King County Housing Authority
600 Andover Park W.
Tukwila, WA 98188
206-574-1100
Fax: 206-574-1350

NOTICE TO APPLICANTS/PARTICIPANTS WITH DISABILITIES REGARDING

REASONABLE ACCOMMODATION

The King County Housing Authority (KCHA) is committed to providing accommodations to persons with disabilities to help ensure that their living arrangements are comparable to those of other public housing applicants and residents. Reasonable accommodations for public housing applicants/residents must be reasonable, meaning they cannot cause either undue financial or administrative burden, or a fundamental alteration in the nature of KCHA’s programs.

Reasonable accommodation requests may be made in any manner that is convenient, including written or verbal, to any property manager/housing assistant or resident services coordinator. Although not required, requests made in writing will simplify processing and help avoid misunderstandings.  KCHA’s request for accommodation forms are designed to assist applicants and residents. If you do not wish to, or cannot use, the attached forms, KCHA will still respond to your request for a reasonable accommodation.

Requests for reasonable accommodations will be considered on a case-by-case basis because people with the same disability may not need or desire the same level of accommodation.

If you make a reasonable accommodation request, KCHA may request reliable documentation (not medical records) that you have a disability and verification of the need for the particular accommodation(s). KCHA will not ask questions about the nature or severity of the disability except as specifically related to the requested accommodation. The type of verification you will need to provide depends on the specifics of the situation.  The verification may be provided by any third party provider familiar with your disability on forms that the Housing Authority provides or in a separate note/letter.  A signed release of information may be helpful in clarifying needs with your provider, but such a release is not required.

You may request assistance with completing the attached forms or ask that the forms be provided in an equally effective format or means of communication, such as:

• Qualified interpreters           ▪  Use of Telecommunications Relay Services          ▪  Large print materials           
• Qualified readers             ▪  Taped text audio recording                  ▪  Braille materials       ▪  TTY

While most decisions are made in less time, we will make every effort to render a decision within forty-five (45) calendar days.

If you have any questions or require additional information on the reasonable accommodation process or procedures, you may contact the KCHA Section 504 Coordinator by calling (206) 574-1351 or (800) 833-6388 TTY number.

These forms and reasonable accommodation information can also be found at http://www.kcha.org/currentresidents/sh_reasonable.aspx

If you choose to complete these forms, please return these forms to your property management office or mail to 600 Andover Park W, c/o Reasonable Accommodations, Seattle, WA 98188.

Request For A Reasonable Accommodation

 Please check one:                 ___ Public Housing Applicant        ___ Public Housing Resident         

Name:__________________________________________ Phone/Cell: _______________________________

Address: __________________________________________________________________________________

• The following member of my household has a disability as defined below: (A physical or mental impairment that substantially limits one or more major life activities; a record of having such an impairment; or being regarded as having such an impairment.)

                                    Name: ______________________________________________________

                                    Date of Birth: ________________________________________________

• As a result of his/her disability, the following changes are requested so that the person listed can reside in their unit here as easily or successfully as other program participants.  Check the kinds of change(s) you need.

                                    [  ]        I request a fully modified, wheelchair accessible unit, including a roll in shower, 5 foot wheelchair turning radius, and lowered counters/switches.

                                    [  ]        I do not request a fully modified unit, but require other modifications to my unit as listed below.  Please be specific.

                                    [  ]        I need other changes to my housing as specified below.

• I need this reasonable accommodation so that I can: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
  __________________________________________________________________________________________________________________________________________________________
• You may verify that I have a disability and my need for this request by contacting: (This is the name of the third party professional familiar with your disability)
  

                                    Provider Name: ______________________________________________

                                    Address: ____________________________________________________

                                    Phone: _____________________________________________________

I give you permission to contact the above individual for purposes of verifying that I or a family member has a disability and needs the reasonable accommodation requested above.  I understand that the information you obtain will be kept completely confidential and used solely to determine if you will provide an accommodation.  This should be signed below by either the member of the household with a disability or the head of household if household member with a disability is a minor.

