II. ITEM 2017-06 Updated VAWA Policies in the HRA Admissions and Continued Occupancy Policy; adopt Resolution 521September 14, 2017HRA Report 2017-06
APPROVAL OF HOPKINS HRA REVISION OF
ADMISSIONSAND CONTINUED OCCUPANCY POLICY
Proposed Action
Staff recommends approval of the following motion: Adopt Resolution521, authorizing
approval of the revised Admissions and Continued Occupancy Policy.
Overview
Each year we review the policies for HRA in relation to the way we process applications and
conduct business with our current residents.Typically, this review and any proposed changes are
presented in January. The Admissions and Continued Occupancy Policy (ACOP) for the HRA is
divided into chapters by various topics and components of the public housing program.
A new final rule implementing VAWA (Violenceagainst Women Act) required the HRA to
revise the existing policy to be in compliance with the new rule. VAWA is referenced numerous
places in our ACOP;however,Chapter 16 Program Administration includes the changes needed
at this time.
Supporting Documentation
HopkinsHRA Admissions and Continued Occupancy Policy, Chapter 16
HRA Resolution 521
Summary of Changes
Updated Definition Section
Updated Resources and Processes
Included new HUD-5382 form
Alternatives
The HRA Board of Commissioners has the following alternatives available for addressing this
issue:
Adopt Resolution 521and approve the revised Admissions and Continued Occupancy
Policies.
Continue for additional information.
_________________________________
Stacy Unowsky, Executive Director
Chapter 16
PROGRAM ADMINISTRATION
INTRODUCTION
This chapter discusses administrative policies and practices that are relevant to the activities
covered in this ACOP. The policies are discussed in seven parts as described below:
Part I: Setting Utility Allowances. This part describes how utility allowances are
established and revised. Also discussed are the requirements to establish surcharges for
excess consumption of PHA-furnished utilities.
Part II: Establishing Flat Rents.This part describes the requirements and policies related
to establishing and updating flat rent amounts.
Part III:Repayment of Family Debts. This part containspolicies for recovery of monies
that have been underpaid by families,and describes thecircumstances under which the
PHA will offer repayment agreements to families. Also discussed arethe consequences
for failure to make payments in accordance with arepayment agreement.
Part IV: Public Housing Assessment System (PHAS). This part describes the PHAS
indicators, how PHAs are scored under PHAS, andhow those scores affect a PHA.
Part V: RecordKeeping. All aspects of the program involve certain types of record-
keeping. This part outlines the privacy rights of applicants and participants and record
retention policies the PHA will follow.
Part VI: Reporting and Record Keeping for Children with Environmental Intervention
Blood Lead Level.This part describes the PHA’s reporting responsibilities related to
children with environmental intervention blood lead levels that are living in public
housing.
Part VII: Violence against Women Act (VAWA): Notification, Documentation, and
Confidentiality.This part contains key terms used in VAWA and describes requirements
related to notifying families about their rights and responsibilities under VAWA;
requesting documentation from victims of domestic violence, dating violence, sexual
assault,and stalking; and maintaining the confidentiality of information obtained
fromvictims.
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PART I: SETTING UTILITY ALLOWANCES\[24 CFR 965 SubpartE\]
16-I.A. OVERVIEW
PHAs must establish allowances for PHA-furnished utilities for all check meteredutilities and
for resident-purchased utilities for all utilities purchased directly by residents from a utility
supplier\[24 CFR 965.502(a)\].
PHAs must also establish surcharges for excess consumption of PHA-furnished utilities \[24 CFR
965.506\].
The PHA must maintain a record that documents the basis on which utility allowances and
scheduled surcharges are established and revised, and the record must be made available for
inspection by residents \[24 CFR 965.502(b)\].
16-I.BUTILITY ALLOWANCES
The PHA must establish separate allowances for each utility and for each category of dwelling
units the PHA determines to be reasonably comparable as to factors affecting utility usage \[24
CFR 965.503\].
The objective of a PHA in establishing utility allowances for each dwelling unit category and
unit size isto approximate a reasonable consumption of utilities by an energy-conservative
household of modest circumstances consistent withthe requirements of a safe, sanitary, and
healthful living environment\[24 CFR 965.505\].
Utilities include gas, electricity, fuel for heating, water, sewerage, and solid waste disposal for a
dwelling unit. In addition, if the PHA does not furnish a range and refrigerator, the family must
be granted a utility allowance for the range and refrigerator they provide \[24 CFR 965.505\].
Costs for telephone, cable/satellite TV, and internet services are not consideredutilities \[PH Occ
GB, p. 138\].
Utility allowance amounts will vary by the rates in effect, size and type of unit, climatic location
and sitting of the unit, type of construction, energy efficiency of the dwelling unit, and other
factors related to the physical condition of the unit. Utility allowance amounts will also vary by
residential demographic characteristics affecting home energy usage \[PH Occ GB, p. 138\].
Chapter 14 of the PH Occupancy Guidebookprovides detailed guidance to the PHA about
establishing utility allowances.
Air-Conditioning
“If aPHA installs air conditioning, it shall provide, to the maximum extent economically
feasible, systems that give residents the option of choosing to use air conditioning in their units.
The design of systems that offer each resident the option to choose air conditioning shall include
retail meters or check meters, and residents shall pay for the energy used in its operation. For
systems that offer residents the option to choose air conditioning but cannot be check metered,
residents are to be surcharged in accordance with 965.506. If an air conditioning system does not
provide for resident option, residents are not to be charged, and these systems should be avoided
whenever possible.” \[24 CFR 965.505(e)\]
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PHA Policy
The PHA has not installed air-conditioning.
Utility Allowance Revisions \[24 CFR 965.507\]
The PHA must review at least annually the basis on which utility allowances have been
established and must revisethe allowances if necessary in order to adhere to the standards for
establishing utility allowances that are contained in 24 CFR 965.505.
The PHA may revise its allowances for resident-purchased utilities between annual reviews if
there is a rate change, and is required to do so if such change, by itself or together with prior rate
changes not adjusted for, results in a changeof 10 percent or more from the rate on which the
allowance was based.
Adjustments to resident payments as a result of such changes must be retroactive to the first day
of the month following the month in which the last rate change taken into account became
effective.
PHA Policy
The PHA currently pays for all of the utilities for Dow Towers. Residents pay a fee for
air conditioning if they install their own air conditioning unit into the sleeve.
If this policy were to change, wewould perform annual reviews of utility allowances;the
PHA will only revise its utility allowances due to a rate change,when required to by the
regulation.
16-I.C. SURCHARGES FOR PHA-FURNISHED UTILITIES\[24 CFR 965.506\]
For dwelling units subject to allowances for PHA-furnished utilities where check meters have
been installed, the PHA must establish surcharges for utility consumption in excess of the
allowances. Surcharges may be computed on a straight per unit of purchase basis or for stated
blocks of excess consumption, and must be based on the PHA’s average utility rate. The basis for
calculating the surcharges must be described in the PHA’s schedule of allowances. Changes in
the amount of surcharges based directly on changes in the PHA’s average utility rate are not
subject to the advance notice requirements discussed under 16-I.D.
For dwelling units served by PHA-furnished utilities where check meters have not been installed,
the PHA must establish schedules of surchargesindicating additional dollar amounts residents
will be required to pay by reason of estimated utility consumption attributable to resident-owned
major appliances or to optional functions of PHA-furnished equipment. The surcharge schedule
must state the resident-owned equipment(or functions of PHA-furnished equipment) for which
surcharges will be made and the amounts of such charges. Surcharges must be based on the cost
to the PHA of the utility consumption estimated to be attributable to reasonable usage of such
equipment.
PHA Policy
The PHA does have PHA-furnished utilities.Currently, we do not have check meters
installed.
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16-I.D. NOTICE REQUIREMENTS \[965.502\]
The PHA must give notice to all residents of proposed allowances and scheduled surcharges, and
revisions thereof. The notice must be given in the manner provided in the lease and must:
Be provided at least 60 days before the proposed effective date of the allowances, scheduled
surcharges, or revisions.
Describe the basis for determination of the allowances, scheduled surcharges, or revisions,
including a statement of the specific items of equipment and function whose utility
consumption requirements were included in determining the amounts of the allowances and
schedule of surcharges.
