the city, u nder no circumstances shall the Service Provider or the assisted household agree to pay more than approved through the reasonable rent review.
▪ Unless previously approved by the city, the assisted household may not make up any difference in the rent offer.
• The city will grant the Service Provider with account access to rent reasonableness data (GoSection8.com). All rent reasonableness verifications for the HAP-F program must be completed on GoSection8.com.
▪ The Anaheim Housing Authority (AHA) will provide support to the Service Provider in completing this task. AHA will be available for technical support and grant access to reasonableness rent data that Service Provider can use in finalizing approvals.
• In the event that there is a conflict between rents authorized by Service Provider and rents authorized for other rent subsidy programs offered by the City of Anaheim, the Service Provider must work with AHA and/or City staff to resolve the conflict so that there is parity in all City sponsored rental assistance programs,
E. Coordination with Landlords
The Service Provider will meet with and provide guidance to landlords participating in the TBRA Program regarding the requirements and procedures that impact landlords.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 8
• Rental Assistance Contract (Appendix D)
▪ The Service Provider will enter into a Rental Assistance Contract with each participating household.
▪ The Rental Assistance Contract will establish the security deposit assistance payment and the initial rental assistance payments to be paid on behalf of the household. The Contract will also establish the participating household’s initial share of the contract rent.
▪ The household's share of rent will be adjusted using an escalation factor of $100 after 60 days of occupancy. The household tenant portion may be further increasing every 60 days thereafter.
▪ This Contract will have a term of up to 12 months.
• Lease Addendum (Appendix E)
▪ The landlord will be required to enter into a lease agreement with a term of up to 12 months with any eligible household occupying a housing unit. ▪ The lease agreement will include a lease addendum that will be executed in connection with the lease between the landlord and the eligible household. ▪ The addendum will include the terms of the rental assistance payments to be paid to the landlord on behalf of the eligible household, confirm the obligations of the landlord, confirm obligations of the eligible household regarding payment of rent, utilities and appliances, rules and regulations of tenancy and confirm the landlord's obligation to maintain the housing unit in accordance with HQS.
▪ The landlord will be required to provide the Service Provider with notice of a lease termination, prohibit discrimination by the landlord against the eligible household as well as lease provisions prohibited by the HOME Program. ▪ The Service Provider will review the lease agreement to confirm its compliance with state law and all HOME Program requirements as outlined in the revised HOME rule published in February 2025.
• IRS Form W-9 (Appendix F)
▪ Each landlord will be required to submit a completed IRS Form W -9 Request for Taxpayer Identification Number and Certification.
▪ The Service Provider will rely on this information when issuing a 1099 form to each payee required by the IRS. A 1099 form must be issued annually to all participating landlord (payee).
IV . Payment Standards, Rent Calculation, Term and Subsidy Reductions As authorized by HOM E TBRA regulations, the HAP -F TBRA program will rely on a unique subsidy calculation model rather than traditional rental assistance calculation. The model allows
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 9
for an initial rent subsidy determination that is based on 30% of household’s Gross Annual Income which is then increased every other month using an escalation factor of $100. The use of this rent subsidy calculation model has been recommended by the Service Provider based on their experience in working with the specific target population served by HAP-F. The escalation factor is used to encourage households to progress in their individual case management goals and to stay on track with objectives aimed at increasing household income. The Service Provider will closely monitor the use of the escalation factor and can waive the next scheduled rent escalation as needed.
A. Rent Assistance Calculations
• The Service Provider will complete a rental assistance calculation for each eligible household. The calculation will determine each household's initial program subsidy and share of the rent.
• The initial household rent is equivalent to the maximum subsidy amount allowed under HOME TBRA regulations and is calculated as the difference between 30% of the household's monthly income and the payment standard for the size of the unit.
Each household’s maximum rent subsidy will vary since the calculation involves the use of individualized factors such as the household's income and family size. • The initial household rent will remain unchanged for the first 60 days of assistance.
Thereafter, household rent contributions may be increased by $ 100 every other month.
Once rent acceleration factors are applied, the household's rent contribution will no longer tie back to a percentage of household income.
• Minimum rent under the TBRA program is set at $50.00. The minimum tenant payment is used if the maximum subsidy calculation would result in the household paying less than $50.00 towards the monthly rent.
B. Payment Standards
• The TBRA program must use -the Anaheim Housing Authority's (AHA) current payment standards (Appendix G) to calculate monthly rental assistance. The AHA's payment standards represent the cost of rent and utilities for moderately priced units in Anaheim. Payment standards are established by bedroom size. • When utilities ar e included in the cost of renting a unit, that is, the owner assumes responsibility for payment for all utility services, the household's entire share of the housing costs will go directly to the owner.
• When the cost of utilities i s not part of the rent, that is, the household is directly responsible for payment of utility services, the household's initial share will be determined by subtracting a utility allowance from 30% of the household's total income.
• The Service Provider must use the AHA utility allowance schedule (Appendix H) to determine the household's utility allowance. The result of 30% of the household’s total income, minus the applicable utility-allowance, is the household’s initial share of rent.
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 10
Each household is responsible for paying their rent share directly to the landlord each month.
• If a selected housing unit i s subject to contractual, statutory and/or regulatory affordability restrictions, the monthly rental assistance payment will not exceed the difference between the, required affordable rent amount for the Housing Unit and 30% of the eligible household's monthly gross income.
C. Term
• The Service Provider will provide rental assistance for an initial term of 12 month s, which can be extended one time , for a cumulative term of 24 months. Extensions beyond the first 12 months will be granted at the discretion of the HAP-F program manager and shall require written approval which will be based on continued program compliance and ongoing need. Written approval must be requested beyond the 12 th month of rental assistance.
• The Service Provider will utilize the Client Outcome Matrix Form (Appendix I) to evaluate ongoing need. Households that score between 0 -80 on the client outcome matrix will be eligible for a subsidy extension.
D. Subsidy Reduction
• During the first 60 days of occupancy in the new unit the household's contribution toward rent will remain unchanged. Thereafter, every other month the rental assistance payment amount paid on behalf of the assisted household may be reduced by $100.00.
When the rental assistance payment is reduced, the assisted household is responsible for making up the difference in the payment.
• Households may request suspensions of their monthly rent increases. All requests will be reviewed by the Service Provider and granted at their sole discretion. In evaluating whether to grant a request to suspend a proposed rental assistance payment decreas e the Service Provider shall consider the family's ability to make additional rental payments, extenuating life circumstance, unplanned expenses, and/ or unexpected loss of income.
▪ Suspensions of the monthly rent increases should be documented in the client’s file with a written explanation of the hardship and a plan from the Service Provider Case Manager on steps being taken to help the household overcome the financial hardship.
E. Non-HOME TBRA Emergency Rental Assistance
• In extreme cases where a suspension of a household’s monthly rent increases has been approved by the Service Provider and the household requires additional non-HOME TBRA rental assistance to meet their tenant portion obligations, the Service Provider
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 11
may connect the HOME assisted household to other emergency rental assistance programs.
▪ Households may not receive rental assistance outside of HOME TBRA if the assistance, Federal, State or local, would result in duplicative subsidies to the household or would result in a reduction of their tenant portion to less than 30% of their Gross Annual Income.
▪ Households participating in the HAP -F program must notify the Service Provider if they plan to apply for any non-HOME TBRA rental assistance programs prior to applying for said programs.
▪ A participating HAP-F household will fall into non-compliance if they receive non-HOME TBRA rental assistance for their tenant portion that resulted in a reduction of their tenant portion to less than 30% of their Gross Annual Income.
V . Utility and Security Deposit
A. Utility Deposit Assistance
• The Service Provider may provide utility deposit assistance to an eligible household in the full amount of any utility deposit required for (electricity, gas, water and trash) to be provided to the utility provider when needed to assist the household in establishing a tenancy.
• Utility deposit assistance may only be provided once during a household’s participation in the HAP-F program, including re-entry into the program following an exit.
• Utility Deposit Assistance may be provided only if the following requirements are met:
▪ Utility deposit assistance is only available where rental assistance is also being provided.
▪ Utility deposit assistance will be paid directly to the landlord or utility provider on behalf of the eligible household.
▪ Utility deposits provided to the participating household will be in the form of a grant.
▪ Utility deposit refunds can be returned directly to the assisted Household
B. Security Deposit Assistance
• As needed, the Service Provider will provide security deposit assistance to eligible households. Such assistance shall be the lesser of;
▪ One month approved rent for the housing unit; or
▪ The standard security deposit required by the Landlord for non -subsidized tenants.
• Security deposit assistance provided to participating households will be in the form of a grant. As such, security deposit assistance may only be provided once during a
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 12
household’s participation in the HAP-F program, including re-entry into the program following an exit.
• The Landlord can provide the security deposit refund directly to the household. Any disputes involving the return, or lack thereof, of a security deposit shall be settled by the tenant and landlord, as provided for in the lease.
VI. Annual Re-Certification, Termination of Assistance and Returning Households A. Annual Recertification
• Recertification of income and program eligibility will occur annually. The Service Provider will gather source documentation for participating households to determine Gross Annual Income. Gross Annual I ncome must be calculated in accordance with 24 CFR Part 5.609.
▪ If the total household Income is above 80 % AMI. Rental assistance must be terminated following a 30-day notification period.
▪ For households between 60% and 80% AMI the Service Provider must obtain approva1 from the City before rental assistance is continued.
B. Termination of Rental Assistance
• Assistance can be terminated for the following reasons:
▪ Failure to comply with HAP-F Program Guidelines and/ or Client Participation Agreements including disengagement in client services. ▪ Eviction from the assisted rental unit based on behavioral issues and/or unlawful activity.
▪ The participant no longer qualifies based on income eligibility, for assistance at annual re-certification.
▪ The family will be assisted by another rental assistance program such as the Section 8 Tenant• Based or Project-based program. Participation in any other rental assistance program is considered a duplicative subsidy therefore all HOME funded rental assistance must terminate.
C. Returning Participants Households
• As needed, participants may be allowed to return to the program for either support services, rental assistance or both. A determination to allow re-entry shall be based on the following criteria:
▪ Participants must have left the program in good standing. To be in good standing, participants must have been engaged in their case management plan, voluntarily left the program (not in lieu of termination) or have been released because their household income exceeded eligibility limits. In
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 13
general, participants will not be allowed to re-enter the program if they are terminated for non-compliance.
▪ At the discretion of the Service Provider, a request for readmission from a non-compliant household may be considered when compelling reasons exist. In such cases, re-admission will require concurrence from the City of Anaheim.
▪ The participant's previous rental assistance did not exceed 24 months.
Cumulatively, participants will only be allowed to receive rental assistance for a maximum of 24 months.
D. Exit Procedures
• The Service Provider will submit a client exit letter to the City of Anaheim for all clients who exit HAP-F detailing the reason for exit and all exit strategies and housing plans.
▪ A copy of this letter must be kept in the client’s file.
VII. Self Sufficiency Program
The Service Provider will request each eligible household receiving rental assistance payments to participate in a Self -Sufficiency Program administered by the Service Provider. The Self - Sufficiency Program Policies and Procedures are outlined in Appendix J.
The Self Sufficiency Program provides participating households with intense case management, which is designed to assist participants move to self -sufficiency within a 12-to-24-month period.
Income re -certifications will be completed annually for participating households. To receive supportive services under the HAP-F program, applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
The family's failure to continue participation in the Self -Sufficiency Program is not a basis for terminating the assistance; however, households that fail to participate in the Self -Sufficiency Program will not be allowed to receive rental assistance extensions. Service Provider reserves the right to give client and landlord a "Notification of Non-renewal” if the client becomes non - responsive (see Section VI).
The Service Provider will utilize their agencies’ respective case management models to carry out these services. Although the Service Provider will utilize their own model, the Service Provider will be required to complete certain activities. The key activities are as follows:
• Development of a comprehensive, individualized service plan ; • Coordination of services required to implement the plan; • Monitoring of client to assess the effectiveness of the plan;
CITY OF ANAHEIM
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
Operating Guidelines
(August 26, 2025) pg. 14
• Periodic service plan re -evaluation at least every three (3) months and adaptation of the plan, as necessary; and
• Clear documentation of assessment, plan, and service referrals.
