Division of Housing and Community Development
P ublished 12/1/2021
FY'24
Strategic Community Investment Fund
(SCIF)
HOUSING
OPPORTUNITIES FOR
PERSON WITH AIDS
(HOPWA) PROGRAM
FY-24 Strategic Community Investment Fund
TABLE OF CONTENTS
Section I
Housing Opportunities for Persons with AIDS (HOPWA) Grant Program Description
Introduction ................................................................................................................................................... 2
Eligible Applicant ...............................................................................................................................3
Eligible Activities ...............................................................................................................................3
Ineligible Activities and Limitations ...................................................................................................6
Eligible Program Participants ...........................................................................................................6
Requirements for Construction or Rehabilitation Programs ............................................................7
Requirements for Rental Assistance Programs ...............................................................................8
Short Term Rent, Utilities and Mortgage Assistance …………………………….……………………..9
Other Requirements Affecting All Programs……………………………………………………………..11
Section II Application Selection Process
Threshold Requirements …………………………………………….…………………………………….14
Grant Review and Selection Process …………………….………………………………………………14
Rating and Ranking ..................................................................................................................................... 15
Grant Award and Implementation Process .............................................................................................. 16
Program Completion and Expenditures of Funds ................................................................................... 17
City Contacts / Questions ........................................................................................................................... 17
Section III Program Application Forms
HOPWA Program Application ……………………………………….…………………………………… 18
Appendix
HOPWA Current Income Limits
HOPWA Current Fair Market Rent
HOPWA Grant Evaluation Form FY23
Criteria for Defining Homeless
Record Keeping Requirements
HOPWA Agency Budget- This is a threshold item.
HOPWA Program Budget- This is a threshold item
Matrix of Required Documents- These are threshold items.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
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SECTION I
HOPWA GRANT PROGRAM DESCRIPTION
INTRODUCTION
The City's Housing Opportunities for Persons with AIDS (HOPWA) Grant Program
provides assistance to low-income individuals diagnosed with HIV/AIDS and their family
members living with them. The program is part of the City’s strategy to provide housing
and supportive services to low-income members of special needs populations.
The program is funded with Housing Opportunities for Persons with AIDS (HOPWA)
entitlement funds annually awarded to the City by the U.S. Department of Housing and
Urban Development (HUD). As such, all activities must comply with applicable HOPWA
regulations, which are found in 24 CFR 574. The program is designed to:
• provide a stable living environment in housing that is safe, decent and sanitary and
reduces risks of homelessness for persons with HIV/AIDS and improves access to
HIV treatment and other health care services for the program participants
• serve low and moderate-income persons diagnosed with HIV/AIDS and their family
members living with them by providing HOPWA-eligible housing and services
• serve persons with HIV/AIDS living in Fayette, Shelby and Tipton counties in
Tennessee, DeSoto, Marshall, Tate and Tunica counties in Mississippi, and
Crittenden County in Arkansas
• award funding for housing and supportive service programs to nonprofit agencies to
serve eligible client population
• develop and maintain a continuum of affordable housing assistance programs to
prevent homelessness, serve the homeless, and provide other permanent housing
opportunities and related supportive services for HOPWA-eligible clients
• work primarily with existing housing resources
• provide services to program participants based on need since this is not an entitlement
• provide one year of funding for approved programs.
The City seeks applications that will:
• help increase access to stable permanent housing opportunities that include low
income, permanent housing, program-based, and tenant-based rental assistance,
transitional housing and comprehensive, residential alcohol and drug treatment
programs for persons with HIV/AIDS
• prevent homelessness
• provide housing accompanied by appropriate supportive services including case
management and improved access and usage of HIV/AIDS treatment and other health
care
• assess each program participant's housing needs, prepare a housing plan, and work
with the person to achieve the plan
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• encourage the self-sufficiency and stability of participants by securing eligible
mainstream resources and other services that bolster independence as well as
employment for participants when feasible. (Mainstream programs may include Food
Stamps, TennCare, SSI, and similar Federal and State programs.)
• address priorities identified in the City’s Consolidated Plan
• coordinate activities with other public and private agencies serving persons with
HIV/AIDS
• provide confidentiality for program participants
• provide services free of charge except for rent.
ELIGIBLE APPLICANT
Nonprofit Organizations
CRITERIA FOR HOPWA-FUNDED PROGRAMS.
Although the feasibility of a HOPWA-funded program relies on many factors, the
eligibility of a program depends on compliance with basic criteria and the provision of
adequate information to properly evaluate a proposed program. These are prerequisites
for consideration for funding and are explained in more detail in the SCIF Agency Profile
or later in this section.
1. The applicant must be a HOPWA eligible program sponsor, a nonprofit
organization that meets criteria listed in the SCIF Agency Profile and that includes
provision of services/housing to persons with HIV/AIDS as one of its primary
purposes.
2. The proposed programs must include only HOPWA-eligible activities per 24 CFR
574 and no ineligible activities per HOPWA regulations.
3. The programs may serve only HOPWA eligible program participants, who are low-
income individuals diagnosed with acquired immunodeficiency syndrome or
related diseases (HIV/AIDS) and the person's family members.
4. Programs must address the goals of the program described above.
5. If an application proposes housing construction and rehabilitation, the programs
must comply with the requirements for housing construction and rehabilitation
found in 24 CFR 574.
6. If the application requests funding for a rental assistance program, it must follow
the requirements for rental assistance found in 24 CFR 574 when rental programs
are developed.
7. The City’s guidelines for short-term rent, mortgage and utility (STRMU) assistance
must be followed when STRMU programs are developed.
8. Other requirements affecting all programs must be taken into consideration when
designing/developing a HOPWA program.
HOPWA ELIGIBLE ACTIVITIES
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There are a number of HOPWA-eligible activities to help meet the housing needs to low-
income persons with HIV/AIDS and their families. See 24 CFR 574 for complete
information.
• Housing Information Services include housing counseling, fair housing
information, housing advocacy activities, housing information and referral, and
housing search and assistance.
• Resource Identification includes outreach and relationship building with
landlords, costs involved in creating brochures and web resources as well as staff
time to locate and identify affordable housing vacancies.