Notify residents of the place where the PHA’s documentation on which allowances and
surcharges are based is available for inspection.
Provide all residents an opportunity to submit written comments during a period expiring not
less than 30 days before the proposed effective date of the allowances, scheduled surcharges,
or revisions.
16-I.E. REASONABLE ACCOMMODATION\[24 CFR 965.508\]
On request from a family that includes a disabled or elderly person, the PHA must approve a
utility allowance that is higher than the applicable amount for the dwelling unit if a higher utility
allowance is needed as a reasonable accommodation to make the program accessible to and
usable by the family \[PH Occ GB, p. 172\].
Likewise, residents with disabilities may not be charged for the use of certain resident-supplied
appliances if there is a verified need for special equipment because of the disability \[PH Occ GB,
p. 172\].
See Chapter 2 for policies regarding the request and approval of reasonable accommodations.
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PART II: ESTABLISHINGFLAT RENTS AND
PUBLIC HOUSING MAXIMUMRENTS
16-II.A. OVERVIEW
Flat rents are designed to encourage self-sufficiency and to avoid creating disincentives for
continued residency by families who are attempting to become economically self-sufficient.
Flat rents are also used to prorate assistance for a mixed family. A mixed family is one whose
members include those with citizenship or eligible immigration status, and those without
citizenship or eligible immigration status \[24 CFR 5.504\].
This part discusses how the PHA established and updates flat rents. Polices related to the use of
flat rents, family choice of rent, flat rent hardships, and proration of rent for mixed family are
discussed in Chapter 6.
16-II.B. FLAT RENTS\[24 CFR 960.253(b)and Notice PIH 2014-12\]
Establishing Flat Rents
Flatrents for public housing units are based on the market rent charged for comparable units in
the private unassisted rental market. The flat rent should be equal to the estimated rent for which
the PHA could promptlylease the public housing unitafter preparation for occupancy.
The PHA must use HUD's rent reasonableness methodologyto determine flat rents. In
determining flat rents,PHAs must consider the following:
Location
Quality
Unit size
Unit type
Age of property
Amenities at the property and in immediate neighborhood
Housing services provided
Maintenance provided by the PHA
Utilities provided by the PHA
PHAs must receive written HUD approval before implementing exception flat rent. PHAs that
use exception flat rents must conduct a new market analysis,and obtain HUD approval,
annually.
PHAs are now required to apply a utility allowance to flat rents. Flat rents set at 80 percent of the
FMR must be reduced by the amount of the unit's utility allowance, if any.
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Review of Flat Rents
The PHA must ensure that flat rents continue to mirror market rent values \[24 CFR 960.253(b)
and Notice PIH 2014-12\].No later than 90 days after HUD publishes new annual FMRs, PHAs
must revise flat rents as necessary based on the rent reasonableness analysis and changes to the
FMR.The PHA must offer changes to the flat rent to all new admissions and to existing families
at the next annual rent option.
If the FMR falls from year to year, the PHA may, but is not required to, lower the flat rent to 80
percent of the current FMR.
PHA Policy
If the FMR/SAFMR/unadjusted rentis lower than the previous year, the PHA will reduce
flat rents to 80 percent of the current FMR/SAFMR/unadjusted rent.
Posting of Flat Rents
PHA Policy
The PHA will publicly postthe schedule of flat rents in aconspicuous manner in the
project office.
Documentation of Flat Rents\[24 CFR 960.253(b)(5)\]
The PHA must maintain records that document the method used to determine flat rents, and that
show how flat rents were determined by the PHA in accordance with thismethod.
PART III: FAMILY DEBTS TO THE PHA
16-III.A.OVERVIEW
This part describes the PHA’s policies for recovery of monies owed to the PHAby families.
PHA Policy
When an action or inaction of aresidentfamily results in the underpayment of rent or
other amounts, the PHA holds the familyliable to return any underpaymentsto the PHA.
The PHA will enter into repayment agreements in accordance with the policies contained
in this part as a meansto recover overpayments.
When afamilyrefuses to repay monies owed to the PHA, the PHA will utilize other
available collection alternatives including, but not limited to, the following:
Collection agencies
Small claims court
Civil law suit
State income tax set-off program
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16-III.B. REPAYMENT POLICY
Family Debts to the PHA
PHA Policy
Any amount owed to the PHA by a public housing familymust be repaid.If the family is
unable to repay the debt within 30 days, the PHA will offer to enter into a repayment
agreement in accordance with the policies below.
If the family refuses to repay the debt,does not enter into a repayment agreement, or
breaches a repayment agreement, the PHA will terminate the family’s tenancy in
accordancewith the policies in Chapter 13. The PHA will also pursue other modes of
collection.
General Repayment Agreement Guidelines
Down Payment Requirement
PHA Policy
Before executing a repayment agreement with a family, the PHA will generally require a
down payment of 10 percent of the total amount owed. If thefamily can provide evidence
satisfactory to the PHA that a down payment of 10 percent would imposean undue
hardship, the PHA may, in its sole discretion, require a lesser percentage or waive the
requirement.
Payment Thresholds
Notice PIH 2010-19 recommends that the total amount that a family must pay each month—the
family’s monthly share of rent plus the monthly debt repayment amount—should not exceed 40
percent of the family’s monthly adjusted income, which is considered “affordable.”Moreover,
Notice PIH 2010-19 acknowledges that PHAs havethe discretion to establish “thresholds and
policies” for repayment agreements with families\[24 CFR 982.552(c)(1)(vii)\].
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PHA Policy
If a family is paying less than 40 percent of its monthly adjusted income (MAI) in rent,
the minimum monthly payment amount will be the greater of the following two amounts:
The difference between 40 percent of the family’s MAI and the TTPat the
time the agreement is executed
$25
If the family’s income increases or decreases during the term of a repayment agreement,
either the PHA or the family may request that the monthly payment amount be adjusted
accordingly.
The PHA has established the following examplesfor repayment of debts:
Amounts between $3,000 and the Federal or State threshold for criminal
prosecution must be repaid within 36 months.
Amounts between $2,000 and $2,999 must be repaid within 30 months.
Amounts between $1,000 and $1,999 must be repaid within 24 months.
Amounts under $1,000 must be repaid within 12 months
Execution of the Agreement
PHA Policy
Any repaymentagreement between the PHA and a family must be signed and dated by
the PHA and by thehead of household and spouse/cohead (if applicable).
Due Dates
PHA Policy
All payments are due by the close of business on the 15thday of the month.If the 15th
does not fall on a business day, the due date is the close of business on the first business
day after the 15th.
Late or Missed Payments
PHA Policy
If a payment is not received by the end of the business day on the date due, and prior
approval for the missed payment has not been given by the PHA, the PHA will send the
family a delinquency notice giving the family 10 business days to make the late payment.
If the payment is not received by the due date of the delinquency notice, it will be
considered a breach of the agreement and the PHA will terminate tenancy in accordance
with the policies in Chapter 13.
If a family receives threedelinquency notices for unexcused late payments in a 12-month
period, the repayment agreement will be considered in default, andthe PHA will
terminate tenancyin accordance with the policies in Chapter 13.
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No Offer of Repayment Agreement
PHA Policy
The PHA generally will not enter into a repayment agreement with a family if there is
already a repayment agreement in place with thefamily, or if the amount owed by the
family exceedsthe federal or state threshold for criminal prosecution.
Repayment Agreements Involving Improper Payments
Notice PIH 2010-19 requires certain provisions to be included in any repayment agreement
involving amounts owed by a family because it underreported or failed to report income:
A reference to the items in the public housing leasethat state the family’s obligation to
provide true and complete information at every reexamination and the grounds on whichthe
PHA may terminate assistance because of a family’s action or failure to act
A statement clarifying that each month the family not only must pay to the PHA the monthly
payment amount specified in the agreement but must also pay to the owner the family’s
monthly share of the rent to owner
A statement that the terms of the repayment agreement may be renegotiated if the family’s
income decreases or increases
A statement that late or missed payments constitute default of the repayment agreement and
may result in termination of tenancy
PARTIV: PUBLIC HOUSING ASSESSMENT SYSTEM(PHAS)
16-IV.A. OVERVIEW
The purpose of the Public Housing Assessment System (PHAS) is to improve the delivery of
services in public housing and enhance trust in the public housing system among PHAs, public
housing residents, HUD and the general public by providing a management tool for effectively
and fairly measuring the performance of a public housing agency in essential housing operations.