Listed below are some of the Self-Sufficiency Case Management Services offered by the Service Provider:
A. Behavioral Health
▪ Behavioral Health assessment in order to appropriately connect clients with needed support based on life experience.
B. Workforce Development
▪ Workforce Development Program provides life skills training, job skills, and employment placement to obtain and maintain employment. Clients are taught how to comply with workplace standards and how to excel in a professional environment.
C. Medical
▪ Provides the homeless, uninsured. and underinsured access to medical care, vision care, and mental health services.
D. Education
▪ Early childhood education and after-school programs for the homeless and at-risk children to overcome the effects of homelessness. The crisis prevention curriculum facilitates parent and child enrichment. financial literacy and life skills.
Case Managers and Resource Specialists will ensure clients are kept abreast of classes and event opportunities that include health and wellness fairs, job fairs, MediCal enrollment workshops, Cal- Works support, food and holiday gift distributions. All Resource Connection offerings are in addition to the standard case management practices which bring wraparound health, financial, documentation, job assistance, childcare connections, and more resources If additional services and resources are needed, the participants will be referred to outside agencies.
Appendix A
HAP – F
Initial Qualification Document
Appendix A – Page 1
Applicant #1 Name: _________________________________________________ Birth Date: ___/___/______ Applicant #2 Name: _________________________________________________ Birth Date: ___/___/______ Child #1 Name: ______________________________________________________ Birth Date: ___/___/______ Child #2 Name: ______________________________________________________ Birth Date: ___/___/______ Child #3 Name: ______________________________________________________ Birth Date: ___/___/______ Child #4 Name: ______________________________________________________ Birth Date: ___/___/______ Household Size _______________
Source of Income: ______________________________________Monthly Gross Income$_______________ Yearly Gross Income $ _______________
☐Household is eligible to participate in the __________ program under the Program Income Limits. ☐Household is not eligible to participate in the _________ program under the Program Income Limits.
Provide a letter to the household stating the reasons for ineligibility. ___________________________________
Intake staff Signature and Date
________________________________________
Date
____________________________________
Client Signature and Date
___________________________________________ ___
Director of Family
Program
Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 2
Applicant’s Information
Adult #1
Last Name:
First Name: M.I.: Gender:
F or M
DOB:
____/____/_____
SSN: Driver’s License or Identification Number/State:
Phone Number: E-mail Address:
Adult #2
Last Name:
First Name: M.I. Gender:
F or M
DOB:
____/____/_____
SSN: Driver’s License or Identification Number/State:
Phone Number: E-mail Address:
Adult #3
Last Name:
First Name: M.I. Gender:
F or M
DOB:
____/____/_____
SSN: Driver’s License or Identification Number/State:
Phone Number: E-mail Address:
Most Recent Street Address: Apartment/Unit #:
City: State: Zip:
Most Recent Landlord Name and Phone Number:
Reference (employer, community member) Name:
Phone:
Date you moved into your current address:
YES NO; If so, what proof do you Have you lived in the City of Anaheim for the last six months? have?
How did you hear about HAP-F Who referred you?
Children’s Information (Please list all children)
Full Name of Child Social Security
Number
Gender Date of Birth Age Living with
You?
School or Childcare
Program and City
F or M Y or N
F or M Y or N
F or M Y or N
F or M Y or N
Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 3
Employment Information for Adult #1
Company: Phone Number:
Address: Supervisor:
Job Title: Wage and Hours per Week:
Responsibilities:
Employment Information for Adult #2
Company: Phone Number:
Address: Supervisor:
Job Title: Wage and Hours per Week:
Responsibilities:
Employment Information for Adult #3
Company: Phone Number:
Address: Supervisor:
Job Title: Wage and Hours/Week:
Responsibilities:
Re-Housing Questions
Do you have pets? YES NO; If so, what kind and how big are they? Does anyone in the household smoke?
Do you receive rental assistance or section 8?
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to participation in the housing program, I understand that false or misleading information in my application or interview may result in my termination from the program.
F or M Y or N
Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 4
Adult #1 Signature: Date:
Adult #2 Signature: Date:
Adult #3 Signature: Date:
Release of Information
CLIENT/PROVIDER INFORMATION:
Client’s Name:
Date of Birth:
Social Security Number: Telephone Number:
Provider:
Provider:
Provider:
Provider:
Pursuant to Federal Guidelines concerning my right to confidentiality, I hereby authorize the:
USE RELEASE EXCHANGE
From: To: Landlord/Property Manager
Employer
Specific nature, extent, and dates of information requested:
Discuss client’s situation and needs, rent & security deposits. Etc.
Reason for request:
Confirm information provided and needed
I understand that I may revoke this consent of release of information at any time. I also understand, however, that any release which has been made prior to my revocation Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 5
and which was made in reliance upon this authorization shall not constitute a breach of my right to confidentiality. Unless I revoke this authorization in writing, prior to such time, this authorization to release information shall expire one year from the signature date below. At that time, no express revocation shall be needed to terminate my consent.
Signature: _______________________________ Today’s Date: ________________ Printed Name: _________________________________________________________ Complete Address: ____________________________________________________ Telephone Number: ________________________________________________ HAP-F Disclaimer & Notice of Responsibility
[Service Provider Name] is a non-profit agency that is authorized to distribute federal rental assistance through the Housing Assistance Program for Families (HAP-F)
The following applicant(s) for the HAP-F program:
Name: ______________________________________________________________________ Name: ______________________________________________________________________ Name: ______________________________________________________________________ Understand and agree to the following terms and conditions 1) All applicants are screened to ensure the highest probability that they will be able to maintain rental payments on their own and within their budget. 2) No guarantee of assistance is being offered by [Service Provider Name].
You are still responsible for your own rent and utility payments while your application is being processed.
3) It is the responsibility of the applicants, not [Service Provider Name], to keep their landlord and other debtors updated on the status of their potential assistance and ability to pay.
4) [Service Provider Name] will deny any application that contains false information.
5) Applicants understand that their personal information is being entered in a central database to monitor and track assistance applied for, and when applicable, awarded.
Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 6
Signature: __________________________________________ Date: ___________________ Signature: __________________________________________ Date: ___________________ Signature: __________________________________________ Date:___________________
Appendix B
Homeless Assistance Program for Families (HAP-F)
Program Application
Appendix B – Page 7
We/I, ________________________ and , a nd our children are currently applying to or are participants in the Housing Assistance Program for Families. We understand that during our application process and during program participation, confidential information will be requested in order to assess the needs of and provide appropriate services to our family.
We acknowledge that [Service Provider Name]maintains a policy of respecting a client’s right to privacy and confidentiality. In an effort to achieve this, [Service Provider Name] keeps paper and electronic client records in locked file cabinets and in a secure database. Also, [Service Provider Name] only shares information on a need-to-know basis with appropriate staff and other authorized professionals.
We understand that all information we provide to [Service Provider Name]staff is confidential within the organization. However, we understand that, according to California law 1 and legal precedent2, all staff are mandated reporters and are legally required to share confidential information about our family with or without our permission under the following circumstances:
• I
f staff has any suspicion that a child or an elderly or dependent adult is being abused or neglected.
• If staff determine that anyone in our family is a danger to his/her self or to another person(s).
Under these circumstances, staff has the legal responsibility to breach our confidentiality to insure the safety of the individual(s) at risk. Should disclosure or reasonable suspicion of the stated above occur, we are aware that staff will contact the appropriate agencies/individuals including, but not limited to, the police, child protective services, adult protective services and/or the person at risk.
By signing below, we indicate that we have read, understood, and agree to comply with [Service Provider Name]’s policy on confidentiality and its limitations. Furthermore, we are aware of [Service Provider Name]’s policy regarding information sharing for collaboration purposes, and we understand that our confidential information, with the exceptions stated above, cannot be released without written consent. We have the right to receive a copy of this document if requested, and a photocopy of this document is as valid as the original
Adult #1 Signature Date
Print Name
Adult #2 Signature D ate
Print Name
1 Child Abuse and Neglect Reporting Act, Sections 11164-11174.3; Welfare and Institutions Code, Sections 11166, 15630.9 and 15610.07 2 Tarasoff vs. Regents of the University of California
Appendix C – Page 1
HUD’s DEFINITION of HOMELESSNESS and CERTIFICATION
Household Name: ______________________________________________ Date: __________________
This is to certify the above individual or household is currently homeless based on the category checked and required documentation. **THE GENERAL HOMELESS CERTIFICATION MUST BE COMPLETED FOR EACH HOUSEHOLD.
CHRONICALLY HOMELESS CERTIFICATION
CHRONICALLY HOMELESS: (If chronically homeless, the General Homeless Certification Category 1, must also be completed).
Individual or family:
(i) Has been homeless and living or residing in a place not meant for human habitation, a safe haven, or in an emergency shelte r continuously for at least one year or on at least four separate occasions in the last three years; and (ii) Has an adult head of household (or a minor head of household if no adult is present in the household) with a diagnosable substance use disorder, serious mental illness, developmental disability (as defined in Section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15002)), post -traumatic stress disorder, cognitive impairments resulting from a brain injury, or chronic physical illness or disability, including the co -occurrence of 2 or more of those conditions.
**GENERAL HOMELESS CERTIFICATION
**Category 1 is eligible for Rapid Re-housing Assistance CATEGORY 1: Literally Homeless
Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:
(i) Has a primary nighttime residence that is a public or private place not meant for human habitation; or (ii) Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state an d local government programs).
To certify homeless status for the above, must provide documentation of 1 of the following:
Written observation by the outreach worker; or
Written referral by another housing or service provider; or Certification by the individual or head of household seeking assistance stating that (s)he was living on the streets or in shelter (Form No. 5).
Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:
(iii) Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution (documentation must include one of the above forms of evidence AND 1 of the following).
Discharge paperwork or written/oral referral; or
Written record of intake worker’s due diligence to obtain above evidence and certification by individual that they exited institution (Form No. 5).
**Categories 2 thru 4 are considered “homeless” but receive assistance under TBRA CATEGORY 2: Imminent Risk of Homelessness
Individual or family who will imminently lose their primary nighttime residence, provided that:
(i) Residence will be lost within 14 days of the date of application for homeless assistance; (ii) No subsequent residence has been identified; and
(iii) The individual or family lacks the resources or support networks needed to obtain other permanent housing .
Appendix C – Page 2
HUD’s DEFINITION of HOMELESSNESS and CERTIFICATION
CATEGORY 2: Imminent Risk of Homelessness (continued)
Documentation must include 1 of the following:
A court order resulting from an eviction action notifying the individual or family that they must leave; or For individual and families leaving a hotel or motel—evidence that they lack the financial resources to stay (Form No. 5); or
A documented and verified oral statement.
In addition to 1 of the above, documentation must include BOTH of the following:
Certification that no subsequent residence has been identified (Form No. 5); AND Self-certification or other written documentation that the individual lack the financial resources and support necessary to obtain permanent housing (Form No. 5).
CATEGORY 3: Homeless under Other Federal Statutes
Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who:
(i) Are defined as homeless under the other listed federal statutes; (ii) Have not had a lease, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to the homeless assistance application;
(iii) Have experienced persistent instability as measured by 2 moves or more during the preceding 60 days; and (iv) Can be expected to continue in such status for an extended period of time due to special needs or barriers.
Documentation must include all of the following:
Certification by the nonprofit or state or local government that the individual or head of household seeking assistance met the criteria of homelessness under another federal statute; and Certification of no public housing in the last 60 days; and Certification by the individual or head of household, and any available supporting documentation, that (s) he has moved 2 or more times in the past 60 days; and
Documentation of special needs or 2 or more barriers.
CATEGORY 4: Fleeing/Attempting to Flee Domestic Violence Any individual or family who:
(i) Is fleeing, or is attempting to flee, domestic violence; (ii) Has no other residence; and
(iii) Lacks the resources or support networks to obtain other permanent housing Documentation required:
For victim service providers:
An oral statement by the individual or head of household seeking assistance which states: they are fleeing; they have no subsequent residence; and they lack resources. Statement must be documented by a self -certification (Form No. 5) or a certification by the intake worker.