• Rental assistance includes payment of rent, including utilities, for housing which
meets local housing codes/quality standards, HUD's standards for Fair Market
Rent in the MSA and Marshall, Tate and Tunica counties, and rent reasonableness
requirements. Persons that receive rental assistance under this program must pay
a portion of their rent and utilities as dictated by HUD guidelines described below.
Rental assistance may include program or tenant-based rental assistance but
does not include short-term supportive housing or short-term rent, mortgage, and
utility assistance described below. Rental assistance is not emergency assistance,
but it helps individuals access permanent housing.
• Short-term supported housing provides funding for temporary shelters which
may include emergency / transitional shelters. This type of housing may provide
residence to any eligible person for up to 60 days during any 6-month period. (The
60 days do not have to be consecutive.) HUD's Fair Market Rent does not apply
to this program, nor do local housing codes and housing quality standards, or rent
reasonableness requirements. However, the City expects the housing conditions
to be safe and sanitary and the rents reasonable for the type of housing provided.
• Short-Term Rent, Mortgage, and Utility (STRMU) Assistance provides
payments to prevent the homelessness of a tenant or mortgagor of a dwelling for
costs accruing over a period of no more than 21 weeks during any 52-week period.
While HUD does not require compliance with Fair Market Rent guidelines, the
City’s guidelines specify that no rent will be paid that is higher than the applicable
FMR. Neither local housing codes and housing quality standards nor rent
reasonableness requirements apply to STRMU. However, the City expects the
assistance to be reasonable and to be used in emergency situations in order to
prevent homelessness. Short-term rent, mortgage and utility assistance are not
appropriate as ongoing assistance when less expensive, more appropriate
housing should be obtained to ensure a client remains housed. All short-term rent,
mortgage and utility assistance programs must comply with the guidelines dictated
by the City and the HOPWA Steering Committee.
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HOPWA Application FY24
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Housing assisted with STRMU may have been secured prior to any HOPWA-
assistance to the client. Or, the funds may be used to pay emergency rent and
utilities to clients that have obtained short-term housing through the HOPWA
program with deposits and first month's rent being paid through Housing
Placement activity funding.
• Acquisition, rehabilitation, conversion, lease and repair of housing provides
housing with or without on-site supportive services; it may include independent
apartments or shared residences; rehabilitation must bring the facility up to current
ADA standards; this may include master leasing of an existing facility. All housing
eligible under this activity must meet local housing codes and quality standards,
rent reasonableness criteria, HUD Fair Market rent standards, and HUD’s rent
guidelines.
• New Construction of Housing is limited to building single room occupancy (SRO)
facilities or community residences. This activity provides funding for construction
of housing, which will include multi-unit dwellings that meet local housing codes
and quality standards, HUD Fair Market rent standards, rent reasonableness
requirements and HUD’s rent guidelines. HOPWA funds may be used to pay the
costs of a percentage of units in a SRO or community residence as long as that
percentage of units is used to house persons with HIV/AIDS.
• Operating Costs for Housing include costs of property maintenance and upkeep,
security measures, insurance, utility costs, furnishings and equipment, operating
supplies and other incidental expenses. This category includes costs associated
with the operation of Short-Term Supported Housing like emergency and
transitional shelters
• Permanent Housing Placement is a supportive housing activity that helps
establish the household in a housing unit and may include reasonable costs of
security deposits and first month’s rent for homeless persons. This shall not
exceed two months of rent costs.
• Supportive Services include the costs of providing a wide range of supportive
services like health, mental health, assessment, permanent housing placement,
drug and alcohol abuse treatment and counseling, housing case management and
other services necessary to ensure the housing stability of the program participant.
Although supportive services not directly related to the provision of housing are
eligible for HOPWA funding, housing-related activities will be considered a higher
priority for funding.
• Administrative Costs - Each program sponsor receiving a HOPWA grant may
use no more than 7 percent of the amount received for administrative costs. A lump
sum is not provided, and costs may include only costs for general management,
oversight, coordination, evaluation and reporting on eligible activities. Such costs
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do not include costs directly related to carrying out eligible activities, since those
costs are eligible as part of the activity delivery costs of such activities.
INELIGIBLE ACTIVITIES
A number of limitations are placed on activities in the HOPWA regulations. They
include but are not limited to the following:
• Funds may be used only for activities that are included in the eligible activities
described above and listed as eligible for HOPWA-funding in 24 CFR 574.
• Activities are ineligible if they do not serve low-income persons with HIV/AIDS
and their family members.
• Activities are ineligible if they do not serve persons living in the MSA.
• Short-term rent, mortgage, and utility assistance to prevent homelessness may not
be used to make deposits and pay first month's rent and utilities for homeless
persons. (However, Permanent Housing Placement funds may be used for costs
not to exceed two month’s rent.)
• Short-term rent, mortgage, and utility assistance may not be provided for costs
accruing for a period of more than 21 weeks in any 52-week period.
• A short-term supported housing facility may not provide residence to any individual
for more than 60 days during any six-month period.
• HOPWA funds may not be used to pay rental assistance for housing units that do
not meet local housing codes/quality standards.
• HOPWA funds may not be used to provide rental or utility assistance that exceeds
HUD’s Fair Market Rent guidelines
• HOPWA funds may not be used to pay rents that are not comparable for similar or
like apartments on the local market. (i.e., rents may not exceed HUD’s Fair Market
Rents for the area.) HOPWA funds may be used to pay only reasonable,
customary deposits and may not be used to pay extraordinary deposits or fees
required by owners because the population is viewed as one with special needs.
• HOPWA funds may not be awarded to a primarily religious organization unless the
organization agrees to provide all services free from religious influences and in
accordance with principles spelled out at 24 CFR 574.300 ( c ) ( 1 ).
• Funds may be used to rehabilitate or convert a structure owned by a primarily
religious organization only under certain conditions spelled out at 24 CFR
574.300(c) (2). Otherwise, funds may not be used to rehabilitate a facility owned
by a church/primarily religious organization.
HOPWA-ELIGIBLE PROGRAM PARTICIPANTS
Eligible person means a person with acquired immunodeficiency (AIDS) syndrome or
related diseases who is a low-income individual, as defined by HUD, and the person's
family. Documentation of the person's diagnosis of AIDS must be submitted and be from
a reliable source.