16-IV.B.PHAS INDICATORS \[24 CFR 902Subparts A, B, C, D, and E\]
The table below lists each of the PHAS indicators, the points possible under each indicator, and a
brief description of each indicator. A PHA’s performance is based on a combination of all four
indicators.
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Indicator 1: Physical condition of the PHA’s projects
Maximum Score: 40
The objective of this indicator is to determine the level to which a PHA is maintaining its
public housing in accordance with the standard of decent, safe, sanitary, and in good
repair.
To determine the physical condition of a PHA’s projects,inspections are performed of
the following five major areas of each public housingproject:site, building exterior,
building systems, dwelling units, and common areas.The inspections are performed by
an independent inspector arranged by HUD, and include a statistically valid sample of the
units in each project in the PHA’s public housing portfolio.
Indicator 2: Financial condition of the PHA’s projects
Maximum Score: 25
The objective of this indicator is to measure thefinancial condition of the PHA’s public
housing projectsfor the purpose of evaluating whether the PHA has sufficient financial
resources and is capable of managing those financial resources effectively to support the
provision of housing that is decent, safe, sanitary,and in good repair.
A PHA’s financial condition is determined by measuring each public housing project’s
performance in each of the following subindicators: quickratio, months expendable net
assets ratio, and debt service coverage ratio.
Indicator 3: Management operations of the PHA’s projects
Maximum Score: 25
The objective of this indicator is to measure certain key management operations and
responsibilities of a PHA’s projectsfor the purpose of assessing the PHA’s management
operations capabilities.
Each project’s management operations are assessed based on the following sub-
indicators: occupancy,tenant accounts receivable, and accounts payable.
An on-site management review may be conducted as a diagnostic and feedback tool for
problem performance areas, and for compliance. Management reviews are not scored.
Indicator 4: Capital Fund
Maximum Score: 10
The objective of this indicator is to measure how long it takes the PHA to obligate capital
funds and to occupy units.
The PHA’s score for this indicator is measured at the PHA level and is based on the
following subindicators: timeliness of fund obligation and occupancy rate.
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16-IV.C. PHAS SCORING \[24 CFR 902Subpart F\]
HUD’s Real Estate Assessment Center (REAC) issues overall PHAS scores, which are based on
the scores of the four PHAS indicators, and the subindicatorsunder each indicator. The PHA’s
indicator scores are based on a weighted average of the PHA’s public housing projects’ scores.
PHAS scores translate into a designation for each PHA as high performing, standard,
substandard, or troubled.
A high performer is a PHA that achieves an overall PHAS score of 90 or greater, and achieves a
score of at least 60 percent of the points available under the physical, financial, and management
indicators and at least 50 percent of the points available under the capital fund indicator.
A standard performer is a PHA that has an overall PHAS score between 60 and 89, and achieves
a score of at least 60 percent of the points available under thephysical, financial, and
management indicators and at least 50 percent of the points available under the capital fund
indicator.
A substandard performer is a PHA that has an overall PHAS score of at least 60 percent and
achieves a score of less than 60 percent under one or more of the physical, financial, or
management indicators.
A troubled performer is a PHA that achieves an overall PHAS score of less than 60, or achieves
less than 50percent of the total points available under the capital fund indicator.
These designations can affect aPHA in several ways:
High-performing PHAs are eligible for incentives including relief from specific HUD
requirements and bonus points in funding competitions \[24 CFR 902.71\].
PHAs that are standard performers may be required to submit and operate under a corrective
action planto eliminate deficiencies in the PHA’s performance \[24 CFR 902.73(a)(1)\].
PHAs that are substandard performers will be required to submit and operate under a
corrective action plan to eliminate deficiencies in the PHA’s performance \[24 CFR
902.73(a)(2)\].
PHAs with an overall rating of “troubled” are subject to additional HUD oversight, and are
required to enter into a memorandum of agreement (MOA) with HUD to improve PHA
performance \[24 CFR 902.75\].
PHAs that fail to execute or meet MOA requirements may be referred to the Assistant
Secretary to determine remedial actions, including, but not limited to, remedies available for
substantial default\[24 CFR 902.75(g) and 24 CFR Part 907\].
PHAs must post a noticeof its final PHAS score and status in appropriate conspicuous and
accessible locations in its offices within two weeks of receipt of its final score and designation
\[24 CFR 902.64(b)(2)\].
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PART V: RECORD KEEPING
16-V.A. OVERVIEW
The PHA must maintain complete and accurate accounts and other records for the program in
accordance with HUD requirements, in a manner that permits a speedy and effective audit. All
such records must be made available to HUD or the Comptroller General of the United States
upon request.
In addition, the PHA must ensure that all applicant and participant files are maintained in a way
that protects an individual’s privacy rights.
16-V.B. RECORD RETENTION
The PHA must keep the last three years of the Form HUD-50058 and supporting documentation
during the term of each assisted lease, and for a period of at least three years from the end of
participation (EOP) date \[24 CFR 908.101\].
PHA Policy
During the term of each public housingtenancy, and for at least fouryearsthereafter,the
PHAwillkeepall documents related to a family’s eligibility,tenancy, and termination.
In addition, the PHA willkeep the following records for at least fouryears:
An application from each ineligible family and notice that the applicant is not
eligible
Lead-based paint records as required by 24 CFR 35, Subpart B
Documentation supporting the establishment of flat rentsand the public housing
maximum rent
Documentation supporting the establishment of utility allowances and surcharges
Documentation related to PHAS
Accounts and other records supporting PHA budget and financial statements for
the program
Complaints, investigations, notices, and corrective actions related to violations of
the Fair Housing Act or the equal access final rule
Other records as determined by the PHA or as required by HUD
If ahearing to establish a family’s citizenship status is held, longer retention requirements
apply for some types of documents. For specific requirements, see Section 14-II.A.
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16-V.C. RECORDS MANAGEMENT
PHAsmust maintain applicant and participant files and information in accordance with the
regulatory requirements described below.
PHA Policy
All applicant and participant information will be kept in a secure location and access will
be limited to authorized PHA staff.
PHA staff will not discuss personal family information unless there is a business reason
to do so. Inappropriate discussion of family information or improper disclosure of family
information by staff will result in disciplinary action.
Privacy Act Requirements \[24 CFR 5.212 and Form-9886\]
The collection, maintenance, use, and dissemination of social security numbers (SSN), employer
identification numbers (EIN), any information derived from these numbers, and income
information of applicants and participants must be conducted, to the extent applicable, in
compliance with the Privacy Act of 1974, and all other provisions of Federal, State, and local
law.
Applicants and participants, including all adults in the household, are required to sign a consent
form, HUD-9886, Authorization for Release of Information. This form incorporates the Federal
Privacy Act Statement and describes how the information collected using the form may be used,
and under what conditions HUD or the PHA may release the information collected.
Upfront Income Verification (UIV) Records
PHAs that access UIV data through HUD’s Enterprise Income Verification (EIV)system are
required to adopt and follow specific securityprocedures to ensure that all EIV data is protected
in accordance with federal laws, regardless of the media on which the data is recorded (e.g.
electronic, paper). These requirements are contained in the HUD-issued document, Enterprise
Income Verification (EIV) System,Security Proceduresfor Upfront Income Verification(UIV)
Data.
PHA Policy
Prior to utilizing HUD’s EIV system, the PHA will adopt and implement EIV security
procedures required by HUD.
Criminal Records
The PHA mayonly disclose the criminal conviction records which the PHA receives from a law
enforcement agency to officers or employees of the PHA, or to authorized representatives of the
PHA who have a job-related need to have access to the information \[24 CFR 5.903(e)\].
The PHA must establish and implement a system of records management that ensures thatany
criminal record received by the PHA from a law enforcement agency is maintained
confidentially, not misused or improperly disseminated, and destroyed, once the purpose for
which the record was requested has been accomplished, including expiration of the period for
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filing a challenge to the PHA action without institution of a challenge or final disposition of any
such litigation \[24 CFR 5.903(g)\].
