DES COMMUNITY NAVIGATION PARTNER PROGRAM APPLICATION.PDF
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DES Community Navigation Partner Program Organization User Application for Access to Housing Stability and Utility Assistance Portal Please identify all of the individuals for whom you are requesting Housing Stability and Utility Assistance Portal user account access, including: • Employees of your organization • Employees of organizations you contract with to provide application assistance at your facilities • Volunteers Each person you list on this form must also complete and sign an Individual User Application. 1. ORGANIZATION INFORMATION 2. PERSON COMPLETING THIS REQUEST First Name Last Name Title Office Telephone (include Extension) E-Mail Address 3. DES COMMUNITY NAVIGATION PORTAL USERS I am requesting that the person(s) listed below be added/removed as a user in conjunction with this organization’s Community Partner Agreement. First and Last Name Work Address Phone Number Email Employee, Contractor or Volunteer? Add or Remove? Joan Smith 1234 W Main St. Phx. AZ. 85007 602-123-4567 Example.Example@Example. com Employee Add State of Arizona Page 1 of 3 Name of Community Partner Organization SECURITY REQUIREMENTS FOR USERS OF THE STATE OF ARIZONA DES HOUSING STABILITY AND UTILITY ASSISTANCE PORTAL The Housing Stability and Utility Assistance Portal contains sensitive information to carry out its mission. Sensitive information is any information, which the loss, misuse, or unauthorized access to, or modification of could adversely affect the privacy to which individuals are entitled. The State of Arizona records all access to its computer systems and conducts routine reviews for unauthorized access to and/or illegal activity. Anyone with access to the Housing Stability and Utility Assistance Portal must abide by the following requirements: • Do not disclose or lend your user name / password to someone else. They are for your use only and serve as your electronic signature. This means that you may be held responsible for the consequences of unauthorized or illegal transactions. • Do not browse or use Arizona data files for unauthorized or illegal purposes. • Do not use Arizona data files for private gain or to misrepresent yourself or Arizona. • Do not make any disclosure of Arizona data that is not specifically authorized. • Do not duplicate Arizona data files, create sub-files of such records, remove or transmit data unless you have been specifically authorized to do so. • Do not change, delete, or otherwise alter Arizona data files unless you have been specifically authorized to do so. • Do not make copies of data files, with identifiable data, or data that would allow individual identities to be deduced unless you have been specifically authorized to do so. • Do not intentionally cause corruption or disruption of Arizona data files. • Complete all required Housing Stability and Utility Assistance Portal trainings. A violation of these security requirements could result in termination of systems access privileges. In addition, Federal, State, and/or local laws may provide criminal penalties for any person illegally accessing or using a Government-owned/operated computer system illegally. If you become aware of any violation of these security requirements or suspect that your user name / password may have been used by someone else, immediately report that information. State of Arizona Page 2 of 3 DES Community Navigation Partner Program Organization User Application for Access to Housing Stability and Utility Assistance Portal Printed Name Signature After signing the form, you will be asked to save a copy for your records. Once saved, please submit the form to: kwilde@azdes.gov DES Community Navigation Partner Program Organization User Application for Access to Housing Stability and Utility Assistance Portal ORGANIZATION’S RESPONSIBILTY FOR USERS Your DES Community Navigation Partner Program organization is responsible for and assumes all liability for each user’s use of the State of Arizona DES Housing Stability and Utility Assistance Portal. SIGNATURE By signing this form on behalf of my organization, I am declaring that I have read and understand the requirements related the use of the State of Arizona DES Housing Stability and Utility Assistance Portal and penalties for violations of these requirements. I declare that the information I provided in this document is correct. I understand that in the future I must submit this document to request any changes in the persons for whom I am requesting access to Housing Stability and Utility Assistance Portal under my organization’s agreement. State of Arizona Page 3 of 3 Community Navigation Workflow DES First Contact (Online Portal) CAA First Contact Crisis / Vulnerable Individuals On-going Supports and Case Management Information and Referral Assessment and Navigation Support Application Submission and Eligibility Determination Payment Confirmation Individual calls/comes to CAA for general help Application Submission: Individual completes application in portal. Information and Referral: Identify, discuss and referral to other resources are needed Individual applies for LIHEAP/ERAP/ LIHWAP via DES portal (First POC) Needs Assessment: Determine and the needs of the unique client, or "gaps" between current conditions and a state of self-sufficiency and safety. Application Receipt: DES receives application and begins eligibility determination Individual comes to CAA to apply for LIHEAP/ERAP/LIHWAP Triage: Does the individual have immediate/urgent need for rental, utility, water assistance? Independence Assessment: Is the individual interested in and able to access DES services independently? Strategic Service Mapping: Develop a roadmap of programs to apply to for assistance that match their unique needs Navigation: Help individual understand, navigate, and access a broad array of programs, either by connecting individuals to tools (online application portals/ phone) or by providing direct assistance with the application (assisted app intake). Case Management: Help the client continue on their path to self- sufficiency and safety by providing a cadence of follow-up evaluation, assessment and transition, mapping, and programmatic re-engagement, as necessary. Perform Follow-up Evaluation Does the individual need to be re- assessed? No No Yes Portal Triage: Does the individual indicate immediate/urgent need for rental, utility, water assistance in application? Assistance Referral to CAA: Does the individual indicate need for application assistance? Yes No Crisis Referral to CAA: Identify individual’s nearest CAA and referral for immediate crisis support. Yes Application Submission: CAA Navigator completes application on behalf of individual in portal. No Priority Application Assessment: Does application indicate 1.) a life-threatening situation or 2.) a potential shutoff/other crisis situation? Priority Determination 1: Due to a life-threatening crisis, the application is processed within 18 hours. Standard Determination: Application is processed within 3 business days. Application Approved? Send Denial Notice No Payment: Payment made to vendor, landlord, or individual applicant. Does the individual require training or coaching? Payment Process Finalized Vendor Communication (Payment) DES contacts vendor to confirm payment was received and ensure utility was reconnected, if applicable. Case Management Assessment: Does the individual have additional needs that are best addressed with on-going case management ? Navigation Support Finalized No Yes No Assist Individual by Setting-up Training/ Coaching Sessions and Refer for Future Case Management Set-up Future Case Management Sessions Yes No Yes Yes Priority Determination 2: Due to potential utility shutoff or other crisis situation, application is processed in 48 hours. Vendor Communication (Crisis) DES contacts vendor to ensure utilities are not disconnected and requests additional 5 days of service to process application. Yes No Refer to Weatherization as needed