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HOPWA Application FY24
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Low income means persons or households with incomes at or below 80% of the Area
Median Income. The income limits for Fayette, Shelby, and Tipton Counties in
Tennessee, Crittenden County in Arkansas and DeSoto County in Mississippi are
included in this application. Income limits for Marshall, Tate, and Tunica Counties in
Mississippi are included in this application. Income must be documented.
Family means a household composed of two or more related persons. The term family
also includes one or more eligible persons living with another person or persons who are
determined to be important to their care or wellbeing, and the surviving member or
members of any family described in this definition who were living in a unit assisted under
the HOPWA program with the person with AIDS at the time of his or her death.
An agency will be required to document the AIDS diagnosis and income of program
participants.
REQUIREMENTS FOR HOUSING CONSTRUCTION OR REHABILITATION
All programs that request funds for construction, rehabilitation or conversion of a
structure or housing unit must comply with the following requirements.
1. Proof of Site Control
Proof of site control in the form of a deed, purchase contract or an option should
be submitted if improvements are to be made to a building owned by or to be
purchased by the applicant. The expiration date of the contract or option must be
included. Applications that propose improvements to a leased facility must include
a copy of a long-term lease between the applicant and the owner.
2. Site Information, present zoning and adjoining land uses
Site information must include a complete legal description of the property. The
present zoning of the property must be indicated as well as any required re-zoning
or special use permits required for the proposed use. The adjoining land uses
must also be described.
3. Construction Estimates
The proposed construction costs should be based on estimates made by a
contractor, engineer, or architect familiar with the program. The City will review
these for feasibility.
4. Design of Improvements
The new construction or rehabilitation/conversion improvements must be designed
by a licensed architect who will also play an integral part in the public bidding of
the program, ensure compliance with all applicable codes and zoning ordinances
(including zoning and handicapped accessibility), and oversee construction and
verify draw requests.
5. Competitive Selection of Architects, Engineers & Construction Contractors
All HOPWA-funded contracts for architectural and engineering services and
construction must be awarded in a competitive manner. Methods of bidding and
contract award may vary with the approval of the City.
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6. Treatment of Existing Lead-Based Paint and Asbestos
Elimination or encapsulation of lead-based paint and asbestos in a shelter may be
required under certain conditions. Construction estimates should include these
costs. Additionally, costs should include a survey of existing lead-based paint and
asbestos to be performed prior to construction by qualified entities.
7. Displacement of Residents or Businesses
No programs will be funded that result in the displacement of individuals, families
or businesses from the site proposed for a shelter.
8. Compliance with Federal Historic Preservation Guidelines.
If the building to be rehabilitated is a historically significant structure, the
construction work must be undertaken in compliance with Federal Preservation
guidelines as interpreted by Memphis Heritage and the State Historic Preservation
Office. This may require use of specific materials that should be considered in the
construction budget
9. Minimum Use Requirements.
Any building assisted with HOPWA funds must be maintained as a facility to
provide housing or assistance for individuals with AIDS or related diseases: a) for
a period of not less than 10 years in the case of assistance provided as
"Acquisition, rehabilitation, conversion, lease, and repair of facilities" or "New
Construction" that involve new construction, substantial rehabilitation or acquisition
of a building or structure; b) for a period of not less than 3 years in cases involving
non-substantial rehabilitation or repair of a building or structure. Substantial
rehabilitation is defined as rehabilitation that involves costs in excess of 75 percent
of the value of the building after rehabilitation. The applicant must also submit a
description of how it plans to manage/operate the rehabilitated structure for the
required period of use.
10. Compliance with Local Codes and State laws.
Any housing constructed, renovated or operated with HOPWA funds must meet all
applicable local construction, housing, and other applicable codes. These include
but are not limited to use and occupancy, zoning, fire and safety, as well as health
and sanitation standards. Estimated costs of complying with codes should be
included in construction costs. Construction permits are required for renovation. If
the shelter requires licensing under local or State law, the agency must obtain and
keep proper licensure to receive HOPWA funds. No exceptions are made.
11. Insurance and Bonding Requirements for Construction.
Bidders and Contractors will be required to meet bonding requirements
established by HUD.
12. Davis-Bacon Wage Rates.
Davis-Bacon Wage Rates do not apply to HOPWA-funded construction unless
they are combined with funds from other Federal programs that are subject to the
Act.
REQUIREMENTS FOR RENTAL ASSISTANCE PROGRAMS
Rental assistance (not short-term rent, mortgage and utilities) may be provided to make
housing more affordable for low-income persons with HIV/AIDS and their family
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HOPWA Application FY24
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members. All housing units supported by rental assistance must comply with local
housing codes and quality standards. Rents may not exceed HUD’s Fair Market Rent
guidelines which is included in the application.
HOPWA-funded rental assistance programs pay the difference between HUD's Fair
Market Rent and an amount that is the higher of the following:
30 percent of the household's monthly adjusted income;
10 percent of the household's monthly gross income;
Or, if the family is receiving payments for welfare assistance from a public agency
and a part of the payments, adjusted in accordance with the family's actual housing
costs, is specifically designated by the agency to meet the family's housing costs.
Tenant-based rental assistance operates in a manner similar to Section 8 and is tied to
the eligible tenant, not the housing unit. The tenant is encouraged to find a housing unit,
which, if located in Memphis, the City will inspect for compliance with housing codes and
housing quality standards. The tenant enters into a lease with the property owner and,
unless the utilities are included in the rent, is responsible for paying utility costs.
Program based rental assistance is tied to a particular program or housing development.
The program / development must comply with local housing codes and quality standards.
And program participants assisted through this program cannot receive rental assistance
except in the units associated with the program.
Leases are required for persons receiving either tenant or program-based rental
assistance. Leases are typically limited to a one-year period.
SHORT TERM RENT, MORTGAGE, AND UTILITY ASSISTANCE
Purpose: The purpose of STRMU is to assist households facing a housing emergency
or crisis that could result in their displacement from their current housing or in
homelessness. This activity may use HOPWA funds to provide short-term rent, mortgage
and utility assistance to low-income persons diagnosed with HIV/AIDS to forestall
eviction, foreclosure, or uninhabitability of the residence.