The PHA must establish and implement a system of records management that ensures that any
sex offender registration information received by the PHA from a State or local agency is
maintained confidentially, not misused or improperly disseminated, and destroyed, once the
purpose for which the record was requested has been accomplished, including expiration of the
period for filing a challenge to the PHA action without institution of a challenge or final
disposition of any such litigation. However, a record of the screening, including the type of
screening and the date performed must be retained \[Notice PIH 2012-28\]. This requirement does
not apply to information that is public information, or is obtained by a PHA other than under 24
CFR 5.905.
Medical/Disability Records
PHAs are not permitted to inquire about the nature or extent of a person’s disability. The PHA
may not inquire about a person’s diagnosis or details of treatment for a disability or medical
condition. If the PHA receives a verification document that provides such information, the PHA
should not place this information in the tenant file. The PHA should destroy the document.
Domestic Violence, Dating Violence, Sexual Assault, or Stalking Records
This topic is addressed in section 16-VII.E.
PART VI: REPORTING REQUIREMENTSFOR CHILDREN WITH
ENVIRONMENTAL INTERVENTION BLOOD LEAD LEVEL
16-VI.A. REPORTINGREQUIREMENTS\[24 CFR 35.1130(e)\]
The PHA has certain responsibilitiesrelative to children with environmental intervention blood
lead levels that are living in public housing.
The PHA must report the name and addressof a child identified as having an environmental
intervention blood lead level to the public health department within 5 business days of being so
notified by any other medical health care professional.The PHA must also report each known
case of a child with an environmental intervention blood lead level to the HUD field office.
PHA Policy
The PHA will provide the public health department written notice of the name and
address of any child identified as having an environmental intervention blood lead level.
The PHA will provide written noticeofeach known case of a child with an
environmental intervention blood level to the HUD field office within 5 business days of
receiving the information.
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PART VII: VIOLENCE AGAINST WOMEN ACT(VAWA): NOTIFICATION,
DOCUMENTATION, ANDCONFIDENTIALITY
16-VII.A.OVERVIEW
The Violence against Women Act of 2013(VAWA) provides special protections for victims of
domestic violence, dating violence, sexual assault,andstalking who are applying for or receiving
assistance under the public housingprogram.If your state or local laws provide greater
protection for such victims, those laws apply in conjunction with VAWA.
In addition to definitions of key terms used in VAWA, this part contains general VAWA
requirements and PHA policies in three areas: notification, documentation, and confidentiality.
16-VII.B. DEFINITIONS\[24 CFR 5.2003, FR Notice 8/6/13\]
As used in VAWA:
The term affiliated individualmeans, with respect to a person:
-A spouse, parent, brother or sister, or child of that individual, or an individual towhom
that individualstands in the position or place of a parent; or
-Any individual, tenant or lawful occupantliving in the household of that individual.
The term bifurcatemeans, with respect to a public housing or Section 8 lease, to divide a
lease asa matter of law such that certain tenants can be evicted or removed while the
remaining family members’ lease and occupancy rights are allowed to remain intact.
The term dating violencemeans violence committed by a person who is or has been in a
social relationship of a romantic or intimate nature with the victim; and where the existence
of such a relationship shall be determined based on a consideration of the following factors:
-The length of the relationship
-The type of relationship
-The frequency of interaction between the persons involved in the relationship
The term domestic violenceincludes felony or misdemeanor crimes of violence committed
by a current or former spouse of the victim, by a person with whom the victim shares a child
in common, by a person who is cohabitating with or has cohabitated with the victim as a
spouse, by a person similarly situated to a spouse of the victim under the domestic or family
violence laws of the jurisdiction receiving grant monies, or by any other person against an
adult or youth victim who is protected from that person’s acts under the domestic or family
violence laws of the jurisdiction.
Hopkins HRA3/1/17
Page 16-15
The term sexual assaultmeans:
-Any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when
the victimlacksthe capacity to consent
The term stalkingmeans:
-To follow, pursue, or repeatedly commit acts with the intent to kill, injure, harass, or
intimidate; or
-To place under surveillance with the intent to kill, injure, harass, or intimidate another
person; and
-In the course of, or as a result of, such following, pursuit, surveillance, or repeatedly
committed acts, to place a person in reasonable fear of the death of, or serious bodily
injury to, or to cause substantial emotional harm to (1) that person, (2) a member of the
immediate family of that person, or (3) the spouse or intimate partner of that person.
16-VII.C. NOTIFICATION\[24 CFR 5.2005(a)\]
Notification to Public
The PHA adopts the following policyto help ensure that allactual and potential beneficiaries of
its public housing program are aware oftheir rights under VAWA.
PHA Policy
The PHA will make availablethe followinginformation regarding VAWA in its offices
and to anyonewho requestsit.
A notice of occupancy rights under VAWA to housing choice voucher program
applicants and participants who are or have been victims of domestic violence,
dating violence, sexual assault, or stalking (Form HUD-5380, see Exhibit 16-1)
A copy of form HUD-5382, Certification of Domestic Violence, Dating Violence,
Sexual Assault, or Stalking and Alternate Documentation (see Exhibit 16-2)
A copy of the PHA’s emergency transfer plan (Exhibit 16-3)
A copy of HUD’s Emergency Transfer Request for Certain Victims of Domestic
Violence, Dating Violence, Sexual Assault,or Stalking, Form HUD-5383
(Exhibit 16-4)
The National Domestic Violence HotLine: 1-800-799-SAFE (7233) or 1-800-
787-3224 (TTY)(included in Exhibit 16-1)
Sojourner is a local organization that works with individuals victimized by
domestic violence or abuse contact them at 952-933-7422
Hopkins HRA3/1/17
Page 16-16
Notification toApplicants and Tenants\[24 CFR 5.2005(a)(1)\]
VAWArequires PHAs to notifypublic housingapplicants andtenantsof their rights under this
law, including their right to confidentiality and the limits thereof, when they are denied
assistance, when they are admitted to the program, and when they are notified of an eviction or
termination of housing benefits.
The PHA must distribute a notice of VAWA rights, along with the VAWA self-certification
form (HUD-5382) at each of these three junctures.
PHA Policy
The VAWA information provided to applicants and tenants will consist of the notices in
Exhibit 16-1 and 16-2.
The PHA will provide all applicants with information about VAWA at the time they
request an application for housing assistance. The PHA will also include such
information in all notices of denial of assistance (see section 3-III.F).
The PHA will provide all tenants with information about VAWA at the time of admission
(see section 8-I.B) and at annual reexamination. The PHA will also include such
information in all lease termination notices (see section 13-IV.D).
The PHA is not limited to providing VAWA information at the times specified in the above
policy. If the PHA decides to provide VAWA information to a tenant following an incident of
domestic violence, Notice PIH 2006-42 cautions against sending the information by mail, since
the abuser may be monitoring the mail. The notice recommends that in such cases the PHA make
alternative delivery arrangements that will not put the victim at risk.
PHA Policy
Whenever the PHA has reason to suspect that providing information about VAWA to a
public housing tenant might placea victim of domestic violenceat risk, it will attempt to
deliver the information by hand directly to the victim.
16-VII.D. DOCUMENTATION \[24 CFR5.2007\]
A PHA presented with a claim for initial or continued assistance based on status as a victim of
domestic violence, dating violence, sexual assault,or stalking, or criminal activity related to any
of these forms of abuse may—but is not required to—request that the individual making the
claim document the abuse. Any request for documentation must be in writing, and the individual
must be allowed at least 14 business days after receipt of the request to submit the
documentation. The PHA may extend this time period at its discretion. \[24 CFR 5.2007(a)\]
The individual may satisfy the PHA’s request by providing any one of the following three forms
of documentation \[24 CFR 5.2007(b)\]:
(1)A completedand signed HUD-approved certification form (HUD-5382, Certification of
Domestic Violence, Dating Violence, or Stalking), which must include the name of the
perpetratoronly if the name of the perpetrator is safe to provide and is known to the victim
(2)A federal, state, tribal, territorial, or local police report or court record
Hopkins HRA3/1/17
Page 16-17
(3)Documentation signed by a person who has assisted the victim in addressing domestic
violence, dating violence,sexual assault,or stalking, or the effects of such abuse. This person
may be an employee, agent, or volunteer of a victim service provider; an attorney; or a
medical professional. Acceptabledocumentation also includes a record of an administrative
agency, and documentation from a mental health professional. The person signing the
documentation must attest under penalty of perjury to the person’s belief that the incidents in
question are bona fide incidents of abuse. The victim must also sign the documentation.