For non-victim service provider (must document all of the following):
Oral statement by the individual or head of household seeking assistance that they are fleeing. This statement is documented by a self-certification (Form No. 5) or by the caseworker. Where the safety of the individual or family is not jeopardized, the oral statement must be verified; and Certification by the individual or head of household that no subsequent residence has been identified (Form No. 5); and
Self-certification, or other written documentation, that the individual or family lacks the financial resources and support networks to obtain other permanent housing (Form No. 5).
Intake Staff Signature: ________________________________________ Date: ________________ Appendi
x D
HAP-
F
HOM
E RENTAL ASSISTANCE CONTRACT
LANDLORD NAME & ADDRESS
Tel
ephone No. ________________
UNIT NO. & ADDRESS TENANT NAME
This HOME Rental Assistance Contract ("Contract") is entered into between the "City of Anaheim, Department of " (program administrator) and the Landlord identified above. This Contract applies only to the Tenant family and the dwelling unit identified above.
1. TE
RM OF THE CONTRACT
The t
erm of this Contract shall begin on 1 and end no later than .2 The Contract automatically terminates on the last day of the term of the Lease.
2. SECU
RITY DEPOSIT3
A. The (
program administrator) will pay a security deposit to the Landlord in the amount of $__________. The Landlord will hold this security deposit during the period the Tenant occupies the dwelling unit under the Lease. The Landlord shall comply with state and local laws regarding interest payments on security deposits.
B. Af
ter the Tenant has moved from the dwelling unit, the Landlord may, subject to state and local law, use the security deposit, including any interest on the deposit, as reimbursement for rent or any other amounts payable by the Tenant under the Lease. The Landlord will give the Tenant a written list of all items charged against the security deposit and the amount of each item. After deducting the amount used as reimbursement to the Landlord, the Landlord shall promptly refund the full amount of the balance to the [Tenant/program administrator].
C. The La
ndlord shall immediately notify the (program administrator) when the Tenant has moved from the Contract unit.
3. RENT
AND AMOUNTS PAYABLE BY TENANT AND (program administrator) A. In
itial Rent. The initial total monthly rent payable to the Landlord for the first twelve months of this Contract is $______________.
B. Rent
Adjustments. With no less than 4 days' notice to the Tenant and the (program administrator), the owner may propose a reasonable adjustment to be effective no earlier than the 13th month of this Contract. The proposed rent may be rejected by either the Tenant or the (program administrator). The Tenant may reject the proposed rent by providing the Landlord 1 Insert the first day of the term of the Lease.
2 The maximum allowable length of a HOME Coupon Contract is two years. 3 Insert the number of days notice the owner must provide of a rent increase. At least 60 days is recommended to enable the program administrator 30 days to review the rent and still enable the landlord to give the tenant 30 days notice.
HOME Rental Assistance Contract (Page Two)
w
ith 30 days' written notice of intent to vacate. If the program administrator rejects the proposed rent, the program administrator must give both the Tenant and the Landlord 30 days' notice of intent to terminate the Contract.
C. T
enant Share of the Rent. Initially, and until such time as both the Landlord and the Tenant are not
ified by the (program administrator), the Tenant's share of the rent shall be $___
____________.
D. P
rogram Administrator Share of the Rent. Initially, and until such time as both the Landlord and T
enant are notified by the (program administrator), the (program administrator's) share of the rent shall be $_______________. Neither the (program administrator) nor HUD assumes any obligation for the Tenant's rent, or for payment of any claim by the Owner against the Tenant.
The (program administrator's) obligation is limited to making rental payments on behalf of the Tenant in accordance with this Contract.
E. P
ayment Conditions. The right of the owner to receive payments under this Contract shall be s
ubject to compliance with all of the provisions of the Contract. The Landlord shall be pai d under
this Contract on or about the first day of the month for which the payment is due. T he Land
lord agrees that the endorsement on the check shall be conclusive evidence that the Land
lord received the full amount due for the month, and shall be a certification that:
1. t
he Contract unit is in decent, safe and sanitary condition, and that the Landlord is providing the services, maintenance and utilities agreed to in the Lease.
2. the Contract unit is leased to and occupied by the Tenant named above in this Contract.
3. the Landlord has not received and will not receive any payments as rent for the Contract unit other than those identified in this Contract.
4. to the best of the Landlord's knowledge, the unit is used solely as the Tenant's principal place of residence.
F
. Overpayments. If the (program administrator) determines that the Landlord is not entitled to any
payments received, in addition to other remedies, the (program administrator) may deduct the amount of the overpayment from any amounts due the Landlord, including the amounts due under any other Rental Assistance Coupon Contract.
4. HO
USING QUALITY STANDARDS AND LANDLORD-PROVIDED SERVICES
A. T
he Landlord agrees to maintain and operate the Contract unit and related facilities to provid e dec
ent, safe and sanitary housing in accordance with 24 CFR Section 882.109, including all of the services, maintenance and utilities agreed to in the Lease.
B. T
he (program administrator) shall have the right to inspect the Contract unit and relate d f
acilities at least annually, and at such other times as may be necessary to assure that the unit is in decent, safe, and sanitary condition, and that required maintenance, services and utilities are provided.
C. I
f the (program administrator) determines that the Landlord is not meeting these obligations, th e pr
ogram administrator shall have the right, even if the Tenant continues in occupancy, to ter
minate payment of the (program administrator's) share of the rent and/or terminate t he C
ontract.
5. T
ERMINATION OF TENANCY
T
he Landlord may evict the Tenant following applicable state and local laws. The Landlord must give the Tenant at least 30 days' written notice of the termination and notify the (program adm
inistrator) in writing when eviction proceedings are begun. This may be done by providing the (program administrator) with a copy of the required notice to the tenant.
HOME Rental Assistance Contract (Page Three)
6. FAIR HOUSING REQUIREMENTS
A. Nondiscrimination. The Landlord shall not, in the provision of services or in any other manner, discriminate against any person on the grounds of age, race, color, creed, religion, sex, handicap, national origin, or familial status. The obligation of the Landlord to comply with Fair Housing Requirements insures to the benefit of the United States of America, the Department of Housing and Urban Development, and the (program administrator), any of which shall be entitled to involve any of the remedies available by law to redress any breach or to compel compliance by the Landlord.
B. Cooperation in Quality Opportunity Compliance Reviews. The Landlord shall comply with the (program administrator) and with HUD in conducting compliance reviews and complaint investigations pursuant to all applicable civil rights statutes, Executive Orders and all related rules and regulations.
7. (Program administrator) AND HUD ACCESS TO LANDLORD RECORDS
A. The Landlord shall provide any information pertinent to this Contract which the (program administrator) or HUD may reasonably require.
B. The Landlord shall permit the (program administrator) of HUD, or any of their authorized representatives, to have access to the premises and, for the purposes of audit and examination, to have access to any books, documents, papers, and records of the Landlord to the extent necessary to determine compliance with this Contract.
8. RIGHTS OF (Program administrator) IF LANDLORD BREACHES THE CONTRACT
A. Any of the following shall constitute a breach of the Contract:
(1) If the Landlord has violated any obligation under this Contract; or
(2) If the Landlord has demonstrated any intention to violate any obligation under this Contract; or
(3) If the Landlord has committed any fraud or made any false statement in connection with the Contract, or has committed fraud or made any false statement in connection with any Federal housing assistance program.
B. The PHA's right and remedies under the Contract include recovery of overpayments, termination or reduction of payments, and termination of the Contract. If the (program administrator) determines that a breach has occurred, the program administrator may exerc ise any of its rights or remedies under the Contract. The (program administrator) shall notify the Landlord in writing of such determination, including a brief statement of the reasons for the determination. The notice by the PHA to the landlord may require the Landlord to take corrective action by a time prescribed in the notice.
C. Any remedies employed by the (program administrator) in accordance with this Contract shall be effective as provided in a written notice by the (program administrator) to the Landlord. The (program administrator's) exercise or non-exercise of any remedy shall not constitute a waiver of the right to exercise that or any other right or remedy at any time.
HOME Rental Assistance Contract (Page Four)
9. P
HA RELATION TO THIRD PARTIES
A. T
he (program administrator) does not assume any responsibility for, or liability to, any pers on i
njured as a result of the Landlord's action or failure to act in connection with the i
mplementation of this Contract, or as a result of any other action or failure to act by the Land
lord.
B. T
he Landlord is not the agent of the (program administrator) and this Contract does not create or affect any relationship between the (program administrator) and any lender to the Landlord, or any suppliers, employees, contractors or subcontractors used by the Landlord in connecti on w
ith this Contract.
C. N
othing in this Contract shall be construed as creating any right of the Tenant or a third party (other than HUD) to enforce any provision of this Contract or to asses any claim against HUD, the (program administrator) or the Landlord under this Contract.
10. C
ONFLICT OF INTEREST PROVISIONS
A. N
o employee of the (program administrator) who formulates policy or influences decisions with respect to the Rental Assistance Program, and no public official or member of a governing body or state of local legislator who exercise his functions or responsibilities with respect to th e
pr
ogram shall have any direct or indirect interest during this person's tenure, or for one year thereafter, in this contract or in any proceeds or benefits arising from the Contract or to any benefits which may arise from it.
11. T
RANSFER OF THE CONTRACT
T
he Landlord shall not transfer in any form this Contract without the prior written consent of t he (
program administrator). The (program administrator) shall give its consent to a transfer if the transferee agrees in writing (in a form acceptable to the (program administrator)) to comply with all terms and conditions of this Contract.
12. EN
TIRE AGREEMENT: INTERPRETATION
A. T
his Contract contains the entire agreement between the Landlord and the program adm
inistrator. No changes in this Contract shall be made except in writing signed by both the Landlord and the (program administrator).
B. T
he Contract shall be interpreted and implemented in accordance with HUD requirements.
HOME Rental Assistance Contract (Page Five)
13. WARRANT
Y OF LEGAL CAPACITY AND CONDITION OF UNIT
A. The Land
lord warrants the unit is in decent, safe, and sanitary condition as defined in 24 CFR Section 882.109, and that the Landlord has the legal right to lease the dwelling unit covered by this Contract during the Contract term.
B. The part
y, if any, executing this Contract on behalf of the Landlord hereby warrants that authorization has been given by the Landlord to execute it on behalf of the Landlord.
Landlor
d Name (Type or Print): (Program administrator) Representative (Type of Print):
(Signature/Date) (Signature/Date)
WARNING: 18 U.S.C. 1001 provides, among other things, that whoever knowingly and willingly makes or uses a document or writing containing any false, fictitious, or fraudulent statements or entries, in any matter within the jurisdiction of any department or agency of the United States, sha ll be fined not more than $10,000, or imprisoned for not more than five years, or both.
LANDLORD'S CHECK TO BE MAILED TO: SS NO. __________________________________ NAME(S)_____________________________________________________________________ ADDRESS______________________________ _____________________________________ ____________________________________________
SIGNATURE OF OWNER DATE
_____________________________________ ___
SIGNATURE OF OWNER DATE
RENT REASONABLENESS CHECKLIST AND CERTIFICATION
P roposed Unit Unit #1 Unit #2 Unit #3
Address
Number of Bedrooms
Square Feet
Type of Unit/Construction
Housing Condition
Location/Accessibility
Amenities
U
nit:
S
ite:
N
eighborhood:
Age in Years
Utilities (type)
Unit Rent
Utility Allowance
Gross Rent
Handicap Accessible?
CE
RTIFICATION:
A. C
ompliance with Payment Standard
____
________________ _____________ __________________
Proposed Contract Rent + Utility Allowance = Proposed Gross Rent A
pproved rent does not exceed applicable Payment Standard of $_____________.
B. R
ent Reasonableness
B
ased upon a comparison with rents for comparable units, I have determined that the proposed rent for the unit [ ]is [ ] is not reasonable.
N
ame: Signature: Date:
VIOLENCE, DATING VIOLENCE U.S. Department of Housing OMB Approval No. 2502-0204 OR STALKING and Urban Development Exp. 6/30/2017 Office of Housing
Form HUD-91067
(9/2008)
LEASE ADDENDUM
VIOLENCE AGAINST WOMEN AND JUSTICE DEPARTMENT REAUTHORIZATION ACT OF 2005
TENANT
LANDLORD UNIT NO. & ADDRESS
This lease addendum adds the following paragraphs to the Lease between the above referenced Tenant and Landlord.