STRMU is suitable for persons who experience episodic problems with paying rent,
mortgage and utility costs and is not suitable for individuals with chronic problems paying
these costs. The funding is not suitable as a long-term solution for households that
require on-going financial assistance to remain in their homes.
STRMU does not address the needs of people who are homeless. STRMU funds cannot
be used to provide first month’s rent or security deposits for a person moving into a new
housing unit.
STRMU assistance is limited to helping the individual remain in the housing where they
reside at the time they seek assistance. The assistance is needs based and is not an
entitlement. All STRMU assistance must be provided as part of a housing care plan
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developed for the client by the HOPWA-funded program sponsor following the limits set
in these Policies and Procedures and based on assessed need to the person with AIDS.
• Area to be Served:
Memphis EMSA which includes Fayette, Shelby, and Tipton Counties in
Tennessee, Crittenden County in Arkansas, and DeSoto, Marshall, Tate and
Tunica Counties in Mississippi.
• General Requirements:
STRMU may be paid only by program sponsors approved for funding through the
competitive application process for HOPWA funds awarded to the City of Memphis
for the Memphis EMSA and that have an existing HOPWA-funded contract that
lists STRMU as a budget line.
• 21 Week Limit:
Rent, mortgage and utility assistance is limited to a maximum of 21 weeks in a 52-
week period. The process for counting the 52-week period is based on the client's
year (when the client's assistance begins) not on the fiscal year of the program
sponsor. The 21 weeks do not have to be consecutive during the 52-week period.
(Program sponsors should not advertise the guaranteed availability of 21 weeks of
assistance, although the full 21 weeks is eligible for funding under the Memphis
STRMU program. Instead, program sponsors should develop rental assistance
programs for clients that require full assistance or help the client find affordable
housing which will not require STRMU assistance for the long term.)
• Caps on Assistance:
An eligible client cannot receive a monthly rental payment that exceeds the area's
HUD Fair Market Rent adjusted by unit size and family/household size.
• Utility Payments:
STRMU will pay utilities, including arrearages, with no cap on the amount.
However, payment of utility arrearages must achieve two goals:
• the full amount of utility arrearages is paid
• the person will be able to resume normal monthly utility payments and,
consequently, remain stably housed.
When utility arrearages are paid, the 21 weeks begins on the date the bill is due
(not on the date when utilities are first provided.
• Survivor Benefits
Survivor benefits in the form of STRMU will be provided for no more than ninety
(90) days after the death of the HOPWA-eligible person
• Eligible Recipients of Payments:
Eligible recipients of STRMU payments are limited to third parties - - i.e., the owner
or management company of a rental housing unit, the holder of the mortgage, or
the utility company to which utility costs are due. No check can be provided to an
INDIVIDUAL without a tax identification number whether or not this results in the
homelessness of the client.
• Shared Housing:
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STRMU assistance may be provided for shared housing situations as long as the
client has a lease for the housing and when the program sponsor determines that
such assistance is necessary as part of the client's housing care plan.
• Roommates:
STRMU assistance may be provided for roommates that are both eligible for
assistance as long as both roommates are listed on the lease or mortgage.
• Declaration of Family:
When two individuals apply for STRMU, they must declare as a family or as
roommates at the initial assessment. Changes in this declaration, which affects
whether two individuals are living as a couple, are not allowed. The declaration
affects the size of apartment/amount of assistance that the client is eligible to
receive. (i.e., if two people are living as a couple and have no other members of
the household, STRMU assistance is capped at the FMR for one bedroom.
However, if two people are living as roommates and there are not other members
of the family, STRMU assistance will be capped at the FMR for a two-bedroom
unit.)
• 1099 Forms:
Program sponsors administering STRMU are responsible for submitting an IRS
1099 form to all entities that receive STRMU payments.
• Habitability Standards
Program sponsors administering STRMU are responsible for ensuring that a unit
receiving more than 16 weeks of STRMU assistance meets HUD’s habitability
standards.
OTHER REQUIREMENTS AFFECTING ALL PROGRAMS
The following requirements apply to HOPWA-funded programs.
1. Fees for Services.
The program sponsor may charge no fee, except rent, of any eligible person for
any housing or services provided with amounts from a HOPWA-funded grant.
2. Disbursement of Funds.
Grant funds are not awarded in one lump sum. They are paid on a monthly basis
to agencies on a reimbursement basis for eligible costs incurred. Agencies
awarded HOPWA funds for operating / maintenance, rental assistance and other
non-construction activities are expected to have adequate cash flow to pay
program costs and then request reimbursement from the City. However, funds for
construction or rehabilitation will be paid when costs have been incurred. These
construction-related payments are not reimbursements and an agency is not
expected to have adequate cash flow to pay for construction costs. No funds will
be used to reimburse costs incurred before the beginning of the grant cycle on July
1
st
or before the award of the grant, environmental clearance of the program by
the City, and execution of the contract between the City and the applicant agency.
3. Federal Administrative Requirements.
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Agencies must comply with Federal administrative requirements. All agencies
awarded HOPWA grants will be required to comply with a variety of requirements
governing their use of Federal funds. These include but are not limited to:
* Standards for Financial Management (OMB Circular A-110)
* Cost Principles and Allowable Costs (OMB Circular A-122)
* Federal Audit Standards (OMB Circular A-133)
* Conflict of Interest (OMB Circular A-110 and 24 CFR 574.440)
* Procurement Principles (OMB Circular A-110)
Additionally, agencies awarded HOPWA grants will be required to open their books
to a representative of the Internal Audit Department of the City to evaluate their
financial management systems. City staff will monitor each program to ensure
compliance with the terms of the funding agreement between the City and the
agency. This will include monitoring records kept by the applicant to demonstrate
the eligibility of clients, the services provided, and other required information.
4. Allocation of Costs.
Costs of activities/programs funded by several sources must be allocated
appropriately. When an agency receives funding from several sources for the
same activity or program, the costs must be allocated among the sources in an
acceptable manner. The City must approve the allocation plan.