The PHA may not require third-party documentation (forms 2 and 3)in addition to certification
(form 1), except as specified below under “Conflicting Documentation,” nor may it require
certification in addition to third-party documentation \[VAWA 2005final rule\].
PHA Policy
Any request for documentation of domestic violence, dating violence, sexual assault,or
stalking will specify a deadline of 14 business days following receipt of the request, will
describe the three forms of acceptable documentation, will provide explicit instructions
on where and to whom the documentation must be submitted, and will state the
consequences for failure to submit the documentation or request an extension in writing
by the deadline.
The PHA may, in its discretion, extend the deadline for 10 business days. Any extension
granted by the PHA will be in writing.
Conflicting Documentation \[24 CFR 5.2007(e)\]
In cases where the PHA receives conflicting certification documents from two or more members
of a household, each claiming to be a victim and naming one or more of the other petitioning
household members as the perpetrator, the PHA may determine which is the true victim by
requiring each to provide acceptable third-party documentation, as described above (forms 2 and
3). The PHA must honor any court orders issued to protect the victim or to address the
distribution of property.
PHA Policy
If presented with conflicting certification documents (two or more forms HUD-50066)
from members of the same household, the PHA will attempt to determine which is the
true victim by requiring each of them to provide third-party documentation in accordance
with 24 CFR 5.2007(b)(2) or (3) and by following any HUD guidance on how such
determinations should be made.
Discretion to Require No Formal Documentation \[24 CFR 5.2007(d)\]
The PHA has the discretion to provide benefits to an individual based solely on the individual’s
statement or other corroborating evidence—i.e., without requiring formal documentation of
abuse in accordance with 24 CFR 5.2007(b).
PHA Policy
If the PHA accepts an individual’s statement or other corroborating evidence of domestic
violence, dating violence, sexual assault,or stalking, the PHA will document acceptance
of the statement or evidence in the individual’s file.
Hopkins HRA3/1/17
Page 16-18
Failure to Provide Documentation \[24 CFR 5.2007(c)\]
In order to deny relief for protection under VAWA, a PHA must provide the individual
requesting relief with a written request for documentation of abuse. If the individual fails to
provide the documentation within 14 business days from the date of receipt, or such longer time
as the PHA may allow, the PHA may deny relief for protection under VAWA.
16-VII.E.CONFIDENTIALITY\[24 CFR5.2007(b)(4)\]
All information provided to the PHA regarding domestic violence, dating violence, sexual
assault,or stalking, including the fact thatan individual is a victim of such violence or stalking,
must be retained in confidence. This means that the PHA (1) may not enter the information into
any shared database, (2) may not allow employees or othersto access the information unless they
are explicitly authorized to do so and have a need to know the information forpurposes of their
work, and (3) may not provide the information to any other entityor individual, except to the
extent that the disclosure is (a) requested or consented to by the individual in writing, (b)
required for use in an eviction proceeding, or (c) otherwise required by applicable law.
PHA Policy
If disclosure is required for use in an eviction proceeding or is otherwise required by
applicable law, the PHA will inform the victim before disclosure occurs so that safety
risks can be identified and addressed.
Hopkins HRA3/1/17
Page 16-19
EXHIBIT 16-1: SAMPLE NOTICE OF OCCUPANCY RIGHTS UNDER THE
VIOLENCE AGAINST WOMEN ACT, FORM HUD-5380
HOPKINS HRA
1
Notice of Occupancy Rights under the Violence Against WomenAct
To all Tenants and Applicants
The Violence Against Women Act (VAWA) provides protections for victims of domestic
violence, dating violence, sexual assault, or stalking. VAWA protections are not only available
to women, but are available equally to all individuals regardless of sex, gender identity, or sexual
2
orientation.The U.S. Department of Housing and Urban Development (HUD) is the Federal
agency that oversees that the Hopkins HRA public housing program is in compliance with
VAWA. This notice explains your rights under VAWA. A HUD-approved certification form is
attached to this notice. You can fill out this form to show that you are or have been a victim of
domestic violence, dating violence, sexual assault, or stalking, and that you wish to use your
rights under VAWA.”
Protections for Applicants
If you otherwise qualify for assistance under the public housing program,you cannot be denied
admission or denied assistance because you are or have been a victim of domestic violence,
dating violence, sexual assault, or stalking.
1
Despite the name of this law, VAWA protection is available regardless of sex, gender identity, or sexual
orientation.
2
Housing providers cannot discriminate on the basis of any protected characteristic, including race, color, national
origin, religion, sex, familial status, disability, or age. HUD-assisted and HUD-insured housing must be made
available to all otherwise eligible individuals regardless of actual or perceived sexual orientation, gender identity, or
marital status.
Hopkins HRA3/1/17
Page 16-20
Protections for Tenants
If you are receiving assistance under the public housing program,you may not be denied
assistance, terminated from participation, or be evicted from your rental housing because you are
or have been avictim of domestic violence, dating violence, sexual assault, or stalking.
Also, if you or an affiliated individual of yours is or has been the victim of domestic violence,
dating violence, sexual assault, or stalking by a member of your household or any guest, you
may not be denied rental assistance or occupancy rights under the public housing programsolely
on the basis of criminal activity directly relating to that domestic violence, dating violence,
sexual assault, or stalking.
Affiliated individual means your spouse, parent, brother, sister, or child, or a person to whom
you stand in the place of a parent or guardian (for example, the affiliated individual is in your
care, custody, or control); or any individual, tenant, or lawful occupant living in your household.
Removing the Abuser or Perpetrator from the Household
HP may divide (bifurcate) your lease in order to evict the individual or terminate the assistance
of the individual who has engaged in criminal activity (the abuser or perpetrator) directly relating
to domestic violence, dating violence, sexual assault, or stalking.
If HP chooses to remove the abuser or perpetrator, HP may not take away the rights of eligible
tenants to the unit or otherwise punish the remaining tenants. If the evicted abuser or perpetrator
was the sole tenant to have established eligibility for assistance under the program, HP must
allow the tenant who is or has been a victim and other household members to remain in the unit
for a period of time, in order to establish eligibility under the program or under another HUD
housing program covered by VAWA, or, find alternative housing.
In removing the abuser or perpetrator from the household, HP must follow Federal, State, and
local eviction procedures. In order to divide a lease, HP may, but is not required to, ask you for
documentation or certification of the incidences of domestic violence, dating violence, sexual
assault, or stalking.
Hopkins HRA3/1/17
Page 16-21
Moving to Another Unit
Upon your request, HP may permit you to move to another unit, subject to the availability of
other units, and still keep your assistance. In order to approve a request, HP may ask you to
provide documentation that you are requesting to move because of an incidence of domestic
violence, dating violence, sexual assault, or stalking. If the request is a request for emergency
transfer, the housing provider may ask you to submit a written request or fill out a form where
you certify that you meet the criteria for an emergency transfer under VAWA. The criteria are:
1.You are a victim of domestic violence, dating violence, sexual assault, or stalking.
If your housing provider does not already have documentation that you are a victim of
domestic violence, dating violence, sexual assault, or stalking, your housing provider
may ask you for such documentation, as described in the documentation section
below.
2.You expressly request the emergency transfer. Your housing provider may choose
to require that you submit a form, or may accept another written or oral request.
3.You reasonably believe you are threatened with imminent harm from further
violence if you remain in your current unit. This means you have a reason to fear
that if you do not receive a transfer you would suffer violence in the very near future.
OR
You are a victimof sexual assault and the assault occurred on the premises
during the 90-calendar-day period before you request a transfer. If you are a
victim of sexual assault, then in addition to qualifying for an emergency transfer
because you reasonably believe youare threatened with imminent harm from
further violence if you remain in your unit, you may qualify for an emergency
transfer if the sexual assault occurred on the premises of the property from which
you are seeking your transfer, and that assault happened within the 90-calendar-
day period before you expressly request the transfer.
HP will keep confidential requests for emergency transfers by victims of domestic violence,
dating violence, sexual assault, or stalking, and the location of any move by such victims and
their families.