Purpose of the Addendum
The lease for the above referenced unit is being amended to include the provisions of the Violence Against Women and Justice Department Reauthorization Act of 2005 (VAWA).
Conflicts with Other Provisions of the Lease
In case of any conflict between the provisions of this Addendum and other sections of the Lease, the provisions of this Addendum shall prevail.
Term of the Lease Addendum
The effective date of this Lease Addendum is ______________. This Lease Addendum shall continue to be in effect until the Lease is terminated.
VAWA Protections
1. The Landlord may not consider incidents of domestic violence, dating violence or stalking as serious or repeated violations of the lease or other “good cause” for termination of assistance, tenancy or occupancy rights of the victim of abuse.
2. The Landlord may not consider criminal activity directly relating to abuse, engaged in by a member of a tenant’s household or any guest or other person under the tenant’s control, cause for termination of assistance, tenancy, or occupancy rights if the tenant or an immediate member of the tenant’s family is the victim or threatened victim of that abuse.
3. The Landlord may request in writing that the victim, or a family member on the victim’s behalf, certify that the individual is a victim of abuse and that the Certification of Domestic Violence, Dating Violence or Stalking, Form HUD-91066, or other documentation as noted on the certification form, be completed and submitted within 14 business days, or an agreed upon extension date, to receive protection under the VAWA. Failure to provide the certification or other supporting documentation within the specified timeframe may result in eviction.
_________________________________________ __________________ Tenant Date
_________________________________________ __________________ Landlord Date
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 1
Administrator: Client Case Number: (as assigned in Neighborly Software) Administrator Address: Phone:
Tenant Name:
Unit Address: Number of Bedrooms:
Landlord Name:
Landlord Address: Phone:
P
urpose of Lease Addendum . Tenant has been approved to receive rental assistance under the HOME Investment Partnerships (HOME) Program Tenant-Based Rental Assistance (TBRA) Activity administered by Administrator on behalf of the City of Anaheim. The Lease for the above-referenced rental unit is hereby amended to include the provisions of this Lease Addendum, as follows:
1. Conflict with Other Provisions of the Lease . In the event of any conflict between the provisions of this Lease Addendum and any sections of the Lease, the provisions of this Lease Addendum prevail.
2. Terms of Lease. The rental term of the Lease begins on:
/ / and terminates on / / , unless it is terminated sooner by one of the following events:
A. The Lease is terminated by Landlord in accordance with applicable state and local laws; or
B. Th
e Lease is terminated by Tenant in accordance with the Lease; or C. The Lease is terminated by mutual agreement of Landlord and Tenant during the term of the Lease; or
D. The HOME Rental Assistance Contract between Tenant and Admini strator is t
erminated.
3. Rental Assistance Payment. The Program Administrator will provide rental assistance for an initial term of up to 12 months, which can be extended for additional periods of up to 3 months each, up to a total, cumulative term not to exceed 24 months in a three y
ear period, all at the discretion of the Program Administrator. The initial total monthly rent payable to the Landlord for the first two months of this Lease Addendum is $
____________________.
A. Payment Conditions. The right of the owner to receive payments under this Lease Addendum shall be subject to compliance with all of the provisions of the Lease. The Landlord shall be paid under this Lease Addendum on or about the first day of the month for which the payment is due. The Landlord agrees that the endorsement on the check Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 2
shall be conclusive evidence that the Landlord received the full amount due for the month, and shall be a certification that:
1. the Lease unit is in decent, safe and sanitary condition, and that the Landlord is providing the services, maintenance and utilities agreed to in the Lease.
2. the Lease unit is leased to and occupied by the Tenant named above in this Lease Addendum.
3. the Landlord has not received and will not receive any payments as rent for the Lease unit other than those identified in this Lease Addendum.
4. to the best of the Landlord's knowledge, the unit is used solely as the Tenant's principal place of residence.
B. Overpayments. If the Program Administrator determines that the Landlord is not entitled to any payments received, in addition to other remedies, the Program Administrator may deduct the amount of the overpayment from any amounts due the Landlord, including the amounts due under any other Rental Assistance Contract.
4. Security Deposit.
A. Administrator has paid: $_________________ directly to Landlord to be held as a Security Deposit paid on behalf of Tenant. Landlord will hold the Security Deposit during the period in which Tenant occupies the rental unit under the Lease. Landlord will comply with state and local laws regarding interest earned on Security Deposits.
B. After Tenant's household has vacated the r ental unit, Landlord may use the Security Deposit as reimbursement for rent or toward any other amounts payable by Tenant under the Lease, in accordance with state and local laws. Landlord will provide Tenant a written list specifying all damages, items, and amounts charged against the Security Deposit. Any Security Deposit amount remaining after the reimbursement to Landlord has been deducted shall be promptly refunded directly to Tenant.
C. The Landlord shall immediately notify the Program Administrator whe n the Tenant has moved from the Leased unit.
5. Utilities and Appliances. Utilities and appliances are provided as indicated in the following table:
Description of
Utility or Appliance Included in Rent? Paid for or Provided by Heating (specify type)
☐ Electric ☐ Gas ☐ Oil
☐ Yes ☐ No ☐ Landlord ☐ Tenant
Air Conditioning ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 3
Cooking (specify type)
☐ Electric ☐ Gas
☐ Yes ☐ No ☐ Landlord ☐ Tenant
Other Electric ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Water Heating (specify type)
☐ Electric ☐ Gas
☐ Yes ☐ No ☐ Landlord ☐ Tenant
Water ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Sewer ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Trash Collection ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Range ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Refrigerator ☐ Yes ☐ No ☐ Landlord ☐ Tenant
Other: ☐ Yes ☐ No ☐ Landlord ☐ Tenant
6. Household Members. ALL Household members authorized to live in this rental unit are listed below. Tenant may not permit other persons to join the household without notifying Administrator and obtaining Landlord's permission.
Full names of ALL household members:
1. 5.
2. 6.
3. 7.
4. 8.
7. Housing Quality Standards. The Landlord agrees to maintain and operate the Lease unit and related facilities to provide decent, safe and sanitary housing in accordance with 24 CFR Section 882.109, including all of the services, maintenance and utilities agreed to in the Lease.
The Program Administrator shall have the right to inspect the Lease unit and related facilities at least annually, and at such other times as may be necessary to assure that the unit is in decent, safe, and sanitary condition, and that required maintenance, services and utilities are provided.
If the Program Administrator determines that the Landlord is not meeting these obligations, the Program Administrator shall have the right, even if the Tenant continues in occupancy, to terminate payment of the Program Administrator's share of the rent and/or terminate the Lease.
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 4
8. Termination of Tenancy. Landlord may evict Tenant for cause in accordance with HOME Program requirements and applicable state and local statute. Landlord must provide all required notices to Tenant and provide copies of such notices to Administrator. Landlord must notify Tenant and Administrator in writing when eviction proceedings begin.
9. Prohibited Lease Provisions. The following provisions may not be included in or applied to the Lease, and may not be enforced by Landlord:
A. Confession of Judgment. Tenant may not be required to consent to be sued, to admit guilt, or to accept or acknowledge a judgment in favor of Landlord in a lawsuit brought in connection with the Lease.
B. Treatment of Property. Tenant may not be required to agree that Landlord may take or hold Tenant's property, or sell such property without notice to Tenant and a court decision on the rights of the parties.
C. Excusing Landlord from Responsibility . Tenant may not be required to excuse Landlord or Landlord's agent from his/her legal responsibility for any action or failure to act, whether intentional or negligent.
D. Waiver of Legal Notice . Tenant may not be required to agree that Landlord may institute a lawsuit without notice to Tenant.
E. Waiver of Court Proceedings for Eviction. Tenant may not be required to agree that Landlord may evict Tenant and/or Tenant's family prior to:
i. the initiation of civil court proceedings in which the family has the opportunity to present a defense; or
ii. the receipt of a decision by the court on the rights of the parties.
F. Waiver of Jury Trial . Tenant may not be required to authorize Landlord to waive Tenant's right to a trial by jury.
G. Waiver of Right to Appeal Court Decision. Tenant may not be required to authorize Landlord to waive Tenant's right to appeal a court decision or waive Tenant's right to sue to prevent a judgment from being put into effect.
H. Tenant Chargeable with Cost of Legal Actions Regardless of Outcome of the Lawsuit.
Tenant may not be required to agree to pay attorney fees or other legal costs in the event Landlord files civil suit.
I. Mandatory supportive services . Landlord may not require agreement by the tenant (other than a tenant in transitional housing) to accept supportive services that are offered.
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 5
10. FAIR HOUSING REQUIREMENTS
A. Nondiscrimination. The Landlord shall not, in the provision of services or in any other manner discriminate against any person on the grounds of age, race, color, creed, religion, sex, handicap, national origin, or familial status. The obligation of the Landlord to comply with Fair Housing Requirements insures to the benefit of the United States of America, the Department of Housing and Urban Development, and the Program Administrator, any of which shall be entitled to involve any of the remedies available by law to redress any breach or to compel compliance by the Landlord.
B. Cooperation in Quality Opportunity Compliance Reviews. The Landlord shall comply with the Program Administrator and with HUD in conducting compliance reviews and complaint investigations pursuant to all applicable civil rights statutes, Executive Orders and all related rules and regulations.
11. PROGRAM ADMINISTRATOR AND HUD ACCESS TO LANDLORD RECORDS A. The Landlord shall provide any information pertinent to this Lease which the Program Administrator or HUD may reasonably require.
B. The Landlord shall permit the Program Administrator or HUD, or any of their authorized representatives, to have access to the premises and, for the purposes of audit and examination, to have access to any books, documents, papers, and records of the Landlord to the extent necessary to determine compliance with this Lease Addendum.
12. RIGHTS OF PROGRAM ADMINISTRATOR IF LANDLORD BREACHES THE LEASE
ADDENDUM
A. Any of the following shall constitute a breach of the Lease Addendum:
1. If the Landlord has violated any obligation under this Lease Addendum; or
2. If the Landlord has demonstrated any intention to violate any obligation under this Lease Addendum; or
3. If the Landlord has committed any fraud or made any false statement in connection with the Lease Addendum, or has committed fraud or made any false statement in connection with any Federal housing assistance program.
B. The PHA's right and remedies under the Lease include recovery of overpayments, termination or reduction of payments, and termination of the Lease. If the Program Administrator determines that a breach has occurred, the Program Administrator may exercise any of its rights or remedies under the Lease Addendum. The Program Administrator shall notify the Landlord in writing of such determination, including a brief statement of the reasons for the determination. The notice by the PHA to the landlord may require the Landlord to take corrective action by a time prescribed in the notice.
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 6
C. Any remedies employed by the Program Administrator in accordance with this Lease Addendum shall be effective as provided in a written notice by the Program Administrator to the Landlord. The Program Administrator's exercise or non-exercise of any remedy shall not constitute a waiver of the right to exercise that or any other right or remedy at any time.
13. RELATION TO THIRD PARTIES
A. The Program Administrator does not assume any responsibility for, or liability to, any person injured as a result of the Landlord's action or failure to act in connection with the implementation of this Lease Addendum, or as a result of any other action or failure to act by the Landlord.
B. The Landlord is not the agent of the Program Administrator and this Lease Addendum does not create or affect any relationship between the Program Administrator and any lender to the Landlord, or any suppliers, employees, contractors or subcontractors used by the Landlord in connection with this Lease Addendum.
C. Nothing in this Lease Addendum shall be construed as creating any right of the Tenant or a third party (other than HUD) to enforce any provision of this Lease Addendum or to asses any claim against HUD, the Program Administrator or the Landlord under this Lease Addendum.
14. CONFLICT OF INTEREST PROVISIONS
A. No employee of the Program Administrator who formulates policy or influences decisions with respect to the Rental Assistance Program, and no public official or member of a governing body or state of local legislator who exercise his functions or responsibilities with respect to the program shall have any direct or indirect interest during this person's tenure , or for one year thereafter, in this Lease Addendum or in any proceeds or benefits arising from the Lease Addendum or to any benefits which may arise from it.