5. Liability Insurance.
Liability insurance is required for all HOPWA grants. All agencies awarded grants
will be required to obtain the following liability coverage’s:
o General liability insurance in the amount of Two Million Dollars
($2,000,000.00)
o Automobile liability insurance in the amount of One Million Dollars
($1,000,000.00)
o Worker’s Compensation insurance for agencies with five (5) or more
employees.
6. Handicapped Accessibility.
All programs must be accessible to persons with disabilities. Programs,
information, participation, communications and services must be accessible to
persons with disabilities. Agencies must comply with Section 504 of the
Rehabilitation Act of 1974 and Americans with Disabilities Act (ADA).
7. Nondiscrimination.
All agencies must ensure nondiscrimination. This applies to employment and
contracting as well as to marketing and selection of program participants.
Discrimination is not allowed on grounds of race, color, national origin, religion,
sex, age, or disability. Fair Housing laws prohibit discrimination based on the
above and on familial status. Disability includes persons living with AIDS.
8. Formal Termination Policy.
Agencies awarded funds must develop a formal Termination policy that clearly
describes a process by which clients' services may be terminated if program
requirements are violated.
9. Supportive Assistance.
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Agencies awarded funds must assure that persons with AIDS are given assistance
in obtaining appropriate supportive services, including permanent housing, mental
health treatment, medical health treatment, counseling, case management,
supervision, and other services essential for achieving independent living.
Additionally, agencies must assure that the persons with HIV/AIDS are assisted in
obtaining other Federal, State, local and private assistance available for such
persons. This will include individually assisting clients to identify, apply for and
obtain benefits under each of the following mainstream health and social services
programs for which they are eligible: TANF, Medicaid, SCHIP, SSI, Food Stamps,
Workforce Investment Act, and Veterans Health Care Programs.
10. Confidentiality.
Agencies/program sponsors must ensure the confidentiality of both the name of
any individual assisted by HOPWA and any other information regarding individuals
receiving assistance through this program per 24 CFR 574.625.
11. Other Federal Regulations.
Agencies awarded funds must agree to comply with all applicable Federal
regulations. All agencies awarded funding will be required to comply with the
regulations. Please review this carefully. Exceptions are not made.
12. Participation in AIDS Consortium.
Each agency awarded HOPWA funds is required to be a member of the AIDS
Consortium headquartered at United Way of the Mid-South and to participate in
monthly meetings.
13. Participation in HMIS database.
Each agency awarded HOPWA funds will be required to regularly submit
information to Community Alliance for the Homeless for their database if the
agency serves the homeless. The City's intention is to strengthen participation in
this database so it can become a more accurate and useful tool in planning and
administering programs for the homeless.
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SECTION II
APPLICATION SELECTION PROCESS
THRESHOLD REQUIREMENTS
All proposals submitted by the deadline will be reviewed by the Homeless and Special
Needs Department staff for technical completeness and adherence to the format required
and in this HOPWA Program Application Packet. If an applicant does not submit the
required documents at the time of the application submitted deadline, the City will
reject that application. The applicant will be informed of the rejection by letter.
Technically complete applications will be reviewed by City staff to determine applicant
eligibility and program eligibility.
1. Applicant Eligibility - Staff will review information required in the SCIF General
Application to determine whether the agency is eligible for HOPWA funding. If the
City determines these standards are not met, the program will be rejected, and the
applicant agency notified by letter. If the applicant is found to be eligible, the
application will be reviewed for program eligibility.
2. Program Eligibility - Staff will review the HOPWA Program Application to determine
whether the proposed activities are eligible for HOPWA funding. If activities are not
eligible, the application will be rejected, and the applicant agency notified by letter.
Applications proposing services to ineligible participants will be rejected. If the
activities are found to be eligible, the application will be submitted to the review
committee for consideration.
GRANT REVIEW AND SELECTION PROCESS
To review and rank applications, the City will appoint a Grant Review Committee,
including persons not employed by the City to obtain certain expertise and outside points
of view. These individuals may include representatives from other funding sources within
Memphis and from programs that work with agencies that serve persons living with AIDS
or that are knowledgeable about various aspects of housing services. The City will not
appoint individuals that have assisted or plan to assist applicants with preparing
applications for these funds. Nor will it appoint individuals that are employed by agencies
that submit an application for the HOPWA funds.
Committee members will review eligible applications and will determine the steps in the
review process with regard to making on-site visits to agencies or inviting agency
representatives to attend a Review Committee meeting to answer questions about their
applications. The City will make available to committee members all monitoring
information related to grants previously awarded to the applicant.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
15
RATING AND RANKING
Members of the Review Committee will rate and rank applications. The points awarded
for the rating factors total 100. The factors for rating and ranking applicants are listed
below in the appendix section. Each applicant should carefully read the factors for rating
and ranking applications described below.
Applicant capacity. Up to 20 points will be awarded based on the extent to which the
application demonstrates that the applicant agency has the capacity and capability to
effectively administer the proposed HOPWA activity. The application must demonstrate
that the agency staff has adequate credentials and experience to carry out the proposed
program. This means that in addition to knowledge of and experience in serving persons
with AIDS, the organization carrying out the program, its employees, or its partners, must
have the necessary experience and qualifications to carry out the specific activities
proposed. Factors to be considered will include: prior agency experience and results in
the type of work being proposed, suitable agency fiscal capacity and organizational
infrastructure to implement the program; and employee experience and credentials in the
area to be implemented. The City’s monitoring records of previously funded programs will
also be included in determining applicant capacity.
Program quality. Up to 20 points will be awarded based on the extent to which the
application demonstrates the quality of the program. The housing and services proposed
must be appropriate to the needs of the persons to be served. The application must
demonstrate a clear understanding of the needs of the clients, the services to be offered,
and the effectiveness of the services in meeting those client's needs. The City may
consider a program to be of poor quality if:
• The type and scale of the housing and services proposed clearly do not fit the
needs of the proposed participants (e.g., the application proposes to house
homeless families with children in the same space as homeless persons with
mental illness or alcohol and drug problems or proposes to separate members of
the same family without an acceptable rationale.)
• The application does not show how the program will help participants to access
permanent housing, achieve housing stability and obtain needed medical care and
supportive services.
• The application does not show how the program will protect the confidentiality of
the clients.