Hopkins HRA3/1/17
Page 16-22
HP’s emergency transfer plan provides further information on emergency transfers, and HP must
make a copy of its emergency transfer plan available to you if you ask to see it.One important
fact regarding the Hopkins HRA public housing program is that is has one 7 story building. We
do not have another property to transfer a VAWA victim to. We will work with other area
housing and service providers to try an locate an alternative unit.
Documenting You Are or Have Been a Victim ofDomestic Violence, Dating Violence,
Sexual Assault or Stalking
HP can, but is not required to, ask you to provide documentation to “certify” that you are or have
been a victim of domestic violence, dating violence, sexual assault, or stalking. Such request
from HP must be in writing, and HP must give you at least 14 business days (Saturdays,
Sundays, and Federal holidays do not count) from the day you receive the request to provide the
documentation. HP may, but does not have to, extend the deadline for the submission of
documentation upon your request.
You can provide one of the following to HP as documentation. It is your choice which of the
following to submit if HP asks you to provide documentation that you are or have been a victim
of domestic violence, dating violence, sexual assault, or stalking.
A complete HUD-approved certification form given to you by HP with this notice, that
documents an incident of domestic violence, dating violence, sexual assault, or stalking.
The form will ask for your name, the date, time, and location of the incident of domestic
violence, dating violence, sexual assault, or stalking, and a description of the incident.
The certification form provides for including the name of the abuser or perpetrator if the
name of theabuser or perpetrator is known and is safe to provide.
A record of a Federal, State, tribal, territorial, or local law enforcement agency, court, or
administrative agency that documents the incident of domestic violence, dating violence,
sexual assault, or stalking. Examples of such records include police reports, protective
orders, and restraining orders, among others.
Hopkins HRA3/1/17
Page 16-23
A statement, which you must sign, along with the signature of an employee, agent, or
volunteer of a victim service provider, an attorney, a medical professional or a mental
health professional (collectively, “professional”) from whom you sought assistance in
addressing domestic violence, dating violence, sexual assault, or stalking, or the effects of
abuse, and with the professional selected by you attesting under penalty of perjury that he
or she believes that the incident or incidents of domestic violence, dating violence, sexual
assault, or stalking are grounds for protection.
Any other statement or evidence that HP has agreed to accept.
If you fail or refuse to provide one of these documents within the 14 business days, HP does not
have to provide you with the protections contained in this notice.
If HP receives conflictingevidence that an incident of domestic violence, dating violence, sexual
assault, or stalking has been committed (such as certification forms from two or more members
of a household each claiming to be a victim and naming one or more of the other petitioning
household members as the abuser or perpetrator), HP has the right to request that you provide
third-party documentation within thirty 30 calendar days in order to resolve the conflict. If you
fail or refuse to provide third-party documentation where there is conflicting evidence, HP does
not have to provide you with the protections contained in this notice.
Confidentiality
HP must keep confidential any information you provide related to the exercise of your rights
under VAWA, including the fact that youare exercising your rights under VAWA.
HP must not allow any individual administering assistance or other services on behalf of HP (for
example, employees and contractors) to have access to confidential information unless for
reasons that specifically call for these individuals to have access to this information under
applicable Federal, State, or local law.
Hopkins HRA3/1/17
Page 16-24
HP mustnot enter your information into any shared database or disclose your information to any
other entity or individual. HP, however, may disclose the information provided if:
You give written permission to HP to release the information on a time limited basis.
HP needs to use the information in an eviction or termination proceeding, such as to evict
your abuser or perpetrator or terminate your abuser or perpetrator from assistance under
this program.
A law requires HP or your landlord to release the information.
VAWA does not limit HP’s duty to honor court orders about access to or control of the property.
This includes orders issued to protect a victim and orders dividingproperty among household
members in cases where a family breaks up.
Reasons a Tenant Eligible for Occupancy Rights under VAWA May Be Evicted or
Assistance May Be Terminated
You can be evicted and your assistance can be terminated for serious or repeated lease violations
that are not related to domestic violence, dating violence, sexual assault, or stalking committed
against you. However, HP cannot hold tenants who have been victims of domestic violence,
dating violence, sexual assault, or stalking to a more demanding set of rules than it applies to
tenants who have not been victims of domestic violence, dating violence, sexual assault, or
stalking.
Theprotections described in this notice might not apply, and you could be evicted and your
assistance terminated, if HP can demonstrate that not evicting you or terminating your assistance
would present a real physical danger that:
1.Would occur within an immediate time frame, and
2.Could result in death or serious bodily harm to other tenants or those who work on the
property.
If HP can demonstrate the above, HP should only terminate your assistance or evict you if there
are no other actions that could be taken to reduce or eliminate the threat.
Hopkins HRA3/1/17
Page 16-25
Other Laws
VAWA does not replace any Federal, State, or local law that provides greater protection for
victims of domestic violence, dating violence, sexual assault, or stalking. You may be entitled to
additional housing protections for victims of domestic violence, dating violence, sexual assault,
or stalking underother Federal laws, as well as under State and local laws.
Non-Compliance with The Requirements of This Notice
You may report a covered housing provider’s violations of these rights and seek additional
assistance, if needed, by contacting or filing a complaint with the Minneapolis HUD field office.
For Additional Information
You may view a copy of HUD’s final VAWA rule at: https://www.gpo.gov/fdsys/pkg/FR-2016-
11-16/pdf/2016-25888.pdf.
Additionally, HP must make a copy of HUD’s VAWA regulations available to you if you ask to
see them.
For questions regarding VAWA, please contact the public housing management office staff at
Dow Towers at 952-548-6345.
For help regarding anabusive relationship, you may call the National Domestic Violence Hotline
at 1-800-799-7233 or, for persons with hearing impairments, 1-800-787-3224 (TTY). You may
also contact Sojourner at 952-933-7422.
For help regarding sexual assault, you may contactRape, Abuse & Incest National Network’s
National Sexual Assault Hotline at 800-656-HOPE.
Victims of stalking seeking help may contact the National Center for Victims of Crime’s
https://www.victimsofcrim.org/our-programs/stalking-resource-
Stalking Resource Center at
center.
Attachment:Certification form HUD-5382\[form approved for this program to be included\]
Hopkins HRA3/1/17
Page 16-26
EXHIBIT 16-2:CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE,
SEXUAL ASSAULT, OR STALKING AND ALTERNATE DOCUMENTATION,
FORM HUD-5382
CERTIFICATION OF U.S. Department of Housing OMB Approval No. 2577-0286
DOMESTIC VIOLENCE, and Urban Development
Exp. 06/30/2017
DATING VIOLENCE,
SEXUAL ASSAULT, OR STALKING,
AND ALTERNATE DOCUMENTATION
Purpose of Form:The Violence Against Women Act (“VAWA”) protects applicants, tenants, and
program participants in certain HUD programs from being evicted, denied housing assistance, or
terminated from housing assistance based on acts of domestic violence, dating violence, sexual assault, or
stalking against them. Despite the name of this law, VAWA protection is available to victims of domestic
violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity, or sexual
orientation.
Use of This Optional Form:If you are seeking VAWA protections from your housing provider, your
housing provider may give you a written request that asks you to submit documentation about the incident
or incidents of domestic violence, dating violence, sexual assault, or stalking.
In response to this request, you or someone on your behalf may complete this optional form and submit it
to your housing provider, or you may submit one of the following types of third-party documentation:
(1) A document signed by you and an employee, agent, or volunteer of a victim service provider, an
attorney, or medical professional, or a mental health professional (collectively, “professional”) from
whom you have sought assistance relating to domestic violence, dating violence, sexual assault, or
stalking, or the effects of abuse. The document must specify, under penalty of perjury, that the
professional believes the incident or incidents of domestic violence, dating violence, sexual assault, or
stalking occurred and meet the definition of “domestic violence,” “dating violence,” “sexual assault,” or
“stalking” in HUD’s regulations at 24 CFR 5.2003.
(2) A record of a Federal, State, tribal, territorial or local law enforcement agency, court, or
administrative agency; or
(3) At the discretion of the housing provider, a statement or other evidence provided by the applicant or
tenant.
Submission of Documentation:The time period to submit documentation is 14 business days from the
date that you receive a written request from your housing provider asking that you provide documentation
of the occurrence of domestic violence, dating violence, sexual assault, or stalking. Your housing
provider may, but is not required to, extend the time period to submit the documentation, if you request an
extension of the time period. If the requested information is not received within 14 business days of when
you received the request for the documentation, or any extension of the date provided by your housing
provider, your housing provider does not need to grant you any of the VAWA protections. Distribution or
issuance of this form does not serve as a written request for certification.
Confidentiality:All information provided to your housing provider concerning the incident(s) of
domestic violence, dating violence, sexual assault, or stalking shall be kept confidential and such details
shall not be entered into any shared database. Employees of your housing provider are not to have access
to these details unless to grant or deny VAWA protections to you, and such employees may not disclose
this information to any other entity or individual, except to the extent that disclosure is: (i) consented to
by you in writing in a time-limited release; (ii) required for use in an eviction proceeding or hearing
regarding termination of assistance; or (iii) otherwise required by applicable law.
Hopkins HRA3/1/17
Page 16-27
TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC VIOLENCE,
DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
1. Date the written request is received by victim: _________________________________________
2. Name of victim: ___________________________________________________________________
3. Your name (if different from victim’s):________________________________________________
4. Name(s) of other family member(s) listed on the lease:___________________________________
___________________________________________________________________________________
5. Residence of victim: ________________________________________________________________
6. Name of the accused perpetrator (if known and can be safely disclosed):____________________
__________________________________________________________________________________
7. Relationship of the accused perpetrator to the victim:___________________________________
8. Date(s) and times(s) of incident(s) (if known):___________________________________________
_________________________________________________________________
10. Location of incident(s):_____________________________________________________________
In your own words, briefly describe the incident(s):
_____________________________________________________________
_________________________
This is to certify that the information provided on this form is true andcorrect to the best of my
knowledge and recollection, and that the individual named above in Item 2 is or has been a victim of
domestic violence, dating violence, sexual assault, or stalking. I acknowledge that submission of false
information could jeopardize program eligibility and could be the basis for denial of admission,
termination of assistance, or eviction.
Signature __________________________________Signed on (Date) ___________________________
Public Reporting Burden: The public reporting burdenfor this collection of information is estimated to
average 1 hour per response. This includes the time for collecting, reviewing, and reporting the data. The
information provided is to be used by the housing provider to request certification that the applicant or
tenant is a victim of domestic violence, dating violence, sexual assault, or stalking. The information is
subject to the confidentiality requirements of VAWA. This agency may not collect this information, and
you are not required to complete this form, unless it displays a currently valid Office of Management and
Budget control number.
Hopkins HRA3/1/17
Page 16-28
EXHIBIT 16-3: NMA EMERGENCY TRANSFER PLAN FOR VICTIMS OF
DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
Attachment: Certification form HUD-5382
Hopkins HRA Public Housing Program
Emergency Transfer Plan for Victims of Domestic Violence, Dating Violence, Sexual
Assault, orStalking
PublicHousing Program
Emergency Transfers
The PHA is concerned about the safety of its tenants, and such concern extends to tenants who
are victims of domestic violence, dating violence, sexual assault, or stalking.Inaccordancewith
3
theViolence AgainstWomen Act (VAWA),the PHA allows tenants who arevictims of
domesticviolence, dating violence, sexual assault, orstalkingto request anemergencytransfer
from the tenant’s current unitto another unit. Theabilityto requestatransfer is available
4
regardlessof sex,gender identity, orsexual orientation.Theabilityof the PHAto honorsuch
request fortenantscurrently receivingassistance, however,maydepend upon apreliminary
determination that the tenant is or has been avictim of domesticviolence, datingviolence,
sexual assault, or stalking,and on whetherthe PHA hasanotherdwellingunitthat is available
and is safeto offerthetenant for
temporaryor morepermanent occupancy.
3
Despitethenameofthislaw, VAWAprotectionisavailabletoallvictimsofdomesticviolence,datingviolence,
sexualassault,andstalking,regardlessofsex,genderidentity,orsexualorientation.
4
Housingproviderscannotdiscriminateonthebasisofanyprotectedcharacteristic,includingrace,color,national
origin,religion,sex,familialstatus,disability,orage.HUD-assistedandHUD-insuredhousingmustbemade
availabletoallotherwiseeligibleindividualsregardlessofactualorperceivedsexualorientation,genderidentity,or
maritalstatus.
Hopkins HRA3/1/17
Page 16-29
This plan identifiestenants who areeligibleforanemergencytransfer, thedocumentation
needed to request anemergencytransfer,confidentialityprotections, how anemergencytransfer
mayoccur,andguidanceto tenants on safetyandsecurity. This plan is based on amodel
emergencytransfer planpublishedbythe U.S.Department of HousingandUrbanDevelopment
(HUD), thefederalagencythat overseesthat the public housing and housing choice voucher
compliance
(HCV) programs are inwith VAWA.
Eligibility forEmergency Transfers
A tenant who is avictimof domesticviolence,datingviolence, sexual assault, or stalking,as
provided in HUD’sregulations at 24 CFR part 5, subpartL,is eligibleforanemergency
transfer, if thetenant reasonablybelieves that there is a threat of imminent harmfrom further
violenceif the tenant remains withinthe same unit.If thetenant is a victim of sexual assault, the
tenant mayalso be eligibleto transfer ifthe sexual assaultoccurred on the premises within the
90-calendar-dayperiod precedingarequest foranemergencytransfer.
A tenant requesting anemergencytransfer must expresslyrequest thetransfer in accordance
with the procedures describedin this plan.
Tenants who arenot ingood standingmaystillrequest an emergencytransfer iftheymeetthe
eligibilityrequirements in this section.
Emergency TransferRequest Documentation
To request anemergencytransfer, thetenant shallnotifythe PHA’s managementofficeand
submita
written request for atransfer to the Dow Towers office. The PHA will provide
accommodations to this policyfor individuals with disabilities. Thetenant’s written
reasonable
request for anemergencytransfer should include either:
1.A statement expressingthatthe tenantreasonablybelievesthat thereis a threat of
imminent harm from further violenceifthe tenantwereto remain in thesame
dwelling unitassisted underthe PHA’sprogram; OR
2.A statement thatthe tenant was asexual assaultvictimand thatthe sexual assault
occurred on the premises duringthe 90-calendar-dayperiod precedingthe tenant’s
request foranemergencytransfer.
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Confidentiality
The PHA will keepconfidential anyinformation thatthe tenant submits in requestingan
emergency transfer,and informationabout theemergencytransfer, unless the tenant gives the
PHA written permission to releasetheinformationon atime-limited basis, or disclosureof the
information is requiredbylaw orrequiredforuse in anevictionproceedingor hearing regarding
termination of assistancefrom thecovered program. This includes keeping confidential thenew
location ofthe dwellingunitof thetenant, if oneis provided, fromtheperson or persons that
committedanactof domesticviolence, datingviolence, sexual assault, or stalkingagainstthe
tenant. Seethe Notice ofOccupancyRights under theViolenceagainstWomen ActforAll
Tenantsformore information about the PHA’s responsibilityto maintainthe confidentialityof
information related to incidents of domesticviolence, datingviolence, sexual assault, or stalking.
Emergency TransferTiming andAvailability
The PHA cannot guaranteethatatransferrequest willbeapproved or how longitwilltaketo
process a transferrequest. The PHAwill, however,act as quicklyas possibleto moveatenant
who is avictimof domesticviolence, datingviolence, sexual assault, or stalkingto anotherunit,
subjecttoavailabilityand safetyofaunit.If atenant reasonablybelieves a proposedtransfer
would not be safe, the tenant mayrequest a transfer to adifferent unit. If aunitis available, the
transferred tenant must agreetoabide bytheterms andconditions thatgovern occupancyin the
unitto which the tenant has been transferred. The PHA maybeunable to transferatenant to ato
another unit in the Dow Towers inventory if the entire building is determined to unsafe by the
victim.
Ifthe PHA has no safeandavailable units forwhich atenantwhoneedsanemergencytransfer is
eligible,the PHA willassistthe tenant in identifyingother housingproviders who mayhavesafe
andavailable units to which the tenant could move. At the tenant’s request, the PHAwillalso
assist tenants incontactingthe local organizations offering assistanceto victims of domestic
violence,dating violence, sexual assault, or stalkingthat areincluded in this plan.