15. TRANSFER OF THE LEASE ADDENDUM
A. The Landlord shall not transfer or assign this Lease Addendum in any manner, without the prior written consent of the Program Administrator. The Program Administrator shall give its consent to a transfer or assignment if the transferee agrees in writing (in a form acceptable to the Program Administrator) to comply with all terms and conditions of this Lease Addendum.
16. ENTIRE AGREEMENT: INTERPRETATION
A. This Lease Addendum contains the entire agreement between the Landlord and the Program Administrator. No changes in this Lease Addendum shall be made except in writing signed by both the Landlord and the Program Administrator.
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 7
B. The Lease Addendum shall be interpreted and implemented in accordance with HUD requirements .
17. WARRANTY OF LEGAL CAPACITY AND CONDITION OF UNIT
A. The Landlord warrants the unit is in decent, safe, and sanitary condition as defined in 24 CFR Section 882.109, and that the Landlord has the legal right to lease the dwelling unit covered by this Lease Addendum during the Lease Addendum term.
B. The individual executing this Lease Addendum on behalf of the Landlord hereby warrants that authorization has been given by the Landlord to execute it on behalf of the Landlord.
Landlord Name (Type or Print): Tenant (Type or Print):
(Signature/Date) (Signature/Date)
WARNING: 18 U.S.C. 1001 provides, among other things, that whoever knowingly and willingly makes or uses a document or writing containing any false, fictitious, or fraudulent statements or entries, in any matter within the jurisdiction of any department or agency of the United States, shall be fined not more than $10,000, or imprisoned for not more than five years, or both.
Signature of Tenant Date
Signature of Tenant Date
Signature of Tenant Date
Signature of Tenant Date
Appendix E
HAP-F Tenant Based Rental Assistance (TBRA)
LEASE ADDENDUM
Appendix E – Page 8
Signature of Landlord Date
Reasonable accommodations will be made for persons with disabilities and language assistance will be made available for persons with limited English proficiency.
2024-2025 PAYMENT STANDARDS FOR AREA-WIDE PHAS
BR
Size
FMR
10/01/24
AHA
EFF 10/01/24
SAHA
EFF 10/01/24
GGHA
EFF 10/01/24
OCHA
EFF 11/01/24
Regular
Exception
Zip Codes
92807
92808
Regular EHVs
Only
All of
Garden Grove
Basic
(1)
Central
(2)
Restricted
(3)
EHVs
Only
SRO 1599 1764 1658 1672 N/A 1613 1613 1613 1764
0 2352 2133 2352 2211 2230 2200 2150 2200 2250 2352
1 2454 2325 2454 2307 2430 2344 2250 2300 2440 2461
2 2903 2793 2903 2729 2920 2783 2625 2725 2900 2922
3 3927 3793 3927 3691 3965 3769 3550 3695 3900 3965
4 4693 4436 4693 4411 4637 4467 4225 4380 4560 4690
5 5396 5101 5397 5073 5332 5137 4859 5037 5244 5394
6 6206 5767 6101 5735 6028 5807 5493 5694 5928 6097
AHA
Anaheim HA's new payment standards are effective 10/01/2024 and vary between 91% and 97% of the Fair Market Rents (FMR) for all bedroom sizes.
GGHA
Garden Grove HA's new payment standards are effective 10/01/2024 and vary between 94% and 96% of the FMR.
OCHA
Orange County HA's new payment standards are effective 11/01/2024 (1) Basic PS: Brea, Buena Park, Cypress, Fullerton, Laguna Woods, La Habra, La Palma, Los Alamitos, Orange, Placentia, Seal Beach, Stanton, Villa Park, Westminster, Yorba Linda, and unincorporated areas (e.g. Midway City) north of the 55 freeway. (2) Central PS: The following "central coast" cities within the county qualify for Central Payments Standards: Costa Mesa, Fountain Valley, and Huntington Beach. (3) Restricted PS: The following "high rent areas" of the county qualify for Restri cted Payments Standards: Aliso Viejo, Dana Point, Irvine, Lag una Beach, Laguna Hills, Laguna Niguel, Lake Forest, Mission Viejo, Newport Beach, Rancho Santa Margarita, San Juan Capistrano (including Capistrano Bea ch), San Clemente, Tustin, and unincorporated areas south of the 55 freeway.
SAHA
Santa Ana HA's new payment standards are effective 10/1/24 for new leases and moves, on or after 12/1/24 for annuals, and set at 94% of the FMR for all bedroom sizes.
For EHVs only, the new payment standard is effective 10/1/24 for new leases and moves, on or after 12/1/24 for annuals, and is set at 98% of the FMR for all bedroom sizes.
Revised 11/01/24
EFFECTIVE DATE: November 1, 2024
01234 5 +
223345
13 15 18 20 24 30
6 7 8 9 11 13
7 8 14 14 18 21
223345
9 1 11 81 92 42 8
5 6 9 1 01 21 4
29 48
38 14
12 TOTA
L
*Based on HUD % Breakdown
Heating
Water Heating
Water
Trash/ Sewer/Street
Refrigerator (Tenant-supplied)
Stove (Tenant-supplied)
Cooking
ANAHEIM HOUSING AUTHORITY
UTILITY ALLOWANCE SCHEDULE
SECTION 8 ASSISTED HOUSING
BEDROOM SIZE
Gas
Cooking
Heating
Water Heating
Electric
Basic
ENERGY-EFFICIENT
01234 5 +
344579
20 24 27 32 41 54
9 1 11 21 41 92 4
9 1 11 72 82 93 3
224678
12 15 22 36 39 44
6 7 11 19 20 23
57 84
38 14
12 TOTA
L
*Based on HUD % Breakdown
Water Heating
Water
Trash/ Sewer/Street
Refrigerator (Tenant-supplied)
Stove (Tenant-supplied)
Heating
SECTION 8 ASSISTED HOUSING
"Regular," non-energy efficient units
EFFECTIVE DATE: November 1, 2024
BEDROOM SIZE
Gas
Cooking
Heating
Water Heating
Electric
Basic
Cooking
UTILITY ALLOWANCE SCHEDULE
ANAHEIM HOUSING AUTHORITY
Appendix I
Client Outcome Matrix
Page | 1
Domains In Crisis
Score: 1
Vulnerable
Score: 2
Safe
Score: 3
Building Capacity
Score: 4
Empowered
Score: 5
Income
Score____
Score____
Score____
No source of income
Inadequate income
and/or spontaneous or
inappropriate spending
Can meet basic needs
with a subsidy;
appropriate spending
Can meet basic needs
and manage debt
without assistance
Income is sufficient,
and well managed;
has discretionary
income and can save
Employment
Score____
Score____
Score____
Unemployed/not
seeking employment
Temporary, part-time,
or seasonal;
inadequate pay; no
benefits
Employed full time;
inadequate pay; few or
no benefits
Employed full-time with
adequate pay and
benefits
Maintains permanent
employment with
adequate income and
benefits
Shelter
Score____
Score____
Score____
Homeless or
threatened with
eviction
In transitional,
temporary, or
substandard housing;
and/or current
rent/mortgage payment
is
unaffordable
In stable housing that
is safe but only
marginally adequate
Household is safe,
adequate, subsidized
housing
Household is safe,
adequate,
unsubsidized housing
Food
Score____
Score______
Score____
No food or means to
prepare it. Relies to a
significant degree on
other sources of free or
low-cost
The household is on
food stamps
Can meet basic needs
but requires occasional
assistance
Can meet basic needs
without assistance
Can choose to
purchase any food
household desires
Childcare
Score____
Score____
Score____
Needs childcare but
none is available/
accessible and/or the
child is not eligible
Childcare is unreliable
or unaffordable;
inadequate supervision
is a problem for
childcare that is
available
Affordable subsidized
childcare is available
but limited
Reliable, affordable
childcare is available;
no need for subsidies
Able to select quality
childcare of choice
Children’s
education
Score____
Score____
score____
One or more eligible
children not enrolled in
school
One or more eligible
children enrolled in
school but not
attending classes
Enrolled in school, but
one or more children
only occasionally
attend classes
Enrolled in school and
attending classes most
of the time
All eligible children
enrolled and
attending regularly
Adult Education
Score____
Score____
Score____
Literacy problems
and/or no high school
diploma/GED are
serious barriers to
employment
Enrolled in literacy
and/or GED program
and/or has sufficient
command of English
so language is not a
barrier to employment
Has a high school
diploma/GED
Need additional
education/training to
improve employment
situation and/or to
resolve literacy
problems to where
they can function
effectively in society
Has completed
education/training
needed to become
employable. No
literacy problems
Legal
Score____
Score____
Score_____
Current outstanding
tickets or warrants
Current charges/trial
pending;
noncompliance with
probation/parole
Fully compliant with
probation/parole terms
Has completed
probation/parole within
the past 12 months; no
new charges filed
No felony criminal
history and/or no
active criminal justice
involvement in more
than 12 months
Health Care
Score____
Score____
Score____
No medical coverage
with an immediate
need
No medical coverage
and great difficulty
accessing medical
care when needed.
Some household
members may be in
poor health
Some members
All members can get
medical care when
needed but may strain
the budget
All members are
covered by
affordable, adequate
health insurance
Basic Needs
Score____
Score____
Score____
Unable to meet basic
needs such as
hygiene, food,
activities of daily living
Can meet a few but not
all needs of daily living
without assistance
Can meet most but not
all daily living needs
without assistance
Able to meet all basic
needs of daily living
without assistance
Able to provide
beyond basic needs
of daily living for self
and family
Appendix I
Client Outcome Matrix
Page | 2
Domains In Crisis
Score: 1
Vulnerable
Score: 2
Safe
Score: 3
Building Capacity
Score: 4
Empowered
Score: 5
Mental Health
Score____
Score____
Score____
Danger to self or
others; recurring
suicidal ideation;
experiencing severe
difficulty in day-to-day
life due to
psychological
problems
Recurrent mental
health symptoms that
may affect behavior
but not a danger to
self/others; persistent
problems with
functioning due to
mental health
symptoms
Mild symptoms may be
present but are
transient; only
moderate difficulty in
functioning due to
mental health
problems
Minimal symptoms that
are acceptable
responses to life
stressors; only slight
impairment in
functioning
Symptoms are absent
or rare; good or
superior functioning in
a wide range of
activities; no more
than everyday
problems/concerns
Substance
Score____
Score____
Abuse______
Meets criteria for
severe abuse; resulting
in problems so severe
that institutional living
or hospitalization may
be necessary
Meets criteria for
dependence;
preoccupation with use
and/or obtaining
drugs/alcohol;
withdrawal or
withdrawal avoidance
behaviors evident; use
results in avoidance or
neglect of essential life
activities
Use within last 6
months; evidence of
persistent or recurrent
social, occupational,
emotional, or physical
problems related to
use; problems that
have persisted for at
least one month
The client has used
during the last 6
months but has no
evidence of persistent
or recurrent social,
occupational,
emotional, or physical
problems related to
use; no evidence of
recurrent dangerous
No drug use/alcohol
abuse in the last 6
months
Family Relations
Score____
Score____
Score____
Lack of necessary
support from family or
friends; abuse (DV,
child) is present or
there is child neglect
Family/friends may be
supportive but lack the
ability or resources to
help; family members
do not relate well with
one another
Some support from
family/friends; family
members acknowledge
and seek to change
negative behaviors;
are learning to
communicate and
support
Strong support from
family or friends;
household members
support each other’s
efforts
Has a
healthy/expanding
support network; the
household is stable
and communication is
consistently open
Transportation/
Mobility
Score____
Score____
Score____
No access to
transportation, public
or private; may have
an inoperable car
Transportation is
available but
unreliable,
unpredictable, and
unaffordable; one may
have a car but no
insurance, license, etc
Transportation is
available and reliable
but limited and/or
inconvenient; drivers
are licensed and
minimally insured
Transportation is
generally accessible to
meet basic travel
needs
Transportation is
readily available and
affordable; the car is
adequately insured
Socialization
Score____
Score____
Score____
Social Isolation
Limited social
connections/
interactions
Few social interactions
limited access to
healthy social outlets
Multiple healthy social
connections
Social
Connection/Engagem
ent with Community
Access to benefits
Score____
Score____
Score____
Not aware benefits are
available or not
receiving benefits
Has applied for
benefits and is
awaiting results
Has received some
benefits, but still
requires others to meet
the level of need
Has received benefits
sufficient to meet the
level of need
Does not require
benefits
Parenting skills
Score____
Score____
Score____
There are safety
concerns regarding
parenting skills
Parenting skills are
minimal
Parenting skills are
apparent but not
adequate
Parenting skills are
adequate
Parenting skills are
well developed
Appendix I
Client Outcome Matrix
Page | 3
Ho
usehold: ________________________
Inta
ke Date: ________________________ CM Completing Matrix: ________________________ 12 Mo
nths: ________________________ CM Completing Matrix: ________________________ Ex
it Date: ________________________ CM Completing Matrix: ________________________ Entry 12 months Exit
Income
Employment
Shelter
Food
Childcare
Children’s Education
Adult Education
Legal
Health Care
Basic Needs
Mental Health
Substance Abuse
Family Relations
Transportation/Mobility
Social/Community Involvement
Access to Benefits
Parenting Skills
TOTAL
LEVEL OF STABILITY
(See the Below Chart)
In Crisis = 33 or below
Vulnerable = 34-50
Safe = 51-67
Building Capacity = 68-80
Empowered = 81 or above
Households that score between 0 - 80 on the client outcome matrix will be eligible for a subsidy extension. Extensions beyond the first 12 months will be granted at the discretion of the City HAP-F program manager and shall require written approval which will be based on continued program compliance and ongoing need. Written approval must be requested beyond the 12th month of rental assistance and obtained before reaching the 15th 18th, 21st, and/or 24th month term
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 1
PRE-INTAKE PROCEDURES
➢ Referrals
• It is anticipated that the primary source of referrals will be received from the Anaheim Union High School District (AUHSD) McKinney Vento Liaison (MVL), city contracted Outreach Teams and the City’s Housing and Community Development Department. ▪ AUHSD referrals will include a completed Client Vulnerability Index form and Release of Information form.