• The program is not cost-effective in the Committee’s opinion and all costs are not
reasonable, but deviate substantially from the norm in Memphis;
• The application shows no evidence of collaboration with other existing programs
and services for persons with AIDS;
• The shelter proposed does not meet City code, health or safety standards;
• The agency does not participate in Community Alliance's database, and/or is not
a member of the Memphis AIDS Consortium.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
16
• The application does not describe how the agency will assist clients enroll in
mainstream programs for which they are eligible.
Need for Program. Up to 30 points may be awarded based on the extent to which the
application demonstrates the need for the program. It must describe the need for the
specific program vis-à-vis existing services. The program may be judged to adequately
describe the need for the program if it addresses the following points:
1. The need for the program is documented by use of waiting lists, references to
similar programs, etc.
2. The program is consistent with the priorities described in the City of Memphis
Consolidated Plan;
3. The program does not duplicate existing programs and services which will
continue to be operational during the funding period.
Operational Feasibility. Up to 30 points may be awarded based on the extent to which
the application demonstrates the feasibility of the program. The application must
include:
1. Clear and complete plans for implementing the program;
2. Adequate committed funding to implement the program;
3. An adequate strategy for securing additional support and commitment;
4. Adequate number of well-trained staff to carry out the proposed program;
5. Indicators that demonstrate that the program is ready to be implemented.
The scores for each factor will be added in order to obtain a total score for each
application. The applications will then be ranked from highest to lowest according to the
combined scores. Funding will be awarded to applications according to ranking,
beginning with the highest score.
The Director of the Division of Housing and Community Development will review and
approve Committee Recommendations.
The City reserves the right to adjust funding amounts.
GRANT AWARD AND IMPLEMENTATION PROCESS
As soon as programs are approved, the City will contact agencies by letter to announce
the awards and to begin negotiation of the funding agreements. If agency awards are
less than original requests, the agency will be asked to provide a revised scope of
services, revised budget and measurable goals for the contract. The City will make its
best efforts to complete environmental and other reviews and contract execution so that
program funding will be effective July 1
st
.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
17
PROGRAM COMPLETION AND EXPENDITURE OF FUNDS
The City must ensure that all HOPWA funds awarded through this process are
expended within 3 years of the date HUD awards the City funds. The contracts will be
for a one-year period beginning July 1
st
. The City reserves the right to reallocate
HOPWA funds if a program is not operational and funds are not being spent in a
timely manner.
CITY CONTACTS TO ANSWER QUESTIONS
Inquiries regarding this grant program should be directed to:
Travis Young
Community Housing Manager
901.636.7431
[email protected]
Kimberly Mitchell
Administrator, Homeless & Special Needs Department
901.636.7347
[email protected]
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
18
SECTION III
HOPWA GRANT PROGRAM APPLICATION
PROGRAM INFORMATION
Program Sponsor:
EIN Number:
Contract Period:
HOPWA Request:
Address:
City/State/Zip:
Agency Director:
(Area Code) Phone No.:
1. Provide a three or four sentence synopsis of your proposed program including a
description of the service area in which you propose to work, the proposed
housing and services, and the number of clients you intend to serve.
2. Briefly describe the proposed program including the eligible HOPWA activities for
which funding is requested, the type of housing and/or housing related services
proposed, the particular HIV/AIDS population to be served, the number of
persons to be served by each activity and the term of the proposed funding.
Please remember that the period of funding is ONE year from July 1, 2023
through June 30, 2024.
3. Describe the population to be served by the proposed HOPWA program
including: a) their characteristics and needs for housing and supportive services;
b) where they will come from; and
c) outreach that will bring them into the program.
The description must demonstrate that the population meets HUD's criteria for
eligibility to receive HOPWA-funded services and housing. Additionally, you
should describe the needs of the group that the program will serve indicating the
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
19
type of housing and supportive services they will need. The description should
show that the program will be coordinated with services and housing provided by
other service providers for persons with HIV/AIDS.
4. Describe the housing where the program participants will reside including:
a) the type of housing (short-term supported housing facilities / emergency or
transitional shelters, single room occupancy facilities, community group
homes, privately owned homes or apartments, housing owned or leased by
nonprofit agencies, etc.);
b) the number of units of housing that will be provided;
c) the number of individuals / households to be served;
d) describe how you will ensure that the units will be accessible to persons with
disabilities in accordance with applicable laws;
e) describe any limits on a resident's length of stay;
f) describe how the type, scale and other characteristics of the housing are
appropriate for and meet the needs of the target population.
5. Describe any rental assistance the program participants will receive including:
a) The type of rental assistance (tenant or program based rental assistance,
rental assistance through master leasing of housing units, or short-term
rent, mortgage and utility assistance);
b) limits on the length or amount of rental support; and
c) describe how the type and scale of rental assistance meets the needs of
the target population.
6. Describe the supportive services that the participants will receive including:
a) how the type (case management, job training, life skills training) and the
scale (the frequency and duration of the services) will fit the needs of the
participants;
b) what agency will provide the supportive services, where they will be provided
and what transportation will be available to the participants to access those
services;
c) how you plan to ensure that the participants will be individually assisted to
identify and apply for and obtain benefits under mainstream health and social
services programs for which they are eligible: TennCare, SSI, Food Stamp,
and so forth;
d) how the services will increase the participants' access to appropriate
healthcare; and
e) how the services will increase the participants’ access to employment
7. Describe how this program will be coordinated with other agencies that serve
low-income persons with AIDS. Include a brief description of your intake and
referral process, how you share clients and coordinate services with other
agencies. Please include in your answer a response to the following:
• Is your agency a participating member of the Mid-South Coalition on
HIV/AIDS?
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
20
• If your agency will serve the homeless, is your agency a participating
member in the Community Alliance for the Homeless?
• If your agency will serve the homeless, does your agency provide data
to Community Alliance for the Homeless for its Homeless Management
Information System (HMIS) database on a regular basis?
• If your agency serves the homeless or provides services to prevent
homelessness, how does your agency work with the Continuum of
Care Network?
8. Describe how the proposed program will help the program participant establish
and maintain stable ongoing residency.
9. Describe how the proposed program will reduce the risks of homelessness for
the proposed population.
