HOUSING ASSISTANCE AND RELATED SERVICES

Transcription

1 New Haven/Fairfield Counties Ryan White Part A Program Housing Service Standards HOUSING ASSISTANCE AND RELATED SERVICES I. DEFINITION OF SERVICE Support for Housing Services that involve the provision of short-term assistance to support emergency, temporary, or transitional housing to enable an individual or family to gain or maintain medical care. Use of funds for:: Housing that provides some type of medical or supportive services such as residential mental health services, foster care, or assisted living residential services Housing that does not provide direct medical or supportive services Housing-related referral services that include assessment, search, placement, advocacy, and the fees associated with them No use of funds for direct payments to recipients of services for rent. These short term payments must be carefully monitored to assure limited amounts, limited use, and for limited periods of time. Note: A 24-month cumulative cap on short-term and emergency housing assistance has been rescinded pending completion of a comprehensive review of HRSA/HAB housing policy. Prepared by Germane Solutions QI Revised April P age

2 New Haven/Fairfield Counties Ryan White Part A Program Housing Service Standards II. DESCRIPTION OF SERVICE SERVICE PERFORMANCE MEASURE/METHOD MONITORING STANDARD LIMITATIONS Support for Housing Services that involve the provision of short-term assistance to support emergency, temporary, or transitional housing to enable an individual or family to gain or maintain medical care Documentation that funds are used only for the provision of short-term assistance to support emergency, temporary, or transitional housing to enable an individual or family to gain or maintain medical care Documentation that indicates services provided including number of clients served, duration of housing services, types of housing provided, and housing referral services Use of funds for: Housing that provides some type of medical or supportive services such as residential mental health services, foster care, or assisted living residential services Housing that does not provide direct medical or supportive services Housing-related referral services that include assessment, search, placement, advocacy, and the fees associated with them No use of funds for direct payments to recipients of services for rent or NOTE: a 24-month cumulative cap on short-term and emergency housing assistance has been rescinded pending completion of a comprehensive review of HRSA/HAB housing policy Documentation that funds are used only for allowable purposes: 1. Housing-related referral services including housing assessment, search, placement, advocacy, and the fees associated with them 2. Housing that includes some type of medical or supportive services 3. Housing that does not include such services Documentation that: 1. Each client receives assistance designed to help him/her obtain stable long-term housing, through a strategy to identify, relocate, and/or ensure the individual or family is moved to or capable of maintaining a stable long-term living situation 2. No funds are used for direct payments to recipients of services for rent or Documentation of the following: 1. Maintain client records that document: client eligibility, housing services including referral services provided, assistance provided to clients to help them obtain stable long-term housing 2. Assurance that no Ryan White funds are used to provide direct payments to clients for rent or No use of funds for direct payments to recipients of services for rent or Prepared by Germane Solutions QI Revised April P age

