Referral Form
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Participant Eligibility Requirements
Transitional Housing, Inc. is designed to provide formerly homeless women
both with a safe environment and with the programs and services that will
direct them toward self-sufficiency and independence. A
vital part of the program is teaching financial management and
responsibility.
Women accepted into the program should have an income or skills that will
enable them to find employment. The basic Eligibility Criteria are
outlined below.
Assessment Criteria
-
Homeless single women ages 18-61
-
Homeless pregnant women ( and infants/toddlers under 24 months old)
-
Motivation and
willingness
-
Employable
-
Have an identifiable source of income
Drug
& Alcohol History
Eligible if:
Mental Health History
Eligible if:
-
Mental Health assessment within the last six months
-
Compliant with medication, verified with letter from doctor
Criminal Background History
All potential participants must bring both a Cuyahoga County and City of
Cleveland criminal background check obtained within six months of intake
date. Appropriateness for THI is determined on a case by case basis.
Criteria for Rooms Available
Transitional Housing has two types of single room units: Transitional
Units and Efficiency Rooms.
Transitional Units (16 rooms)
Participants who qualify for a Transitional Unit
(employed or
with monthly income):
-
Must have an income (SSI, employment, etc.) to cover $125.00 monthly
rent.
-
Must have employment skills and experience that would help them to
gain employment immediately.
Efficiency Rooms (45 rooms)
THI contracts with The Cuyahoga Metropolitan Housing Authority (CMHA) for 45 efficiency rooms.
Participants pay 30% of their income to CMHA toward their rent.
Participants who qualify for an Efficiency Room:
-
Must not owe CMHA any fees.
-
Must not have a substance possession or abuse charge within the past
three
years.
-
Must have employable skills and experience that would help
them gain
employment
Questions
regarding the referral process can be answered by
Leslie Henderson Burnside, Intake Coordinator
or
Sherri Brandon, Associate / Program Director
at (216) 781-2250.
Thank you!

THI Referral Process
1.
Referral Form submitted by Referring Agency
A contact person from the referring agency must complete the
THI
Referral Form
and send the form by fax to Leslie Henderson Burnside, Intake Specialist, at
(216) 781-2252.
All correspondence will be done
through THI and the referring agency's contact person, so a Release
of Information
should be obtained before the referral form is faxed to THI.
2.
THI Review for Participation in Orientation
After reviewing the referral form, Leslie Henderson sends the
referral form back to
the contact person by fax, with the response portion completed
indicating whether the client is appropriate or inappropriate for
orientation.
-
If the client is inappropriate for orientation, the reason is stated on the
response.
-
If the client is appropriate for orientation, the client will
be scheduled for an orientation. The date and time of orientation for
which the
client has been scheduled will appear on the response. Please note
that orientation is held twice a month, generally the second and
fourth Wednesdays from 2:00 to 4:00 pm.
3. Client
Attends Scheduled Orientation & Intake
Orientation, including
a tour, generally takes about 90 minutes. Following Orientation, Intake
is conducted by one of THI’s Program Advisors. This usually lasts not
more than 30 minutes.
The client should bring the
following documents with them to the Orientation session:
-
Birth certificate
-
Photo ID
(driver's license or State of Ohio ID)
-
Social Security card or letter from Social Security office
-
Police background check
(City of Cleveland and Cuyahoga County)
-
Proof of income
-
Substance Abuse Assessment
(when applicable)
-
Mental Health Assessment
(when applicable)
-
TB test results
(no more than six months old)
-
Verification of homelessness on referring agency letterhead stating
length of and reason for homelessness
-
CMHA documentation showing no
outstanding balances (when applicable)
Clients must be informed by the contact
person at the referring agency that a drug screen may be given at
orientation.
-
If the client fails the drug screen she is unable to continue
with the referral process, and may reapply in six months.
-
If the client passes the drug screen, the Intake is completed.
4. Determination
of Appropriateness for Assessment
After Intake, the referring agency contact person is called.
-
If the client is inappropriate for an assessment, the reasons
an assessment is not being scheduled with the client are discussed.
Possible reasons
for this are missing two scheduled appointments and/or being unprepared
for the intake by not having all necessary documents. If the client is
determined to be
ineligible for an assessment, the client may reapply for THI in six
months.
-
If the client is appropriate for an assessment, the Program
Advisor contacts the referring
agency case worker or counselor to schedule an assessment with the
potential participant.
5. Case
Review by THI Staff
Once the assessment is complete, the client’s case is presented to
all Program Advisors
during a case review. At this time, it is decided by all
Program
Advisors if a client is eligible for THI.
-
If a client is found to be ineligible, a letter is sent to
her through the referring agency contact
person stating why she was determined ineligible. The client may
reapply for
THI in six months.
-
If the client is found to be eligible, she is placed on
the waiting list. A letter
is
sent to the client through the referring agency contact person
welcoming her into the program and explaining the waiting list
process.
Referral Form
Click
here for a Referral Form
(388kB PDF)
that you can print from your browser, complete, and send to us by fax.
|
To
download this file, you'll need the free Adobe Acrobat
Reader, available for download by clicking the Adobe logo. |
 |