10. Describe how the proposed program will ensure the program participant
develops an individualized service plan and increases access to health care
services.
11. Does your agency plan to acquire, repair or renovate existing housing or acquire
a site for construction of new housing using HOPWA funds?
If so, list the address and include a photograph of the building/site as well as
documentation of site control.
Or, is your agency leasing the structure to be renovated?
If so, include a copy of the current lease.
12. Describe the experience your agency has in repairing/renovating or constructing
new housing. List the experience of all entities involved in the planned program.
13. If you plan to use HOPWA funds to renovate or operate a shelter, will it be
licensed?
If so, by what agency and for what services?
14. If you plan to use HOPWA funds to construct a new SRO or community residence
or acquire and/or renovate housing for persons with HIV/AIDS, you must agree to
operate those units for the appropriate use period dictated by HOPWA regulations.
To ensure that you are able to manage/operate the housing, the City requires that
you submit a management/operational plan for the use period. If your program
proposes repairs or non-substantial rehabilitation, you must submit a three (3) year
management/operations plan. You should provide a ten-year plan if you are
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
21
requesting funds for substantial rehabilitation (greater than 75% of the value of the
property after rehab) or new construction of an SRO or community residence.
15. If you are requesting funds to operate a shelter, please provide a management
/operation plan for the period of the proposed grant. Also, please describe the
experience your agency has in operating a shelter or group housing program.
16. List staff members and positions currently employed by your agency that will be
paid with HOPWA funds. Also attach resumes, job descriptions, and salaries as
well as other information that demonstrate that the staff has appropriate
credentials and experience to carry out the jobs.
17. List new staff positions that will be created to carry out the proposed program.
Attach a copy of job descriptions, employment requirements, and proposed
salaries for each new staff position to be funded through this grant.
Job Titles
Qualifications
Proposed Salaries
18. If you are awarded HOPWA funds, how do you plan to fund/operate the program
after they are spent? What long-range plans do you have for the program? Be
specific.
19. If your program does not receive HOPWA funds or receives less than you are
requesting, are specific activities higher priorities for funding than others? Please
list them beginning with the highest priority and associated budget amount.
20. Provide a schedule or timetable for implementing your program. Funds will be
available on July 1, 2023.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
22
CURRENT INCOME LIMITS (as of April 2022)
Fayette, Shelby and Tipton Counties in Tennessee,
Crittenden County in Arkansas and Desoto County in
Mississippi
FAMILY SIZE
80% Median
Family Income
50% Median
Family Income
30% Median
Family Income
1 PERSON
$43,050
$26,900
$16,150
2 PEOPLE
$49,200
$30,750
$18,450
3 PEOPLE
$55,350
$34,600
$20,750
4 PEOPLE
$61,450
$38,400
$23,050
5 PEOPLE
$66,400
$41,500
$24,900
6 PEOPLE
$71,300
$44,500
$26,750
7 PEOPLE
$76,200
$47,650
$28,600
8 PEOPLE
$81,150
$50,700
$30,450
CURRENT INCOME LIMITS (as of April 2022)
Marshall County, Mississippi
FAMILY SIZE
80% Median
Family Income
50% Median
Family Income
30% Median
Family Income
1 PERSON
$32,950
$20,600
$12,400
2 PEOPLE
$37,650
$23,550
$14,150
3 PEOPLE
$42,350
$26,500
$15,900
4 PEOPLE
$47,050
$29,400
$17,650*
5 PEOPLE
$50,850
$31,800
$19,100*
6 PEOPLE
$54,600
$34,150
$20,500*
7 PEOPLE
$58,350
$36,500
$21,900*
8 PEOPLE
$62,150
$38,850
$23,300*
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
23
The FY2014 Consolidated Appropriations Act changed the definition of extremely low-income to be the greater of
30/50ths (60 percent) of the Section 8 very low-income limit or the poverty guideline as established by the
Department of Health and Human Services (HHS), provided that this amount is not greater than the Section 8 50%
very low-income limit. Consequently, the extremely low-income limits may equal the very low (50%) income
CURRENT INCOME LIMITS (as of April 2022)
Tate County, Mississippi
FAMILY SIZE
80% Median
Family Income
50% Median
Family Income
30% Median
Family Income
1 PERSON
$38,050
$23,800
$14,250
2 PEOPLE
$43,450
$27,200
$16,300
3 PEOPLE
$48,900
$30,600
$18,350
4 PEOPLE
$54,300
$33,950
$20,350
5 PEOPLE
$58,650
$36,700
$23,650
6 PEOPLE
$63,000
$39,400
$23,650*
7 PEOPLE
$67,350
$42,100
$25,250*
8 PEOPLE
$71,700
$48,850
$26,900*
*The FY2014 Consolidated Appropriations Act changed the definition of extremely low-income to be the greater of
30/50ths (60 percent) of the Section 8 very low-income limit or the poverty guideline as established by the
Department of Health and Human Services (HHS), provided that this amount is not greater than the Section 8 50%
very low-income limit. Consequently, the extremely low-income limits may equal the very low (50%) income
CURRENT INCOME LIMITS (as of April 2022)
Tunica County, Mississippi
FAMILY SIZE
80% Median
Family Income
50% Median
Family Income
30% Median
Family Income
1 PERSON
$32,950
$20,600
$12,760
2 PEOPLE
$37,650
$23,550
$14,150
3 PEOPLE
$42,350
$26,500
$15,900
4 PEOPLE
$47,050
$29,400
$17,650*
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
24
5 PEOPLE
$50,850
$31,800
$19,100*
6 PEOPLE
$54,600
$34,150
$20,500*
7 PEOPLE
$58,350
$36,500
$21,900*
8 PEOPLE
$62,150
$38,850
$23,300*
*The FY2014 Consolidated Appropriations Act changed the definition of extremely low-income to be the
greater of 30/50ths (60 percent) of the Section 8 very low-income limit or the poverty guideline as
established by the Department of Health and Human Services (HHS), provided that this amount is not
greater than the Section 8 50% very low-income limit. Consequently, the extremely low-income limits
may equal the very low (50%) income limits.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
25
CURRENT FAIR MARKET RENTS
FOR
Fayette, Shelby and Tipton Counties in Tennessee,
Crittenden County in Arkansas and DeSoto County in
Mississippi (FY2023)
Efficiency
1BR
2BR
3BR
4BR
Fair Mkt
$800
$902
$1,032
$1,365
$1,584
CURRENT FAIR MARKET RENTS
FOR
Marshall County, Mississippi (FY2023)
Efficiency
1BR
2BR
3BR
4BR
Fair Mkt
$644
$701
$831
$1,011
$1,291
CURRENT FAIR MARKET RENTS
FOR
Tate County, Mississippi (FY2023)
Efficiency
1BR
2BR
3BR
4BR
Fair Mkt
$599
$684
$773
$1,017
$1,172
CURRENT FAIR MARKET RENTS
FOR
Tunica County, Mississippi (FY2023)
Efficiency
1BR
2BR
3BR
4BR
Fair Mkt
$811
$816
$946
$1,151
$1,271
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
26
HOPWA GRANTS RATING/RANKING FORM FY23
Applicants must have a minimum score of 75 to be considered for funding.