3 New Haven/Fairfield Counties Ryan White Part A Program Housing Standard of Care III. NATIONAL FISCAL MONITORING STANDARDS (HRSA issued April 2013): SERVICE PERFORMANCE MEASURE/METHOD SECTION D: Imposition & Assessment of Client Charges 1. Ensure grantee and subgrantee policies and procedures require a publicly posted schedule of charges (e.g. sliding fee scale) to clients for services, which may include a documented decision to impose only a nominal charge 2. No charges imposed on clients with incomes below 100% of the Federal Poverty Level (FPL) 3. Charges to clients with incomes greater than 100% of poverty are determined by the schedule of charges. Annual limitations on amounts of charge (i.e. cap on charges) for RW services are based on the percent of client s annual income, as follows: 5% for clients with incomes between 100% and 200% of FPL 7% for clients with incomes between 200% and 300% of FPL 10% for clients with incomes greater than 300% of FPL Review of subgrantee policies and procedures, to determine: Existence of a provider policy for a schedule of charges. A publicly posted schedule of charges based on current Federal Poverty Level (FPL) including cap on charges Client eligibility for imposition of charges based on the schedule Track client charges mad and payments received How accounting systems are used for tracking charges, payments, and adjustments Review of provider policy for schedule of charges to ensure clients with incomes below 100% of the FPL are not charged for services Review of policy for schedule of charges and cap on charges Review of accounting system for tracking patient charges and payments Review of charges and payments to ensure that charges are discontinued once the client has reached his/her annual cap. MONITORING STANDARDS Establish, document and have available for review: Policy for a schedule of charges Current schedule of charges Client eligibility determination in client records Fees charged by the provider and the payments made to that provider by clients Process for obtaining, and documenting client charges and payments through an accounting system, manual or electronic Document that: Policy for schedule of charges does not allow clients below 100% of FPL to be charged for services Personnel are aware of and consistently following the policy for schedule of charges. Policy for schedule of charges must be publicly posted. Establish and maintain a schedule of charges and policy that includes a cap on charges and the following: Responsibility for client eligibility determination to establish individual fees and caps Tracking of Part A charges or medical expenses inclusive of enrollment fees, deductibles, co-payments, etc. A process for alerting the billing system that the client has reached the cap and should not be further charged for the remainder of the year Personnel are aware and consistently following the policy for schedule of charges and cap on charges. LIMITATIONS Prepared by Germane Solutions QI Revised April P age

4 New Haven/Fairfield Counties Ryan White Part A Program Housing Standard of Care IV. HOUSING AND RELATED SERVICES CARE COMPONENTS Program Outcomes: 75% of clients who report stable living arrangements reported on a quarterly basis. Number of referred clients into program Number of people receiving housing assistance Indicator: enrolled in stable living arrangements. with documentation of housing as stable/permanent, temporary, unstable or unknown. Service Unit(s): Successful Completed Enrollment Via Voucher Request, Advocacy/Counseling, and Placement Face to Face or Phone contacts placed in stable housing by type: Permanent, Transitional, Scattered Site, Group, Skilled Nursing Facility Standard of Care Outcome Measure Numerator Denominator Data Source Goal/Benchmark I. Structure Agency licensure & accreditation Licensed or accredited agency License or Accreditation Ongoing professional staff training in HIVspecific topics II. Process Provider has collaborative relationships with other housing providers. Eligibility for Housing documented 2x per measurement year Information provided by Case Managers as a means to obtain Housing Timeliness of housing assistance funds receipt Program complies with all federal, state and local laws, regulations and ordinances including but not limited to those required by contracts At least 10 hours of HIVspecific in-service training annually for each professional staff member serving RWCA clients. Agency has letter(s) of collaboration with housing providers. Eligibility criteria documented and used. Process documented as to means to obtain Housing Housing funds to clients within 7 days of request Number of staff with documentation of at least 10 hours of HIV-specific training annually Number of agencies with letter(s) of collaboration Number of client charts with CARC eligibility criteria Written policy given to clients outlining process to obtain Housing receiving Housing checks within 7 days Number of total staff providing Housing services Number of Housing agencies Personnel files &/or Agency Training Log Letter(s) of Collaboration Prepared by Germane Solutions QI Revised April P age 100% of agencies offering housing assistance have valid licenses or accreditation. 100% of HA staff with at least 10 hours annually of HIV-specific training. All Housing agencies have letter(s) of collaboration Client charts 85% of charts document eligibility criteria at least 2x per measurement year Number of Housing check requests Client charts Billing files 85% of charts document process to obtain Housing 85% of client charts document funds to clients within 7 days of request

5 New Haven/Fairfield Counties Ryan White Part A Program Housing Standard of Care II. Process (continued) Assess service intensity of housing assistance using intensity scale Determine baseline needs for housing support to vary intensity of efforts accordingly by intensity level a. Prior history of incarceration b. Substance use c. Mental health d. Foreign born or undocumented e. Income or employment status f. High cost of living areas g. Residential or assisted living history (e.g. Leeway) Intensity Scale Correlation of housing assistance hours/duration of efforts to client need. III. Outcome Housing Advocacy -- assessment, search, placement and advocacy services to seek housing (application to funding sources, visits to court systems Improved client readiness for stable housing Secure stable housing with fewer barriers to stable housing* securing stable housing Advocacy seeking stable housing URS 80% of Housing Advocacy clients with fewer barriers to stable housing 80% of Housing Advocacy clients securing stable housing Housing -- Emergency housing assistance (rental vouchers, eviction prevention, short-term rental assistance); emergency shelter stays; temporary/transitional housing programs; residential treatment; temporary assisted living Prevent eviction or stabilize housing situation for 1 year Clients financial stability increases* Number of Housing clients able to stabilize housing Number of Housing clients demonstrating improved money management skills* seeking Housing support URS follow up of housing situation at 6- month intervals Client charts 80% of Housing clients with stabilized housing 80% of Housing client who demonstrate improved money management skills Both Engage clients in Primary Care entering Primary Care & staying in care Client charts 100 % of clients engaged in primary care Increased client housing stability Number of months client in housing 80% in client in housing for 1 year Prepared by Germane Solutions QI Revised April P age

6 New Haven/Fairfield Counties Ryan White Part A Program Housing Standard of Care Money management skill examples: Percent of clients who demonstrate improved money management skills Number of loan, mortgage, or rent defaults Number of evictions Number of referrals to credit counseling who declare bankruptcy Number of bankruptcies resolved with payees with savings accounts and money saved who contribute to utility payments Number of emergency loans who are employed who receive or are referred to employment service Typical barriers to stable housing Unresolved legal issues Involvement with the criminal justice system Chronic alcohol and drug use Poor psychosocial state Lack of financial capacity Untreated mental health issues Weak support network Unresolved credit issues V. DATA REPORTING Part A service providers are responsible for documenting and keeping accurate records of Ryan White Program Data/Client information, units of service, and client health outcomes. Reporting units of service are a component of each agency s approved workplan. Please refer to the most current workplan, including any amendments, for guidance regarding units of service. Summaries of service statistics by priority will be made available to the Planning Council by the Grantee for priority setting, resource allocation and evaluation purposes. The Chart Audit Tool for Housing Services is attached on the next page. Prepared by Germane Solutions QI Revised April P age

7 New Haven/Fairfield Counties Ryan White Part A Program Housing Standard of Care STRUCTURE ( WHO ) Housing Tool STAFF 1 Agency Accreditation/Certification/Licensure Agency has all required accreditations/certifications/licenses 2 Staff Education Minimum of 10 hours of HIV 101 at orientation and per year DOCUMENTATION Housing Advocacy Improved client readiness for stable housing; Secure 12 stable housing (defined as permanent housing in past years) Recordkeeping Requirements Chart is properly stored & secure; chart is clearly organized; entries legible; documentation of assistance provided including referral services Client Consent, Bill of Rights/Grievance Procedures Client signed consent, bill or rights, non- discrimination & grievance procedures Medical Record Release Forms Release forms (as necessary) present, current, & signed by client Confirmation of HIV Diagnosis HIV antibody test record, confirmatory lab data, or letter of diagnosis Client Demographics/Eligibility Age, ethnicity, gender, risk/exposure documented; client eligibility documented 2x per measurement year Sliding Fee Scale maintained and current per HRSA mandate Agency has letter of collaboration with housing providers PROCESS ( How ) Process to Obtain Housing Process documented as to means to obtain Housing Timeliness of Funds Housing fund to client within 7 days of request; documentation of assurance RW funds are not direct payments to clients for rent or Intensity of Housing Baseline needs determined for housing support & vary in intensity efforts acordingly OUTCOME ("What Impact") Housing Prevent eviction or stabilized housing situation for 1 year Clients financial stability increased Both - Housing Advocacy & Housing Client is engaged in Primary Care Increased client housing stability (residing in permanent housing) New Addition/Updated Program and HAB Program Monitoring Standards HAB Measure Indicates National HIV/AIDS Strategy Goal Refers to Scope of Services Outcome Fiscal Monitoring Standards Prepared by Germane Solutions QI Revised April P age