▬ Prior to referring to a household to HAP-F, the MVL will verify a household’s residency history in the City of Anaheim and the children's enrollment in an Anaheim School.
▪ For referrals submitted by city contracted Outreach Teams and the City’s Housing and Community Development Department, the Service Provider must complete the vulnerability assessment.
▬ In some intense the Service Provider may coordinate with the AUHSD or verify ties to Anaheim, as applicable.
• Upon receipt of the referral, the Service Provider must attempt to contact the family within five (5) business days of.
▪ The Service Provider will meet with the prospective eligible household to conduct a needs assessment and complete an Initial Qualification Form (Appendix A). ▪ The Service Provider shall also request and/or assist the prospective eligible household with the completion of the following documents:
▬ TBRA Application (Appendix B)
▬ Homeless Certification Form (Appendix C)
• The Service Provider must meet with the prospective eligible households throughout the application process and must counsel each prospective eligible household regarding TBRA program policies, the household's responsibilities as participants, and the goals and objectives of the TBRA Program.
➢ Waitlist
• Once the program has reached maximum enrollment, the Service Provider shall maintain a waitlist of prospective eligible households.
▪ Prioritization must be based on:
▬ Client outcome matrix form
▬ Most urgent need
▬ Date and time of referral or initial direct contact with the Service Provider (if not a referral from another agency).
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 2
• If the program has reached maximum capacity, the Service Provider shall review the referral to assess if other services may be offered while the applicant is waiting for a slot to open in the HAP-F.
➢ Determination of Intake Eligibility
• Applicant households may proceed with completing intake if they meet the following general criteria:
▪ Have valid photo identification or are in the process of acquiring a valid photo identification.
▪ Current homelessness or at-risk of homelessness status ▬ HAP-F abides by the definition of homelessness that has been established by the U.S. Department of Housing and Urban Development
▬ HAP-F abides by the definition of at -risk of homelessness that has been established by the U.S. Department of Housing and Urban Development ▪ Have a history of residency or work in the City of Anaheim ▬ Due to the nature of the population served by HAP-F, it may not be possible to obtain traditional proof of residency documentation such as a previous lease agreement or utility bill. The following documentation can be accepted to establish that an applicant household qualifies for the program’s Anaheim live/work preference:
⬧ Proof that the family's last place of stable residency was in the City of Anaheim. Verification from a landlord is acceptable.
⬧ Documentation from an Anaheim City School that the children in the household have been enrolled and attending a school for at least the last 90 days from the time of admission into HAP-F.
Under this documentation verification, it is still a requirement that the last place of the family's stable residency be in the City of Anaheim.
⬧ Documentation from a partner agency in the Anaheim Homeless Collaborative, evidencing that the family is known to be chronically homeless in Anaheim.
⬧ Proof that an adult member of the household is working or has been recently hired to work in Anaheim.
▬ Under no circumstances may a client solely submit a self -certification of Anaheim live/work preference to meet this requirement.
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 3
▪ The household includes at least one child
▬ A child is defined by HAP-F as an individual who is 18 years of age or younger. ▬ Have minor-aged children under 18 or are at least 7 months pregnant. ▬ The child must reside in the household at least 5l % of the time. • Applicant households are ineligible for the program if they:
▪ Are a registered sex offender.
▪ Have a record of violent crimes, sex crimes, or crimes against a child. (Adults with a criminal history will be reviewed on a case -by-case basis and can be considered for the program. depending upon the nature of the offense and date that the offense occurred.)
▪ Have a total household income that falls above the extremely low -income limit Published by HUD adjusted family size.
▬ Applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
INTAKE PROCEDURES
➢ Required Program Documents
• Upon receiving an appropriate referral, the applicant household will participate in program intake, during which the Service Provider will collect and review all intake paperwork and begin to build a physical household case file.
▪ The documents listed below must be collected during the intake process. ▬ HAP-F referral submitted by the AUHSD, a city contracted Outreach Team, or the City of Anaheim.
▬ HAP-F TBRA Application
▬ HAP-F Initial Qualification Form
▬ Proof of child enrollment in Anaheim Schools (if applicable), or verifiable proof of Anaheim Live/Work preference
▬ A g overnment-issued Photo Identification (driver’s license, etc.) for all adult household members.
▬ 2 months’ worth proof of income for all adult members, as applicable ▬ 2 months’ worth proof of assets for all adult members, as applicable ▬ Homeless Certification Form
⬧ Documentation of housing status
▪ Documentation from a homeless shelter, other evidence of homelessness (motel receipts), self-certification of homelessness, or 3 days’ notice to pay or quit if at risk. ▬ Service Provider HAP-F Program Guidelines
▬ Service Provider HAP-F Disclaimer and Notice of Responsibilities ▬ Service Provider HAP-F Release of Information
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 4
• As applicable, all required program documentation must be signed and dated by all adult(s) members of the applicant household.
• Copies of all signed paperwork must be provided to the applicant household. ➢ Determination of Income Eligible
• To receive supportive services under HAP-F , applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
• To receive rental assistance under HAP-F , applicant households must meet HOME eligibility requirements and have a total household Gross Annual Income at or below 60% of the AMI.
• On a case-by-case basis, exceptions may be granted to households with incomes between 60% and 80% of the AMI.
▪ The Service Provider must obtain written approval from the City before rental assistance is provided to houaeho1ds above 60% AMI.
• Gross Annual Income shall be determined in accordance with 24 CPR pert 5 (often referred to as the Section 8 definition), with the allowable inclusions and exclusions from income established at 24 CFR 5.611.
▪ Gross Annual Income includes all payments from all sources, whether in cash or in- kind, that are anticipated to be received by all adult members of the Participating Tenant Household during the 12- month period following the date of application and before any deductions are made.
▪ The Service Provider may refer to HUD’s Technical Guide for Determining Income and Allowances for the HOME Program Third Edition (January 2005) Exhibit 3.12 Income Inclusions and Exclusions:
▬ https://archives.hud.gov/offices/cpd/affordablehousing/modelguides/1780. pdf
• The Service Provider will determine and verify eligibility for assistance under HAP-F through the review of income source documents outlined in the revised HOME rule published in July 2013, applicants must provide evidence of income for the two (2) most recent months. Acceptable source documents are listed below. ▪ The Service Provider may also consider any likely changes in income when collecting income verification documentation.
▪ The definition of income for the purposes of the HAP-F are located in 24 CFR 5.609.
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• Eligibility determination calculations for Gross Annual Income must be calculated and documented in the applicant household’s case file.
▪ The case manager must use HUD’s CPD Income Eligibility Calculator (HOPWA Model) to determine Adjusted Income and furthermore, initial Tenant Total Payment (TTP).
▬ Income verifications are valid for 6 months.
▬ If admission into the HAP -F program takes longer than 6 months, income verifications must be updated and reevaluated.
▬ After initial verification, income re-certifications shall be conducted annually.
Examples of Income
Irregular/Sporadic Income
Wages
Tips and Bonuses
Commissions
Self-employment – including drivers.
(Uber, Postmates, Grubhub, Amazon, etc.)
Temporary or “Gig” Jobs (babysitting,
recycling, etc.)
Cash Payments/Jobs/Assistance
Non-Cash Assistance from Friends or Family
(pays one of your bills every month,
repetitively buys food, clothes, diapers, etc.)
Personal Business Income
Unemployment (EDD)
Child Support
Lottery/gambling
Social Security
SSI (Supplemental Security Income)
State Disability
IHSS wages
Alimony/Spousal Support
Retirement Income
Workers Compensation
Welfare Assistance (Cash Aid/CalWorks)
Childcare Assistance or Reimbursement
Veterans Benefits
School Grants/Financial Aid
SSP Restoration payments
Military Pay (Active Duty/ Reserves)
Inheritance
Examples of Assets
Cash
Checking Accounts
Savings Accounts
Dividends
Retirement Accounts (401(k), 403(b), IRA’s
etc.)
Certificates of Deposit (CD’s)
Investments or Stocks (Robinhood, Acorns,
Charles Schwab, Fidelity, etc.)
Mutual Funds
Pension Funds
Inheritance
Real Estate
Money Market Accounts
Vehicles
Safe deposit box
Coin or Jewelry Collection
Promissory Notes
Lump Sums Received
Lottery/gambling winnings
Settlements (Insurance/Legal)
Trusts
Annuities
Any other asset
Life Insurance Policies
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➢ Background Checks
• The Service Provider will conduct a background check on all adult members of the applicant household via the OCCourts.org
• The Service Provider will review the background check for any criminal cases and discuss any concerns with the Management Team and the City of Anaheim.
➢ HMIS Requirement
• HMIS participation is not a statutory requirement for recipients of HOME funding but will be used for the HAP-F to collect client-level data and data on the provision of housing and services to individuals and families at risk of and experiencing homelessness. • All HUD mandated information will be entered into the HMIS system per 211 OC requirements.
• All eligible HAP-F households must be entered into HMIS prior to receiving any HOME subsidy.
▪ The a ssigned Case Manager will update HMIS as necessary and collect the following documents as part of the household case file. ▬ HMIS Client Intake, signed and dated by all adults
▬ HMIS Client Consent Form, signed and dated by all adults
➢ Neighborly Software Requirements
• The city will grant the Service Provider with Neighborly account access. • Upon the completion of intake, the Service Provider must create an electronic case file for each eligible HAP-F household on Neighborly Software.
▪ All case files must be created under the “TBRA Client Cases” module. ▪ All household program documentation must be uploaded to Neighborly Software.
➢ Assessment Period
• Upon completing the necessary paperwork during the program intake, the participating household will begin a two-week assessment period.
• During the first two weeks of enrollment the participating household and their assigned case worker must work together to:
▪ Develop a Housing Plan, where proof of income and expenses will be provided to complete a budget and to determine the household’s rent payment for the first month. ▪ Schedule the household ’s first Resource Group Meeting, Behavioral Health and Workforce assessments, and the New Family Orientation.
▪ Review a calendar of important upcoming events for the month. ▪ Review guidelines, job leads, resources. and other important information.
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▪ Schedule workforce development with the Job Coach to receive recommendations for participation in the job readiness training.
▪ Complete a referral form for an in -home medical visitation by a Public Health Nurses.
• Through enrollment, the participating household is expected to:
▪ Meet with the assigned Case Manager weekly.
▪ Be expected to complete goals mutually set during case management. ▪ Be expected to attend at least 80% of the activities. ▪ Pay their rent portion monthly.
