partner agency training manual - crisisassistance.org€¦ · partner agency staff is available...
TRANSCRIPT
SUBMITTING REQUESTS FOR FINANCIAL ASSISTANCE
If you identify a need for rent or utility assistance in the course of working with a Mecklenburg County resident, you may request an application form by emailing [email protected]. A packet will be sent via email for you to complete with the customer.
Partner Agency staff is available Monday – Friday 8:30 am – 5:00 pm, except holidays.
During peak times, the Partner Agency team utilizes the following triage system in order to ensure service is provided to the most at-risk individuals:
1. Utilities off already
2. Utilities off the day of referral
3. Padlock situations
4. Utilities off later
5. Rent
6. New Moves (limited to those defined in training)
We are not currently accepting referrals for furniture assistance.
If you have any questions about being a Partner Agency, please email [email protected].
PROPRIETARY & CONFIDENTIAL 2
SUBMISSION TIPS
Referrals should only be submitted for individuals actively receiving case management services. Please refrain from submitting referrals for yourself, your relatives, coworkers, or personal friends.
Applications should only be submitted by caseworkers who have received Partner Agency training.
All supporting documentation must be submitted in order to process the request.
Include information for each person resident at the applicant's address, regardless of their legal or biological relationshipto the applicant.
Complete case notes should address the following:
How will the applicant sustain household expenses in the future should he/she receive financial assistance?
If income is significantly greater than expenses, where was the excess spent? Please provide any related receipts.
What resources (savings, relatives etc.) does the applicant have to help solve the problem?
If the applicant qualifies for a rent reduction (Charlotte Housing Authority or Section 8) has she/he applied for it?
PROPRIETARY & CONFIDENTIAL 3
INTAKE PAGE 1: CHECKLIST
The form is designed to auto-populate fields that are needed in multiple places throughout the packet.
Please be sure to complete all relevant fields.
Please check all types of financial assistance that are being requested.
PROPRIETARY & CONFIDENTIAL
4
INTAKE PAGE 2: CHECKLIST
PROPRIETARY & CONFIDENTIAL 5
Please ensure that you have included all the needed documentation to expedite the processing of the application packet.
Handwritten and incomplete forms will not be processed.
Please make sure to check off each item that is attached to this request.
INTAKE PAGE 3: RESIDENCE INFORMATION
PROPRIETARY & CONFIDENTIAL 6
This section is required for ALL assistance requests.
Please choose one option from the drop-down menus.
INTAKE PAGE 3: RENTAL & MORTGAGE INFORMATION
PROPRIETARY & CONFIDENTIAL
7
Please add all rental/ mortgage information for the applicant’s household.
INTAKE PAGE 3: HOUSEHOLD INFORMATION
PROPRIETARY & CONFIDENTIAL
8
List adult that caseworker is working with on this page.
Each additional person living at the address should be included on the supplemental Additional Household Members sheet.
INTAKE PAGE 3: HOUSEHOLD INFORMATION
PROPRIETARY & CONFIDENTIAL
9
Please choose one option from the drop-down menus.
INTAKE PAGE 4: SCREENING INFORMATION – EXPENSES
PROPRIETARY & CONFIDENTIAL 10
Please take the time to engage the applicant in a conversation regarding their relationship with money and how to maximize income and minimize expenses when appropriate.
Go down each expense line item and gain insight from the applicant on how much is spent each month. Don’t overlook topics such as laundry, transportation and other personal expense.
Take time to discuss ideas to decrease expenses where possible and make supporting plans to achieve these budgetary changes, then record these plans in the Projected Column.
If the applicant is receiving SNAP (food stamps,) please only record what is spent on food over and above what is received in SNAP benefits in the 30-day average column. For those not receiving SNAP benefits, record all monies spent on food in the 30-day average column.
INTAKE PAGE 4: SCREENING INFORMATION – EARNED INCOME
PROPRIETARY & CONFIDENTIAL11
Income either earned and/or unearned needs to be reported for EVERY PERSON living at the applicant’s address.
Earned income is income related to employment/odd jobs.
Please be sure to include paystubs for the last 30 days of earned income when submitting the packet.
For the self-employed, a copy of the first page of their latest tax return will be sufficient.
If the applicant is paid in cash for odd jobs (babysitting, private lawn care, etc.), a statement from the employer will be sufficient.
Please choose one option from the drop-down menus.
INTAKE PAGE 4: SCREENING INFORMATION – UNEARNED INCOME
PROPRIETARY & CONFIDENTIAL12
Unearned income is income related to SSA, SSI, child support, unemployment, retirement, VA benefits, etc.