Proposal No: _____________ Applicant ___________________________
Program Title: _______________________________________________________
___________
APPLICANT CAPACITY (Maximum 20 points)
Does the agency have sufficient qualified staff to carry out the program?
Does the agency/staff have suitable prior experience serving target population?
Does the agency have a positive record of implementing similar programs?
Does the agency have capacity for the proposed program vis-a-vis current activities and
program commitments?
Does the agency have adequate fiscal capacity to implement the program?
__________
NEED/ EXTENT OF PROBLEM (Maximum 30 points)
Are the needs of the target population and the need for the program described well?
Is the program consistent with the priorities described in a Con Plan?
Does the application demonstrate the need for the program?
Does the program duplicate existing programs and services?
Is there a demand for the services? Are there waiting lists, etc.?
_________
SOUNDNESS OF APPROACH (Maximum 20 points)
Are the services and programs to be offered clearly described as well as the specific
target population to be served?
Do the proposed services respond to the needs of the population to be served? Are the
type and scale of services appropriate for the target population?
Does the program propose adequate and appropriate services for the population?
Does the application include expected outcomes and specific measures by which the
program's success can be assessed periodically?
Does the proposed program encourage service coordination with other organizations?
___________
OPERATIONAL FEASIBILITY (Maximum 30 points)
Does the application contain clear and complete plans for implementing the program?
Is committed funding adequate for implementation of the proposed program?
Is the strategy for securing additional support and commitment adequate?
Is the proposed staffing and training adequate for the proposed services?
Is the program ready to be implemented? How soon?
TOTAL POINTS AWARDED __________
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
27
INSTRUCTIONS FOR COMPLETING BUDGET JUSTIFICATION
The Budget Justification is a narrative explanation of the HOPWA funding requested.
Please itemize costs for each category indicated on your budget on page 19 as per the
following guidelines. The following information is to serve as a guide for the completion
of your agency's budget justification. THE FOLLOWING ARE EXAMPLES ONLY.
Short-Term Housing
Maximum monthly rent
Units of rental assistance
Total HOPWA rent request
Permanent Housing Placement - Rent & Utility Deposits/ First Month's Rent
(Not to exceed the value of two month’s rent)
Maximum Rent Deposit
Maximum Utility Deposit
Maximum
First
Month's Rent
Number of
Units of
Service
Total HOPWA
Cost
Personnel Costs - Salaries and Fringes:
Position
Title
No. of
Positions
Hourly
Wage
No. of Hours Per
Pay Period
Total Cost
% charged
to HOPWA
Total HOPWA
Social Sec.
Medicare
Health Ins.
Pension
Rate
Salary
Total Cost
% HOPWA
Total HOPWA
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
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CRITERIA FOR DEFINING HOMELESS
Category 1
Literally Homeless
(1) Individual or family who lacks a fixed , regular,
and adequate nighttime residence, meaning:
• Has a primary nighttime residence that is a
public or private place not meant for human
habitation;
• Is living in 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 and local
governments); or
• Is exiting an institution where (s) he 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.
Category 2
Imminent Risk of
Homelessness
(2) Individual or family who will imminently lose
their primary nighttime residence, provided that:
• Residence will be lost within 14 days of
the date of application for homeless
assistance;
• No subsequent residence has been
identified; and
• The individual or family lacks the
resources or support networks needed
to obtain other permanent housing.
Category 3
Homeless under
other Federal
statues
(3) 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:
• Are defined as homeless under the
other listed federal statues;
• Have not had a lease, ownership
interest, or occupancy agreement in
permanent housing during the 60 days
prior to the homeless assistance
application ;
• Have experienced persistent instability
as measured by two moves or more
during in the preceding 60 days; and
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
29
• Can be expected to continue in such
status for an extended period of time
due to special needs or barriers.
Category 4
Fleeing/Attempting
to Flee Domestic
Violence
(4) Any individual or family who:
• Is fleeing, or is attempting to flee,
domestic violence;
• Has no other residence: and
• Lacks the resources or support
networks to obtain other permanent
housing.
:
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
30
RECORD KEEPING REQUIREMENTS
Category 1
Literally Homeless
• 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;
• For individuals exiting an institution –
one of the forms of evidence above and:
• 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
Category 2
Imminent Risk of
Homelessness
• 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; or
• A documented and verified oral
statement; and
• Certification that no subsequent
residence has been identified; and
• Self-certification or other written
documentation that the individual lack
the financial resources and support
necessary to obtain permanent
housing.
City of Memphis – Div., Housing Community Development
HOPWA Application FY24
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Category 3
Homeless under
other Federal
statues
• 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 statue; and
• Certification of no PH in last 60 days;
and
• Certification by the individual or head of
household, and any available
supporting documentation, that (s) he
has moved two or more times in the last
60 days; and
• Documentation of special needs or 20 or
more barriers.
Category 4
Fleeing/Attempting
to Flee Domestic
Violence
• 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 or a
certification by the intake worker.
• For non-victim service providers:
Oral statement by the individual or head of
household seeking assistance that are fleeing.
This statement is documented by a self-
certification or by a case worker. 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; and
Self-certification or written documentation, that
the individual or family lacks the financial
resources and support networks to obtain
permanent housing: