Instructions: Applicants taking points on the Self-Scoring Worksheet for setting aside units for people with disabilities (PWD)1 must complete this narrative and must also submit a signed Service Agreement. This document may serve as the initial Service Agreement between the owner and the county or tribal human services entity for the housing and services plan for people with disabilities when signed by both parties, or the applicant can submit a separate signed Service Agreement. 

Applicants must work with the county or tribal human services department in the jurisdiction where the property will be located to determine the population to be served and to develop a plan for providing outreach, referrals, and services. The plan should be driven by the human services department. Using Housing Support that requires long-term homelessness (LTH) eligibility is not recommended for PWD units unless that is a priority population determined by the human services department. Note that there is a different PWD narrative for Section 811 PRA units.

Applicants are expected to contact the county or tribal human services entity early in the planning process, but no later than 30 days prior to the application due date, to discuss supportive housing needs for people with disabilities in the community and develop an appropriate plan to address the needs. The applicant should coordinate a request for Housing Support with the human services agency at the same time (when applicable). 

Refer to Chapter 12 in the Supportive Housing Information and Resources document for more information about creating units for people with disabilities. 

Development Information	
Development Name	     	
Development Location	     	
Applicant/Developer/Company Name	     	
Applicant Contact Person Name and Email 	     /     	
County or Tribal Nation 	     	
County or Tribal Nation Representative Name	     	
Title	     	
Department	      	
Phone Number and Email	     /     	

Housing Units 
1.	Enter the housing unit distribution for this property.
Total number of units at the property	     	
Number of units that will be set aside and rented to people with disabilities (PWD units)	     	
Number of high priority homeless (HPH) or supportive housing (SH) units that will be set aside and rented to people who are homeless (not including the units set aside for people with disabilities noted above)	
     	

2.	PWD Unit Types and Rents: The income limit for the units must be restricted to 30% MTSP. Enter the number of unit types that will be set aside and rented to people with disabilities. Indicate the type of rental subsidy secured or proposed. The unit type and number of units must match the Multifamily Workbook and the Self-Scoring Worksheet.
Unit Size	Number of Units	Subsidy Type and Source	Committed	
			Yes (Documentation Provided)	No	Application Pending	
0-BR units	     	     				
1-BR units	     	     				
2-BR units	     	     				
3-BR or more	     	     				
NOTE: Subsidy Type could include project-based Section 8 rental assistance, *Housing Support – regular or LTH, or **Minnesota Supplemental Aid (MSA) Housing Assistance. If no subsidy is available, rent levels must be underwritten to the current supportive housing standards outlined in the Multifamily Underwriting Standards and must be financially feasible.
*If using Housing Support that requires LTH eligibility, note LTH Housing Support as the Subsidy Type and Source. 
**MSA Housing Assistance does not work like a subsidy but is a benefit that a person receiving Supplemental Security Income (SSI) may qualify for. It is an income supplement that provides additional income to pay for housing costs.

Partnership
PWD units are intended to serve low-income people with disabilities who are not homeless and who receive, or are eligible to receive, mainstream services through the county or tribal human services. Each county or tribe may provide the services directly or they may contract with local providers to provide the service(s).

3.	Describe the collaboration between the applicant/owner and county or tribal human services department to create these affordable housing units to address the needs of people with disabilities in the community.
     

4.	The county or tribal human services department may choose to be the service provider or may designate a specific service provider(s), a type of contracted service provider (e.g., TCM, ARMHS, Waiver, Housing Stabilization) and/or funding source(s) to provide the services for the population. Identify the proposed plan for a service provider and funding source(s).
 	County or tribal human services department. Name of department(s) and funding source(s):      
 	Designated service provider. Name of provider and funding source(s):      
 	County contracted service provider (e.g., TCM, ARMHS, Waiver, Housing Stabilization) or dedicated funding source. 
Describe the service type(s) and funding source(s):      

5.	If the county or tribal human services department will be the primary service provider or use a contracted service provider, describe how the owner/property management and the county or tribal human services department will regularly communicate and coordinate to lease open units, address tenant needs, and solve problems.
     

Population Served, Outreach and Referral (to be completed by the county or tribal human services department)
6.	Describe the proposed population that will be served, including the specific type(s) of disability (individuals living with a severe mental illness, substance use disorder, brain injury, developmental or physical disability [not limited to mobility impairments]). NOTE: If the proposed population is people living with physical disabilities, the property must meet the accessibility requirements described on the Housing Tax Credit (HTC) Self-Scoring Worksheet if PWD is the only minimum threshold criteria that the project meets. 
     

