Qualified Residence Certification Forms
These forms provide guidance on the requirements of a qualified residence as defined by the Money Follows the Person Demonstration. A qualified residence certification form must be completed for all consumers who are transitioning from a long-term care facility to independent housing in the community. In addition, a copy of the applicable form must be maintained in the consumer’s case record.
Additional Resources for Qualified Residence Certification Forms
Walk Through Residential Checklist
This checklist should be completed by the consumer (with guidance from the MFP Transition Coordinator) and the landlord or manager within three days of moving in. All parties should perform a walk-through review of the property to mutually agree on its condition upon move-in by signing this document. Each party should keep a copy of the signed checklist. The Transition Coordinator should encourage the consumer and landlord or manager to use the checklist during the pre-move out inspection and again when determining if any of the tenant’s security deposit will be retained for cleaning or repairs after move-out.
Additional Resources for Walk Through Residential Checklist
Housing Search Needs and Preferences Assessment Form
This form is used to determine the housing needs and preferences for Money Follows the Person enrollees who require affordable housing in the community. This form should be completed by the Transition Entity, or the consumer’s Housing Search Entity, if applicable, and submitted to the Statewide Strategic Housing Partnership Coordinator or Regional Housing Coordinator in your region. In addition, a copy must be maintained in the consumer’s case record.