OHOP Client Participation Agreement

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                                            OHOP Client Participation Agreement
   Public Health Division
   HIV/STD/TB Program
   HIV Care and Treatment Program
   Oregon Housing Opportunities in Partnership Program (OHOP)

Welcome to the Oregon Housing Opportunities in Partnership Program (OHOP). This
program is designed to assist you and your family to find and maintain housing
stability. As an OHOP client you have rights and responsibilities, which ensure the
integrity of the program. Please read the following information carefully and don’t
hesitate to ask your housing coordinator if you have questions regarding this

Your rights as an OHOP client:

  • To be treated with respect, dignity, consideration and compassion.
  • To receive services free of discrimination on the basis of race, color, sex/gender,
    ethnicity, national origin, religion, age, class, sexual orientation, physical and/or
    mental ability.
  • To have access to the OHOP program policies and procedures.
  • To have the opportunity to ask questions and obtain answers related to program
  • To participate in making decisions and creating a plan for maintaining your
  • To not be subjected to physical, sexual, verbal and/or emotional abuse or
  • To be informed about additional resources available to you.
  • To withdraw your voluntary participation in the OHOP program at any time.
  • To have your personal information and OHOP records be treated confidentially.
  • To have your information released/shared with other people only with your
  • To request a reasonable accommodation as described by Section 504 of the
    Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990.
  • To file a complaint or grievance about the services or decisions made by the
    OHOP program.

CC: Case manager                                  Page 1 of 4                DHS 8434 (11/09)
                                           OHOP Client Participation Agreement
  Public Health Division
  HIV/STD/TB Program
  HIV Care and Treatment Program
  Oregon Housing Opportunities in Partnership Program (OHOP)

 Your responsibilities as an OHOP client:
 • To provide accurate, honest, comprehensive information/completed forms
   requested by your housing coordinator within the timeframe requested.
 • To notify your housing coordinator of any changes to your income or the income
   of the people who live with you within 15 days of the change.
 • To notify your housing coordinator if any member of your household leaves the
   household or if a new person comes to live with you within 15 days of the
 • To maintain current contact information, including a current mailing address,
   phone number and emergency contacts with your housing coordinator.
 • To respect the rights, property, and privacy and/or confidentiality of others and
   their right to peaceful enjoyment of their homes.
 • To comply with your housing coordinator and OHOP requirements, policies and
   procedures as detailed in the OHOP Program Policies and Procedures manual.
   This includes:
       • cooperating in the development and implementation of a Housing Stability
       • seeking and applying for other financial assistance and housing programs
          as identified (i.e. section 8)
       • maintaining regular contact with your housing coordinator
       • keeping scheduled appointments
       • informing your housing coordinator of any problems you are having that
          could affect your housing
       • asking questions when clarification is needed
 • To treat all OHOP program staff with respect and courtesy at all times. Physical
   violence or threats of violence toward staff, landlords or neighbors will result in
   termination of OHOP assistance.
 • To abstain from unlawful commission of crimes or possession of illegal drugs on
   the rental premises.
 • To assume full responsibility for the consequences of violating program rules.
 • To actively participate in Ryan White case management and to provide consent
   for the exchange of information between the OHOP program and the case
   management agency.
 • For OHBHI clients only: To actively participate in local mental health counseling
   services and comply with the individualized treatment plan developed by your
   mental health provider. To provide consent for exchange of information between
   the OHOP program and your mental health provider.
CC: Case manager                                 Page 2 of 4          DHS 8434 (11/09)
                                            OHOP Client Participation Agreement
   Public Health Division
   HIV/STD/TB Program
   HIV Care and Treatment Program
   Oregon Housing Opportunities in Partnership Program (OHOP)

The following section            Does         Does not apply to you.

If you receive long-term rental assistance through the OHOP program, you have the
following additional responsibilities as an OHOP client:

      • To locate your own rental housing. However, understand that the OHOP
        program must first authorize rental assistance to begin before payments will
      • To pay the rent and any utilities on or before the due date. If late fees do
        accrue you will be responsible for those fees. OHOP funds will pay part of
        your rent and utilities, but you are responsible to pay the remaining balance or
        seek additional assistance if you cannot.
      • To never pay a landlord, roommate, or other housing provider more than your
        portion of the rent as established by your Housing Coordinator.
      • To maintain the housing unit in good condition as required by the rental
      • To notify your Housing Coordinator of any problems that you are having with
        the landlord or rental unit.
      • To live in the rental unit as stated in the rental agreement and give the
        landlord and your Housing Coordinator required notice if you decide to move.
        If you wish to move to a new rental unit, you must request authorization
        to move from your Housing Coordinator 60 days in advance. If you leave
        your rental unit for more than 30 days, you may be terminated from OHOP.
      • To comply with all terms of the lease or rent agreement.

This document can be provided upon request in alternative formats for individuals with
disabilities. Other formats may include (but are not limited to) large print, Braille, audio
recordings, Web-based communications and other electronic formats. E-mail:
karen.l.smith@state.or.us, call 971-673-0144 (voice) or call 971-673-0372 (TTY) to
arrange for the alternative format that will work best for you.

 CC: Case manager                                 Page 3 of 4               DHS 8434 (11/09)
                                             OHOP Client Participation Agreement
    Public Health Division
    HIV/STD/TB Program
    HIV Care and Treatment Program
    Oregon Housing Opportunities in Partnership Program (OHOP)

I understand that the following actions will result in my immediate termination from the
OHOP program (please initial next to each):
         Committing fraud, bribery or any other corrupt or criminal acts in connection
         with any federal housing program. This includes lying about or misrepresenting
         information like my income or my relationship to other people that live with me.
         Leaving my OHOP-assisted unit for longer than 30 days except in cases where
         I am hospitalized or placed into residential substance abuse or mental
         health treatment.
         Moving into a new rental unit without approval from my housing coordinator.
         Threatening or abusive behavior toward OHOP staff or others people that help
         me with my housing, neighbor(s) or my landlord. This can include me making
         threats out loud or implying threats of violence even if I don’t directly say it.
         Commission by myself, any member of my household, my guests or any
         person under my control, of any violent or drug-related criminal activity that
         threatens the health, safety or right to peaceful enjoyment of the premises by
         other residents. This includes making or selling drugs illegally.
         Causing serious damage to my OHOP-assisted unit (including damage caused
         by my guest or a member of my household). This includes vandalism, arson,
         and breaking or soiling fixtures, floors, walls, windows, doors or appliances.

I have agreed to the requirements listed on all pages of this form and I understand that
it is my responsibility to ask questions that I might have regarding this agreement. I
also understand that failure to comply with this agreement may result in loss of my
housing assistance and termination from the OHOP program.

Client/OHOP participant signature                                             Date

Housing coordinator signature                                                 Date

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 CC: Case manager                                  Page 4 of 4                       DHS 8434 (11/09)