7.	Describe the referral process and referral source(s) when a unit is available for leasing.  Will the population served be referred from a specific institutional2 setting type, Coordinated Entry) or from another source(s)?      

8.	Describe how outreach will be conducted to the proposed population.
     

Services
9.	NOTE: If the development is using a designated service provider for the PWD units and will also have homeless or High-Priority Homeless (HPH) units, the staffing and service funding must also be included on the Supportive Housing Narrative on the service staffing table. Describe the types of services that will be available to address the needs of tenants to maintain housing stability and what entity will provide the services.
     

10.	If the services will be provided by a designated service provider, describe the staffing level (weekly hours per household).
     

11.	Describe how the property manager and service provider will work together to provide crisis intervention, eviction prevention, and address and mitigate lease infractions.
     

Tenant Screening and Occupancy
Each property funded through Minnesota Housing’s Consolidated RFP is required to follow Minnesota Housing’s Tenant Selection Plan (TSP) Guidelines. There are new requirements for tenant screening for supportive housing units. Supportive housing units are intended to house people who often have poor credit, poor rental histories, criminal histories, or other barriers. Supportive housing is successful in serving the people for whom it is designed only when these issues do not raise insurmountable barriers to accessing housing. 

12.	The applicant acknowledges that the project’s TSP will comply with Minnesota Housing’s TSP Guidelines.
Yes    No 

13.	Indicate occupancy conditions for the units.
a.	Will the tenants have their own apartment with a private bathroom and kitchen? 	
Yes 	  No  
If no, provide an explanation:      
b.	Will the tenants hold a lease or rental agreement?	Yes    No 
	If no, provide an explanation:      
c.	Will there be limitations on the length of stay?	Yes    No 
	If yes, provide an explanation:      
d.	Will there be any specific occupancy requirements for PWD units beyond standard lease terms 
	(e.g., sobriety, participation in services, curfew)?	Yes    No 
If yes, describe the requirements and the rationale:      
1 Disability for People with Disabilities unit is defined as:
1.	A serious and persistent mental illness as defined in Minn. Stat. § 245.462, subdivision 20, paragraph (c)
2.	A developmental disability as defined in United States Code, Title 42, Section 6001, paragraph (5), as amended
3.	Assessed as drug dependent as defined in Minn. Stat. § 254A.02, subdivision 5, and are receiving or will receive care and treatment services provided by an approved treatment program as defined in Minn. Stat. § 254A.02, subdivision 2
4.	A brain injury as defined in Minn. Stat. § 256B.093, subdivision 4, paragraph (a)
5.	Permanent physical disabilities that substantially limit major life activities

2Institutional settings include Intermediate Care Facilities for Developmental Disabilities (ICF-DDs), nursing facilities, the Minnesota Specialty Health System facility in Cambridge, the Anoka Metro Regional Treatment Center, the Minnesota Security Hospital, and licensed residential treatment facilities for mental illness or chemical dependency. This may also include people with disabilities who are exiting state correctional facilities, including juvenile facilities, or “potentially” segregated residential settings, which may include the following:
i.	
i.	Adult foster care
ii.	Assisted living residence (customized living service) 
iii.	Board and lodge (includes homeless shelters) 
iv.	Board and lodge with special services 
v.	Boarding care 
vi.	Child foster care 
vii.	Children’s residential care (children’s residential facilities- Rule 5)
viii.	Crisis respite (foster care)
ix.	Housing with services establishment
x.	Supervised living facilities
xi.	Supported living services

Signatures 
The owner and the county or tribal human services department agree to provide the housing and services outlined in this narrative for people with disabilities for the units set aside in this development. If the owner is selected for funding, the parties may wish to enter into a more formal agreement. The final agreement must be submitted to Minnesota Housing prior to closing.

Owner:

     		     	
Name of Organization		Signature 	
			
     	     	     	
Authorized Signatory	Title of Authorized Signatory	Date 	

The signature of the human services entity is necessary if the parties intend to use this narrative as the Service Agreement for the housing and services plan for people with disabilities. A Service Agreement is required for the application, but the owner and service entity may elect to use their own document.

County or Tribal Human Services Entity:

     		     	
Name of County/Tribal Nation		Signature 	
			
     	     	     	
Authorized Signatory	Title of Authorized Signatory	Date