PROGRAM PROCEDURES
➢ HOME Rental Assistance Briefing and Coupon Issuance
• The Service Provider must conduct and schedule a program briefing with all eligible tenant households to review program policies and procedures.
• The Service Provider must issue the eligible household their HOME Rental Assistance Coupon upon the conclusion of a households briefing.
• All eligible households must attend a HOME Rental Assistance Briefing and be issued a HOME Rental Assistance Coupon prior to receiving housing navigation services. ▪ The assigned Case Manager must include the following documents as part of the household case file
▬ HOME Rental Assistance Coupon (Appendix K).
➢ Selection of Housing
• Eligible households may elect to rent any housing unit in the City of Anaheim (unincorporated areas of Anaheim are excluded) so long as the unit meets federal Housing Quality Standards (HQS) or such other standards as may be made applicable to the TBRA Program by HOME Program statues and/or regulation, specially including Uniform Physical Condition Standards (UPCS) and passes a rent reasonableness test. • Eligible households will be encouraged by their Case Manager to begin searching for an appropriate apartment.
▪ Due to the nature of the population served by HAP-F, it is expected that the Service Provider will assist eligible households with finding and selecting an appropriate housing unit that meets all program requirements.
▬ The Service Provider may be responsible for assisting participants with the following:
⬧ Providing transportation services (if needed).
⬧ Completion of rental application and other leasing related paperwork. ⬧ Connecting a program participant to landlords
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⬧ Once a unit is identified, ensure completion of paperwork needed to secure the unit.
▬ Participants may need other support to secure housing placement, including assistance gaining income, handling health or mental health issues, or other needs. • While the Service Provider can refer eligible households to appropriate housing units, households may not be required to select a particular housing unit.
➢ Occupancy Standards
• The number of people in each eligible household will determine the required unit type. ▪ Each household must comply with the two per bedroom plus one occupancy standard.
▪ The following table provides occupancy standards by unit type:
Unit Type Number of People in Household
One-Bedroom Unit 1 to 3 People
Two-Bedroom Unit 3 to 5 People
Three-Bedroom Unit 5 to 7 People
Four-Bedroom Unit 7 to 9 People
➢ Rent Reasonable
• Rental assistance paid on behalf of HOME (TBRA) assisted household must be in compliance with federal rent reasonableness requirements which require that rent paid by or on behalf of HOME assisted household be similar to rents paid by non -assisted households.
▪ Rent reasonableness reviews will be performed by the Service Provider. ▪ The factors listed below shall be considered when determining rent comparability. ▬ Location and age
▬ Unit size, including the number of rooms and square footage of room. ▬ The type of unit, including construction type (e.g., single family, duplex, garden, low-rise, high-rise).
▬ The quality of the unit (e.g., building construction, maintenance and improvements).
▬ Amenities, services, and utilities included in the rent • The Service Provider will follow both the rent reasonableness regulations established for the Housing Choice V oucher (HCV) program at 24 CPR 982.507 and the methodology described in Chapter 8, Part III of the Anaheim Housing Authority Administrative Plan for the HCV program to evaluate rents.
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• In the event that a rent request does not meet rent reasonableness requirements, the Service Provider shall attempt to negotiate lower rent with the property owner. If the owner is not willing to accept the lower rent, the household must be instructed to search for another unit. ▪ Unless previously approved by the city, under no circumstances shall the Service Provider or the assisted household agree to pay more than approved through the reasonable rent review.
▪ Unless previously approved by the city, the assisted household may not make up any difference in the rent offer.
• The city will grant the Service Provider with account access to rent reasonableness data (GoSection8.com). All rent reasonableness verifications for the HAP -F program must be completed on GoSection8.com.
▪ The Anaheim Housing Authority (AHA) will provide support to the Service Provider in completing this task.
▪ AHA will be available for technical support and grant access to reasonableness rent data that Service Provider can use in finalizing approvals. ▬ In the event that there is a conflict between rents authorized by Service Provider and rents authorized for other rent subsidy programs offered by the City of Anaheim, the Service Provider must work with AHA and/or City staff to resolve the conflict so tha t there is parity in all City sponsored rental assistance programs.
• The assigned Case Manager must include the following documents as part of the household case file
▪ Completed Rent Reasonableness Assessment from GoSection8.com. ▪ Fair Market Rent (FMR) Certifications.
➢ Coordination with Landlords
• The Service Provider will meet with and provide guidance to landlords participating in the HAP-F regarding the requirements and procedures that impact landlords. • The assigned Case Manager must include the following documents as part of the household case file
▪ Declaration of Ownership and Authorization Form.
➢ Housing Quality Standards (HQS)
• Housing Choice V oucher (HCV) Program regulations 24 CFR Part 982 set forth basic housing quality standards (HQS) which all units must meet before assistance can be provided to a household at least annually throughout the term of the assisted tenancy. • Prior to the occupancy of any housing unit by an eligible household, and again during the annual verification process, the Service Provider must inspect each housing unit to ensure
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the unit complies with Housing Quality Standards (HQS) as set forth in the HOME Program (24 CFR 982 401(a)) as well as all applicable state and local codes and ordinances, including zoning ordinance.
• Each HQS inspection will include the following:
▪ Verification of property ownership.
▪ Verification of the age of the housing unit.
▪ Complete HQS Inspection Form (HUD – 52580).
▪ Lead-based paint hazard assessment, dissemination of lead-based paint information pamphlet and disclosure form and lead-based paint reduction activities, if required. ▪ Adequate opportunity for landlord to correct any deficiencies indicated in the HQS Inspection form to bring the housing unit into compliance. ▪ Verification that occupancy by the eligible household will comply with occupancy standards.
• The assigned Case Manager must include the following documents as part of the household case file.
▪ Lead Qualification and Certification (per 24 CFR 982) ▪ Landlord’s HQS Inspection Notice
▪ Initial Completed HQS Inspection Form (with results)
▪ Tenant’s Annual Reinspection HQS Inspection Notice (at annual recertification ONLY)
▪ Landlord’s Annual Reinspection HQS Inspection Notice (at annual recertification ONLY)
▪ Completed Annual Reinspection HQS Inspection Form (with results) ▪ Property Notices, as applicable
• Upon completion of a successful inspections, Service Provider will deliver certified move in funds and the household may move into their secured apartment.
➢ Rental Assistance Contract (Appendix D)
• The Service Provider will enter into a Rental Assistance Contract with each participating household.
• The Rental Assistance Contract will establish the security deposit assistance payment and the initial rental assistance payments to be paid on behalf of the household. The Contract will also establish the participating household’s initial share of the contract rent. ▪ The household's share of rent will be adjusted using an escalation factor of $100 after 60 days of occupancy.
▪ The household tenant portion may be further increasing every 60 days thereafter.
▪ This Contract will have a term of up to 12 months.
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• The assigned Case Manager must include the following documents as part of the household’s case file.
▪ Lease Agreement
▪ HOME Rental Assistance Contract
➢ Lease Addendum (Appendix E)
• The landlord must enter into a lease agreement with a 12 month-term with any eligible household occupying HAP-F assisted unit.
▪ The lease agreement must include a lease addendum that will be executed in connection with the lease between the landlord and the eligible household. ▪ The addendum must:
▬ Include t he terms of the rental assistance payments to be paid to the landlord on behalf of the eligible household
▬ Confirm the obligations of the landlord
▬ Confirm obligations of the eligible household regarding payment of rent, utilities and appliances, rules and regulations of tenancy and confirm the landlord's obligation to maintain the housing unit in accordance with HQS. • The landlord must provide the Service Provider with a notice of a lease termination, prohibit discrimination by the landlord against the eligible household as well as lease provisions prohibited by the HOME Program.
• The Service Provider will review the lease agreement to confirm its compliance with state law and all HOME Program requirements as outlined in the revised HOME rule published in February 2025.
• The assigned Case Manager must include the following documents as part of the household’s case file.
▪ HOME Lease Addendum
▪ V AWA Lease Addendum
➢ IRS Form W-9 (Appendix F)
• Landlords must submit a completed IRS Form W -9 Request for Taxpayer Identification Number and Certification.
• The Service Provider will rely on this information when issuing a 1099 form to each payee u required by the IRS. A I099 form must be issued annually to all participating landlord (payee).
• The assigned Case Manager must include the following documents as part of the household’s case file.
▪ Completed Landlord W9
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➢ Payment Standards
• The Service Provider must use-the Anaheim Housing Authority's (AHA) current payment standards (Appendix G) to calculate monthly rental assistance. ▪ The AHA's payment standards represent the cost of rent and utilities for moderately priced units in Anaheim. Payment standards are established by bedroom size.
▪ When utilities are included in the cost of renting a unit, that is, the owner assumes responsibility for payment for all utility services, the household's entire share of the housing costs will go directly to the owner. ▪ When the cost of utilities is not part of the rent, that is, the household is directly responsible for payment of utility services, the household's initial share will be determined by subtracting a utility allowance from 30% of the household's total income.
▪ The Service Provider must use the AHA utility allowance schedule (Appendix H) to determine the household's utility allowance. The result of 30% of the household’s total income, minus the applicable utility -allowance, is the household’s initial share of rent. Each household is responsible for paying their rent share directly to the landlord each month.
▪ If a selected housing unit is subject to contractual, statutory and/or regulatory affordability restrictions, the monthly rental assistance payment will not exceed the difference between the required affordable rent amount for the Housing Unit and 30% of the eligible household's monthly gross income.
➢ Rental Assistance Calculations
• The Service Provider will complete a rental assistance calculation for each eligible household using HUD’s (CPD) Tenant Payment Calculator (HOPWA Model). The calculation will determine each household's initial program subsidy and share of the rent. • The initial household rent is equivalent to the maximum subsidy amount allowed under HOME TBRA regulations and is calculated as the difference between 30% of the household's monthly income and the payment standard for the size of the unit. Each household’s maximum rent subsidy will vary since the calculation involves the use of individualized factors such as the household's income and family size. • The initial household rent will remain unchanged for the first 60 days of assistance.
Thereafter, household rent contributions may be increased by $ 100 every other month.
Once rent acceleration factors are applied, the household's rent contribution will no longer tie back to a percentage of household income.
• Minimum rent under the TBRA program is set at $50.00. The minimum tenant payment is used if the maximum subsidy calculation would result in the household paying less than $50.00 towards the monthly rent.
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• The service provider must provide the family with a Stipend Award Letter which will detail the incremental increase for the households’ Total Tenant Portion (TTP). • The assigned Case Manager must include the following documents as part of the household’s case file.
▪ TBRA Set-up Form.
▪ HUD (CPD) Tenant Payment Calculator Printout (HOPWA Model). ▪ Utility Allowance Schedule Form (completed with total).
➢ Total Tenant Portion (TTP)
• By the first of each month the Service Provider must notify all apartment properties of the rental amounts for families.
• HAP-F assisted households must pay the Tenant Total Payment (TTP), in full directly to the Property Manager or Landlord at their apartment location within the time specified on their lease.
• HAP-F assisted households must request a rent receipt to document to verify that they have paid their TTP.
▪ A copy of the receipt must be provided to their HAP-F assigned Case Manager every month.
• The Housing Navigator and/or Case Manager must communicate with partnership properties every month to ensure that the TTP is paid in full. • The Property Manager or Landlord may notify the Service Provider of which households have not paid their TTP.
▪ By the first of each month, households who have not paid their TTP must be reviewed by the Service Provider for continuation or termination from the program.
▪ Any issues or concerns regarding non-payment of the TTP must be discussed the participating households.
▪ Rent issues must be resolved at least one week before the rent deadline. ▪ Any rent adjustments made must be approved by the Service Provider
➢ Utility Deposit Assistance
• The Service Provider may provide utility deposit assistance to an eligible household in the full amount of any utility deposit required for (electricity, gas, water and trash) to be provided to the utility provider when needed to assist the household in establishing a tenancy.
• Utility deposit assistance may only be provided once during a household’s participation in the HAP-F program, including re-entry into the program following an exit. • Utility Deposit Assistance may be provided only if the following requirements are met:
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▪ Utility deposit assistance is only available where rental assistance is also being provided.