Hopkins HRA3/1/17
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Emergency Transfers: Public Housing (PH) Program
If you are a public housing resident and request an emergency transfer as described in this plan,
the PHA will attempt to assist you in moving to a safe unit quickly. The PHA will make
exceptions as required to policies restricting moves.
Emergency transfers for which you are not required to apply for assistance include the following:
Public housing unit in a different development(NOT APPLICABLE AT THIS TIME)
Public housing unit in the same development, if you determine that the unit is safe
At your request, the PHA will refer you to organizations that may beable to further assist you.
Emergency transfers will not take priority over waiting list admissions for these types of
assistance. At your request, the PHA will refer you to organizations that may be able to further
assist you.
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Safety andSecurity ofTenants
Pendingprocessingof thetransferand theactual transfer, ifitis approvedand occurs, thetenant
is urged to takeallreasonable precautionsto be safe.
Tenants who areor havebeen victims of domesticviolenceareencouragedto contactthe
National DomesticViolenceHotlineat1-800-799-7233, or alocal domesticviolenceshelter,for
assistancein creatingasafetyplan. Forpersonswith hearingimpairments, that hotlinecan be
accessed bycalling1-800-787-3224(TTY).
Tenants who havebeenvictims of sexual assaultmaycallthe Rape, Abuse, and Incest National
Network’s NationalSexual Assault Hotline at 1-800-656-HOPE, orvisittheonlinehotline at
.
https://ohl.rainn.org/online/
Tenants who areorhavebeen victims of stalkingseekinghelp mayvisittheNationalCenterfor
Victims
https://www.victimsofcrime.org/our-
of Crime’sStalkingResourceCenterat
programs/stalking-resource-center.
Attachment:Localorganizationsofferingassistancetovictimsofdomesticviolence,dating
violence,sexualassault,orstalking.
Hopkins HRA3/1/17
Page 16-33
Hopkins HRA3/1/17
Page 16-34
EXHIBIT 16-4: EMERGENCY TRANSFER REQUEST FOR CERTAIN VICTIMS OF
DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING,
FORM HUD-5383
EMERGENCY TRANSFER U.S. Department of Housing OMB Approval No. 2577-0286
REQUEST FOR CERTAIN and Urban Development Exp. 06/30/2017
VICTIMS OF DOMESTIC
VIOLENCE, DATING VIOLENCE,
SEXUAL ASSAULT, OR STALKING
Purpose of Form:If you are a victim of domestic violence, dating violence, sexual assault,or stalking,
and you are seeking an emergency transfer, you may use this form to request an emergency transfer and
certify that you meet the requirements of eligibility for an emergency transfer under the Violence Against
Women Act (VAWA). Although the statutory name references women, VAWA rights and protections
apply to all victims of domestic violence, dating violence, sexual assault or stalking. Using this form does
not necessarily mean that you will receive an emergency transfer. See your housing provider’s
emergency transfer plan for more information about the availability of emergency transfers.
The requirements you must meet are:
(1)You are a victim of domestic violence, dating violence, sexual assault, or stalking.
If your housing provider does not already have documentation that you are a victim of
domestic violence, dating violence, sexual assault, or stalking, your housing provider
may ask you for such documentation. In response, you may submit Form HUD-5382, or
any one of the other types of documentation listed on that Form.
(2)You expressly request the emergency transfer. Submission of this form confirms
that you have expressly requested a transfer. Your housing provider may choose to
require that you submit this form, or may accept another written or oral request. Please
see your housing provider’s emergency transfer plan for more details.
(3)You reasonably believe you are threatened with imminent harm from further
violence if you remain in your current unit. This means you have a reason to fear that
if you do not receive a transfer you would suffer violence in the very near future.
OR
You are a victim of sexual assault and the assault occurred on the premises during
the 90-calendar-day period before you request a transfer. If youare a victim of
sexual assault, then in addition to qualifying for an emergency transfer because you
reasonably believe you are threatened with imminent harm from further violence if you
remain in your unit, you may qualify for an emergency transfer if the sexual assault
occurred on the premises of the property from which you are seeking your transfer, and
that assault happened within the 90-calendar-day period before you submit this form or
otherwise expressly request the transfer.
Submission of Documentation:If you have third-party documentation that demonstrates why you are
eligible for an emergency transfer, you should submit that documentation to your housing provider if it is
safe for you to do so. Examples of third party documentation include, butare not limited to: a letter or
other documentation from a victim service provider, social worker, legal assistance provider, pastoral
counselor, mental health provider, or other professional from whom you have sought assistance; a current
restraining order; a recent court order or other court records; a law enforcement report or records;
communication records from the perpetrator of the violence or family members or friends of the
perpetrator of the violence, including emails, voicemails, text messages, and social media posts.
Hopkins HRA3/1/17
Page 16-35
Confidentiality:All information provided to your housing provider concerning the incident(s) of
domestic violence, dating violence, sexual assault, or stalking, and concerning your request for an
emergency transfer shall be kept confidential. Such details shall not be entered into any shared database.
Employees of your housing provider are not to have access to these details unless to grant or deny VAWA
protections or an emergency transfer to you. Such employees may not disclosethis information to any
other entity or individual, except to the extent that disclosure is: (i) consented to by you in writing in a
time-limited release; (ii) required for use in an eviction proceeding or hearing regarding termination of
assistance; or (iii) otherwise required by applicable law.
TO BE COMPLETED BY OR ON BEHALF OF THE PERSON REQUESTING A TRANSFER
1. Name of victim requesting an emergency transfer: ______________________________________
2. Your name (if different from victim’s)_________________________________________________
3. Name(s) of other family member(s) listed on the lease:____________________________________
___________________________________________________________________________________
4. Name(s) of other family member(s)who would transfer with the victim:____________________
____________________________________________________________________________________
5. Address of location from which the victim seeks to transfer: _______________________________________
6. Address or phone number for contacting the victim:____________________________________
7. Name of the accused perpetrator (if known and can be safely disclosed):___________________
8. Relationship of the accused perpetrator to the victim:___________________________________
9. Date(s), Time(s) and location(s) of incident(s):___________________________________________
_____________________________________________________________________________________
10. Is the person requesting the transfer a victim of asexual assault that occurred in the past 90
days on the premises of the property from which the victim is seeking a transfer? If yes, skip
question 11. If no, fill out question 11. ______________
11. Describe why the victim believes they are threatened with imminent harm from further
violence if they remain in their current unit.
___________________________________________________________________________________
_____________________________________________________________________________________
12. If voluntarily provided, list any third-party documentation you are providing along with this
notice: ___________________________________________________________________
Hopkins HRA3/1/17
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This is to certify that the information provided on this form is true and correct to thebest of my
knowledge, and that the individual named above in Item 1 meets the requirement laid out on this form for
an emergency transfer. I acknowledge that submission of false information could jeopardize program
eligibility and could be the basis for denial of admission, termination of assistance, or eviction.
Signature __________________________________Signed on (Date) ___________________________
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HOUSING AND REDEVELOPMENT AUTHORITY
IN AND FOR THE CITY OF HOPKINS
Hennepin County, Minnesota
RESOLUTION NO. 521
RESOLUTION APPROVING THE HOPKINS HRA REVISION OF
THE ADMISSIONS AND CONTINUED OCCUPANCY POLICY
WHEREAS,the Housing and RedevelopmentAuthority In and For the City of
Hopkins, Minnesota, (the “Authority”) operates a Low Rent Public Housing Program;
WHEREAS,the Authority, as a requirement by HUD, must have an Admissions
and Continued Occupancy Policy Statement;
WHEREAS, the Authority has established and revised such policies previously;
and,
WHEREAS, Chapter 16 containing Program Administration on VAWA needed
revision to comply with recent final rule by HUD.
NOW, THEREFORE, BE IT RESOLVED,that the Authority Board of
Commissioners hereby approves the revision and updated form of the Admissions and
Continued Occupancy Policy.
th
Adopted this 19
day of September2017.
_____________________________________
Chair
ATTEST:
_________________________________________
Executive Director