Signed:                       
Date:

King County Housing Authority

Board of Commissioners
Nancy Holland-Young, Chair
Delores Brown, Vice Chair
Michael Brown
Doreen Marchione
Peter Orser

Executive Director: Stephen Norman

Dear:

Enclosed is a form signed by __________________________________ asking you to verify his or her disability and need for a reasonable accommodation in his or her current housing.

The person named above is an applicant for either admission to, or continued occupancy in, our King County Housing Authority Public Housing program.  They have indicated that they or a family member have a disability that requires an accommodation.  Please note that such changes must be necessary as a result of the person’s disability as opposed to a change that merely benefits the individual.

Federal laws require public housing providers to make changes to rules, policies and procedures, as a reasonable accommodation, if such changes are necessary to enable a person with a disability to have equal access to, and enjoyment of, their apartment.

Please specify on the enclosed Verification of Need form the accommodation that you recommend for the above-named person.  Also indicate whether you believe the individual has a disability with the definition provided and that the accommodation is necessary and will achieve its stated purpose.  You may also add or provide additional information that would be helpful in making the appropriate accommodation for this person. 

This form should not be used to discuss the person’s specific disability or diagnosis or any other information that is not directly relevant to the request for an accommodation; however, it is important to be as specific as possible about this individual’s housing needs as they relate to their disability so that we may provide the most appropriate response.

Please note that the applicant/resident has signed a Release of Information requesting that you provide information and answer the questions.  If you have any questions feel free to contact me at (206) 574-1351.

Sincerely,

Ron Ovadenko

Section 504 Coordinator

VERIFICATION OF NEED FORM – This form must be completed by a qualified professional whose function is to provide services to the below-named person with a disability.  It is important to be as clear as possible about what is being requested to help us provide the most appropriate response.

The King County Housing Authority (KCHA) applicant/resident named below has applied for a reasonable accommodation and is requesting that you, as his/her provider, fill out the following certification. Page 2 is a copy of the Request for Reasonable Accommodation Form completed by the resident/applicant with his/her signature for release of information.

Individual Member of Household with disability requesting accommodation (from page2):

• Please describe any reasonable accommodation needs that are medically necessary as a result of his/her disability in order for him/her to enjoy an equal housing opportunity (for example: 24-hour live-in-aide with overnight support with activities of daily living (ADLs), additional bedrooms, etc.): Feel free to provide additional documentation if needed.

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________

In my opinion, the named person has a disability as defined below:

1. A physical or mental impairment which substantially limits one or more of this person's major life activities; ___ YES ___ NO

2. A record of having such an impairment; or ___ YES ___ NO

3. Is regarded as having such an impairment (does not include current, illegal use of or addiction to a controlled substance as defined in section 102 of the Controlled Substance Act, 21 U.S.C. 802).
___ YES ___ NO

________________________________________
PRINT NAME

________________________________________
SIGNATURE

________________________________________
DATE

________________________________________
Title of Physician/Professional

________________________________________
Street Address

________________________________________
Telephone/Fax

________________________________________
Agency

________________________________________
City

________________________________________
State

________________________________________
Zip Code

Definition of Live-in Aides (24 CFR Section 5.403): a person who resides with one or more elderly persons, near elderly persons or persons with disabilities and who is 1) determined to be essential to the care and well-being of the persons, 2) is not obligated for the support of the persons, and 3) would not be living in the unit except to provide the necessary supportive services.  The live-in aide must be identified by the family and approved by the Housing Authority.
Occasional, intermittent, multiple, or rotating care givers do not meet the definition of a live-in aide since 24 CFR Section 982.402(7) implies live-in aides must reside with the family permanently for the family unit size to be adjusted in accordance with the subsidy standards established by the PHA.  Therefore, regardless of whether these care givers spend the night, an additional bedroom should not be approved.