Please be sure to include award letters/other documentation of unearned income when submitting the packet.
If the applicant is starting a new job, please remember to submit a new hire letter on company letter head indicating start date, rate of pay, hours per week, date of first check and how frequently client will be paid.
Please choose one option from the drop-down menus.
INTAKE PAGE 5: SCREENING INFORMATION –RENT/MORTGAGE/UTILITIES
PROPRIETARY & CONFIDENTIAL13
Fill in account numbers for utility requests.
Please choose one option from the drop-down menus.
INTAKE PAGE 5: INTERVIEWER ASSESSMENT
Please provide complete case notes on what caused the applicant’s financial emergency and how the applicant will maintain household expenses going forward.
PROPRIETARY & CONFIDENTIAL 14
INTAKE PAGE 6: ADDITIONAL HOUSEHOLD INFORMATION
PROPRIETARY & CONFIDENTIAL 15
Include information about ALL other household members who live in the home.
Please choose one option from the drop-down menus.
INTAKE PAGE 7: CONSENT TO RELEASE INFORMATION
PROPRIETARY & CONFIDENTIAL 16
Customer should read, sign, and date all sections.
If under 17 or unable to sign, the caseworker submitting this application needs to sign witness signature line at bottom.
INTAKE PAGE 8: IDENTIFICATION VERIFICATION
PROPRIETARY & CONFIDENTIAL17
This document is needed if you DO NOT have copies of IDs and Social Security cards for everyone in the household.
If this page is filled out, please choose one option from the drop-down menus.
INTAKE PAGE 9: SELF DECLARATION OF NO INCOME
PROPRIETARY & CONFIDENTIAL 18
This document needs to be signed if there is no income for the applicant or anyone living in the household.
INTAKE PAGE 10: CLIENT ELIGIBILITY CHECKLIST
PROPRIETARY & CONFIDENTIAL 19
Please complete the following fields:
Date
Applicant Name
Interviewed by (caseworker name)
Referred by (caseworker agency)
INTAKE PAGE 10: CLIENT ELIGIBILITY CHECKLIST
PROPRIETARY & CONFIDENTIAL 20
The applicant’s name needs to go in the blank space after “1,” and the applicant should sign and date the form.
The Crisis Assistance Ministry staff person receiving the application signs this form. Please do not sign if you are submitting the application.
INTAKE PAGE 11: EMERGENCY ASSISTANCE (EA) APPLICATION
PROPRIETARY & CONFIDENTIAL21
Please complete all fields.
INTAKE PAGE 12: EMERGENCY ASSISTANCE (EA) APPLICATION
PROPRIETARY & CONFIDENTIAL22
Please complete all fields.
INTAKE PAGE 13: EMERGENCY ASSISTANCE (EA) APPLICATION
PROPRIETARY & CONFIDENTIAL23
Please document additional referrals made to community resources.
The applicant should sign and date the form.
INTAKE PAGE 14: CRISIS INTERVENTION PROGRAM (CIP) APPLICATION
PROPRIETARY & CONFIDENTIAL24
Please complete all fields.
INTAKE PAGE 15: ENERGY PROGRAMS APPLICATION
PROPRIETARY & CONFIDENTIAL25
Please complete all fields.
INTAKE PAGE 16: ENERGY PROGRAMS APPLICATION
PROPRIETARY & CONFIDENTIAL26
The applicant should sign and date the form.
INTAKE PAGE 17: NOTICE ON THE USE OF SOCIAL SECURITY NUMBERS
PROPRIETARY & CONFIDENTIAL27
The applicant should sign and date the form.
INTAKE PAGE 26: NOTICE OF RIGHTS
PROPRIETARY & CONFIDENTIAL28
The applicant should sign and date the form.
FREQUENTLY ASKED QUESTIONS
Q. How do I add household members?
A. Please complete the additional household member page to include all demographics of each household member.
Q.What if I forget to send additional documents?
A. The request is not complete and will not be processed without all documentation. You will receive notification of an incomplete packet and will be advised to resubmit missing documents and/or the complete packet.
Q.What if the applicant has an additional request within 30 days after submission?
A. Submit the new requested bill(s) and any updated income information to the caseworker that processed the initial request.
Q.What is the triage system used?
A. We triage requests based on the severity of the emergency.
1. Utilities off already
2. Utilities off the day of referral
3. Padlock situations
4. Utilities off later
5. Rent
6. New Moves (limited to those defined in training)
Q. Does Crisis Assistance Ministry help with hotel payments?
A. Yes, the applicant would have to reside in the same room at the same hotel for a minimum of 60 days in order to qualify for assistance.
PROPRIETARY & CONFIDENTIAL 29