▪ Utility deposit assistance will be paid directly to the landlord or utility provider on behalf of the eligible household.
▪ Utility deposits that an, provided to the participating household will be in the form of a grant.
▪ Utility deposit refunds can be returned directly to the assisted Household
➢ Security Deposit Assistance
• As needed, the Service Provider will provide security deposit assistance to eligible households. Such assistance shall be the lesser of;
▪ One month approved rent for the housing unit; or
▪ The standard security deposit required by the Landlord for non -subsidized tenants.
▪ Security deposit assistance provided to participating households will be in the form of a grant. As such, security deposit assistance may only be provided once during a household’s participation in the HAP -F program, including re -entry into the program following an exit.
▪ The 1andlord can provide the security deposit refund directly to the household.
Any disputes involving the return, or lack thereof, of a security deposit shall be settled by the tenant and landlord, as provided for in the lease.
➢ Term
• The Service Provider will provide rental assistance for an initial term of 12-month, which can be extended to a second 12-month term, for a cumulative term of 24 months. • Extensions beyond the first 12 months will be granted at the discretion of the HAP -F program manager and shall require written approval which will be based on continued program compliance and ongoing need.
• Written approval must be requested beyond the 12th month of rental assistance and obtained.
• The Service Provider will utilize the Client Outcome Matrix Form (Appendix I) to evaluate ongoing need. Households that score between 0 -80 on the client outcome matrix will be eligible for a subsidy extension.
➢ Subsidy Reductions
• During the first 60 days of occupancy in the new unit the household's contribution toward rent will remain unchanged. Thereafter, every other month the rental assistance payment
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amount paid on behalf of the assisted household may be reduced by $100.00. When the rental assistance payment is reduced, the assisted household is responsible for making up the difference in the payment.
• Households may request suspensions of their monthly rent increases. All requests will be reviewed by the Service Provider and granted at their sole discretion. In evaluating whether to grant a request to suspend a proposed rental assistance payment decreas e the Service Provider shall consider the family's ability to make additional rental payments, extenuating life circumstance, unplanned expenses, and/ or unexpected loss of income. ▪ Suspensions of the monthly rent increases should be documented in the client’s file with a written explanation of the hardship and a plan from the Service Provider Case Manager on steps being taken to help household overcome the financial hardship.
➢ Non-HOME TBRA Emergency Rental Assistance
• In extreme cases where a suspension of a household’s monthly rent increases has been approved by the Service Provider and the household requires additional non-HOME TBRA rental assistance to meet their tenant portion obligations, the Service Provider may connect the HOME assisted household to other emergency rental assistance programs. ▪ Households may not receive rental assistance outside of HOME TBRA if the assistance, Federal, State or local, would result in duplicative subsidies to the household or would result in a reduction of their tenant portion to less than 30% of their Gross Annual Income.
▪ Households participating in the HAP -F program must notify the Service Provider if they plan to apply for any non -HOME TBRA rental assistance programs prior to applying for said programs.
▪ A participating HAP-F household will fall into non-compliance if they receive non-HOME TBRA rental assistance for their tenant portion that resulted in a reduction of their tenant portion to less than 30% of their Gross Annual Income
➢ Annual Recertification
• Recertification of income and program eligibility will occur annually. The Service Provider will gather source documentation for participating households to determine Gross Annual Income. Gross Annual Income must be calculated in accordance with 24 CFR Part 5.609.
▪ If the total household Income is above 80% AMI. Rental assistance must be terminated following a 30-day notification period.
▪ For households between 60% and 80% AMI the Service Provider must obtain appiova1 from the City before rental assistance is continued.
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➢ Self Sufficiency Program
• The Service Provider will request each eligible household receiving rental assistance payments to participate in a Self-Sufficiency Program administered by the Service Provider.
• The family's failure to continue participation in the Self-Sufficiency Program is not a basis for terminating the assistance; however, households that fail to participate in the Self -Sufficiency Program will not be allowed to receive rental assistance extensions.
Service Provider reserves the right to give client and landlord a "Notification of Non- renewal” if the client becomes non-responsive (see Section VI). ▪ At the end of each month all participating households will be assessed for goal progress and communication with their Case Manager.
▪ Participating households who have disengaged from holding communication with their assigned Case Manager must be placed on an intervention plan (participation agreement) by the service provider, detailing barriers and mutually agreed upon intervention to address concerns.
▪ If a family receives an intervention plan for three consecutive months subsidies will be terminated due to lack of engagement. • The Service Provider will utilize their agencies’ respective case management models to carry out these services. Although the Service Provider will utilize their own model, the Service Provider will be required to complete certain activities. The key activities are as follows:
▪ Development of a comprehensive, individualized service plan; ▪ Coordination of services required to implement the plan; ▪ Monitoring of client to assess the effectiveness of the plan; ▪ Periodic service plan re-evaluation at least every three (3) months and adaptation of the plan, as necessary; and
▪ Clear documentation of assessment, plan, and service referrals. ▪ Ensure that school aged children must be enrolled and attend school regularly. • The plan must outline the household’s goals to stabilize their housing in key areas. Some examples of key areas are the following:
▪ Increase income through employment, benefits or a combination of the two, as needed to sustain housing.
▪ Outpatient physical and/ or mental health services.
▪ Outpatient substance abuse treatment services
▪ Landlord mediation and credit building
▪ Transportation assistance
▪ Education services including consumer education, health education, ▪ substance abuse prevention, literacy, ESL and GED
▪ Employment assistance and job training
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▪ Life skills training such as budgeting, money management, household management, nutrition, and other skills that may never have been learned or have been lost
▪ Other self-established priorities
• All families will develop a mutually agreed upon five-month program exit plan. Families will work to increase gross household income in order to maintain independence at the end of the five-month subsidy term.
• The assigned Case Manager must include the following documents as part of the household case file.
▪ Self-sufficiency Assessments.
▪ Case Notes, as applicable.
▪ Client Outcome Matrix.
▪ Household Budget Worksheets.
▪ Student Grades.
➢ Case Management Approach
• Self-sufficiency case management must provide the support necessary to help the participant retain housing once it is secured and to secure resources that can sustain them after the program is over.
• The program is intended to be compassionate, individualized and Housing First oriented.
➢ Drug Testing and Harm Reduction Program
• Drug test requirement will be determined by the Management Team and Case Managers during.
▪ Adults may be tested randomly or based on suspicion.
▪ Site Coordinator, Associate Managers, and the Director of Program Operations must be Universal Precautions Certified in order to conduct drug tests safely.
▪ The Site Coordinator will conduct the drug test. with a member of the Management Team present during testing.
▪ Clients retain the right to request a different staff person to conduct the drug test based on gender.
▬ The Services Provider must attempt to accommodate the client's request in a timely manner.
▪ Clients may not leave the office until the drug test has been conducted, otherwise the test will be considered Invalid and a refusal to comply. ▬ Refusal to comply with drug testing equates to a positive drug test.
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▪ Clients who test positive for illegal drugs will choose to either begin a treatment plan and comply with a Harm Reduction Program or exit the program.
• Harm Reduction Program requirements are listed below. ▪ Participating in a minimum of 4 (up to 6) drug test screenings. ▪ Attending weekly case management session.
▬ A total of two case management sessions per week for eight weeks. ▬ The following topics must be discussed with the client:
⬧ Self-assessment
⬧ Timeline of life and use
⬧ Education and consequences
⬧ Stress coping and alternatives
⬧ Triggers
⬧ Boundaries and high-risk situations
⬧ Relapse prevention and lessons learned.
▪ Completing at least one item from each category in a list of Level 1, Level 2, and Level 3 activities.
▪ All Harm Reduction Program updates and completed requirements will be documented by the Case Manager
▪ The meeting will cover any major concerns with families, potential exits, drug tests needed, harm reduction updates, participation agreement updates, rent issues, probation, client concerns. successes, and other general program issues and announcements.
▪ Outside collaborators may participate in Case Management Team Meetings upon invitation and must sign the Confidentiality Agreement.
➢ Children and Families Commission Requirements
• The Case Manager is responsible for- creating goals in accordance with Children Family Commission requirements.
• The Case Manager must document these goals.
➢ Termination of Rental Assistance
• Assistance can be terminated for the following reasons:
▪ Failure to comply with HAP-F Program Guidelines and/ or Client Participation Agreements including disengagement in client services. ▪ Eviction from the assisted rental unit based on behavioral issues and/or unlawful activity.
▪ The participant no longer qualifies based on income eligibility, for assistance at annual re-certification.
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APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 19
▪ The family will be assisted by another rental assistance program such as the Section 8 Tenant Based or Project-based program. Participation in any other rental assistance program is considered a duplicative subsidy therefore all HOME funded rental assistance must terminate.
➢ Retuning Participants Households
• As needed, participants may be allowed to return to the program for either support services, rental assistance or both. A determination to allow re-entry shall be based on the following criteria:
▪ Participants must have left the program in good standing. To be in good standing, participants must have been engaged in their case management plan, voluntarily left the program (not in lieu of termination) or have been released because their household income exceeded eligibility limits. In general, participants will not be allowed to re-enter the program if they are terminated for non-compliance.
▪ At the discretion of the Service Provider, a request for readmission from a non-compliant household may be considered when compelling reasons exist.
In such cases, re-admission will require concurrence from the City of Anaheim.
▪ The participant's previous rental assistance did not exceed 24 months.
Cumulatively, participants will only be allowed to receive rental assistance for a maximum of 24 months.
➢ Exit Procedures
• All participating households must work along with their assigned Case Manager to develop a mutually agreed upon 12-to-18-month program exit plan. ▪ Families must work to increase gross household income to maintain independence at the end of the 12-to-18-month period from enrollment. • Participating households that are reaching their one-year mark in the program will be exited from the program (if deemed stable) and considered a graduate. and they may continue to receive case management and other program services for up to six months. • Households that fail to comply with program guidelines will be reviewed and assessed by the service provider for continuation or termination from the program. • In the case that the Case Manager
• Exiting households must complete an exit interview with their Case Manager, during which the family will complete the CMIS and exit forms and the 0-5 exit forms If applicable.
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 20
• The Case Manager must review the completed file and case notes with the Manager or Director of Housing Services. Upon approval. the Case Manager will exit the family from HMIS.
• The Service Provider will submit a letter of exit to the City of Anaheim for all clients who exit HAP-F detailing the reason for exit and all exit strategies and housing plans. ▪ Upon exit, a client will be assigned a Program Exit Status:
▬ Permanent housing
▬ Motel on own,
▬ Transitional housing,
▬ Stayed with family/friends,
▬ Self-checkout,
▬ Motel vacated,
▬ Non-compliant,
▬ Didn't meet requirements.
▪ Graduate status may include any families in the following categories:
▬ Permanent housing
▬ Remained In motel on own,
▬ Transitional housing,
▬ Stayed with family/friends.
• The Case Manager is responsible for acquiring a method of contact for the exiting families, in order to maintain a relationship with graduates. ▪ Graduates will be tracked by their Case Manager at three months and six months after exiting the program.
• The assigned Case Manager must include the following documents as part of the household case file.
▪ Household Exit Letter.
▪ HMIS Exit Form.
➢ Case Management Files and Reporting
• Case Management Databases must be updated monthly.
• Quarterly data reviews must be conducted to ensure data quality and to evaluate program effectiveness.
• The Service Provider must maintain adequate records of services in sufficient detail to demonstrate compliance with the policies and procedures of the program. ▪ All supportive services received by the participant must be clearly documented in their case file.
• All meetings held with program participants must be documented in case notes and include:
▪ Date of meeting
HOMELESS ASSISTANCE PROGRAM FOR FAMILIES (HAP-F)
TENANT-BASED RENTAL ASSISTANCE PROGRAM (TBRA)
APPENDIX J: SELF-SUFFICIENCY PROGRAM
POLICIES AND PROCEDURES
(February 2025) pg. 21
▪ Overview of meeting content
▪ Observations/concerns
▪ Status of service plan progress and goals
▪ Staff initials
• All case management information must be kept confidential, and information should not be disclosed to anyone outside the Service Provider and program staff without a signed disclosure form.
▪ All participant personal information should be protected and only shared when necessary to ensure the client receives quality assistance. • These records shall be retained for 5 years from the date service provision stops.