2026_07_01_WashCoDHSProgramManual.pdf

Washington County

Department of Housing Services

Homeless Program Manual

Updated July 1, 2026

Table of Contents

I. INTRODUCTION

II. GUIDING PRINCIPLES

A. Housing First

B. Harm Reduction

C. Trauma-Informed Care

D. Progressive Engagement

E. Centering Racial Equity

III. OVERARCHING PROGRAM EXPECTATIONS

A. System Coordination and Collaboration

B. Community Connect System Participation

C. Homeless Management Information System (HMIS) Participation

D. Ethical Standards

E. Equal Access and Non-Discrimination

F. Compliance with VAWA

G. Requirements for Services Sites

H. Reasonable Accommodations and Accessibility

I. Service and Emotional Support Animals

J. Health, Safety, and Incident Reports

K. Personnel

L. Customer Service

M. Due Diligence for Program Engagement

N. Grievance Policy

O. Termination Policy

IV. HOMELESSNESS DEFINITIONS AND HOUSEHOLD COMPOSITION

A. HUD Definitions of Homelessness

B. Washington County DHS Supportive Housing Services Definitions

C. Program Standards and Program Eligibility

D. Eligible Expenses

V. HOUSING RESOLUTION FUND

A. Rehousing assistance

B. Move-in only

C. Homelessness Prevention

D. Payment information

VI. STREET OUTREACH

A. Street Outreach Access

B. Street Outreach Availability of Services & Program Coordination

C. Street Outreach Services

D. Street Outreach Exits

E. Street Outreach Data Entry Requirements

VII. ACCESS CENTERS

A. Access and Availability of Services

B. Access Center Services

C. Access Center Participation Guidelines

D. Access Center Exits and Exclusions

E. Data Entry Requirements

VIII. INCLEMENT WEATHER RESPONSE

A. IWS Activation and Deactivation Standards

B. Core Components of IWS

C. IWS Expectations

IX. EMERGENCY SHELTER

A. Eligibility

B. Shelter Access

C. Length of Stay

D. Participant Guidelines and Agreements

E. Shelter House Rules

F. Shelter Exits and Exclusions

G. Core Components of Shelter

H. Shelter Data Entry Requirements

X. TRANSITIONAL HOUSING

A. Eligibility

B. Access

C. Length of Stay

D. Participant Guidelines and Agreements

E. House Rules

F. Shelter Exits and Exclusions

G. Core Components

H. Transitional Housing Data Entry Requirements

XI. HOUSING AND SHELTER LIAISON SERVICES

A. Housing Liaison Partnership Agreement Requirements

B. Liaison Services Referrals and Enrollment

C. Liaison Services Length of Available Programming

D. Housing Liaison Case Conferencing and Housing Stability Plan

E. Liaison Supportive Services and Activities

F. Liaison Exits

G. Liaison Data Entry Requirements

XII. HOUSING PROGRAMS OVERVIEW

A. Housing Program Access and Referral

B. Program Eligibility

C. Individualized Case Management Plan (ICMP)

D. Program and Intervention Transfers

XIII. RAPID REHOUSING

A. Eligibility

B. Length of Programming

C. Core Services

D. RRH Data Entry Requirements

XIV. HOUSING CASE MANAGEMENT SERVICES

A. Eligibility

B. Core Services

C. HCMS Data Entry Requirements

XV. PERMANENT SUPPORTIVE HOUSING

A. Eligibility

B. Core Services

C. Memorandum of Understanding (MOU) Requirements

D. PSH Data Entry Requirements

XVI. MEDICAL RESPITE

A. Eligibility, Referrals, and Enrollment

B. Medical Respite MOU Requirements

C. Core Services

D. Exits from Medical Respite

E. Staffing

XVII. GLOSSARY

I. INTRODUCTION

This Program Manual (hereinafter referred to as the “Manual”) sets out the Washington County

Department of Housing Services’ (DHS) guiding principles for work on ending homelessness in

Washington County, as well as the overarching and program specific standards and requirements for each type of DHS-funded program that serves people experiencing homelessness (DHS programs). All DHS programs are expected to operate as part of the homelessness response system in Washington County to support a coordinated and supportive approach to homelessness response in the community.

This manual summarizes and refers to certain applicable laws and legal obligations of providers.

Providers must be familiar with these laws, stay up to date on amendments and changes and be sure that their policies and procedures reflect all applicable aspects accurately, whether covered in this manual or not.

DHS will produce bi-annual updates to the Manual and providers are invited to raise suggestions or concerns about the content of the Manual with DHS staff.

II. GUIDING PRINCIPLES

All providers operating DHS programs are expected to adopt policies and practices that align with these Guiding Principles that help inform our work. Although Guiding Principles are the underlying principles that guide our system, DHS providers must apply these effectively while bringing their expertise to the work to achieve the fundamental objective of addressing homelessness and achieving housing stability.

A. Housing First

All DHS programs are required to adopt Housing First principles that are adapted to their program types. Housing First is a homeless assistance approach that prioritizes providing permanent housing to people experiencing homelessness, thus ending their homelessness.

Permanent housing is recognized as the best platform from which to pursue personal goals and improve quality of life. This approach is guided by the understanding that people are more able to make changes and achieve outcomes such as getting a job, following a budget or addressing substance use issues when their basic needs for food and a place to live are met.

Additionally, Housing First1 recognizes that client choice is crucial in housing selection and supportive service participation; exercising choice is likely to make a client more successful in permanently ending their homelessness.

All programs must adhere to the following principles to meet Housing First standards:

1. Low Barrier: Low barrier programs reflect a commitment to minimize, to the greatest extent possible, the requirements for entry into and continued participation in programming. This includes not unnecessarily screening people out based on past behaviors, not requiring sobriety or participation in treatment, and not requiring employment or income to receive assistance. Each program type will have distinct ways of reducing barriers to programming. In implementing a low barrier approach, programs should not add unnecessary eligibility criteria beyond funding requirements that may keep people from participating.

2. Person-Centered Services: Programs are expected to offer tailored and voluntary services to participants while they are in the program. Participation in services should be encouraged rather than mandated as a program condition whenever possible. Some program models, such as Rapid Rehousing and Emergency Shelter, may require participants to engage in a minimum level of case management services or have and follow a housing plan. However, even in these programs, there is not a required set of additional services that a person must participate in to remain in the program.

1 “Housing First,” National Alliance to End Homelessness online. 2022.

https://endhomelessness.org/resource /housing-first/. (Last Accessed April 2, 2024) https://endhomelessness.org/resource%20/housing-first/

3. Crisis Response: Homelessness is a significant crisis, and the longer it continues the greater the negative consequences. DHS programs must be designed to resolve a participant’s homelessness as quickly as possible. Programs must also recognize the range of psychological and neurological impacts the crisis of homelessness may have on participants. The excessive physical and emotional stress of homelessness can affect participants’ ability to make, remember, or carry out plans; shift their behaviors in response to new information; and alter their emotional responses. Programs must accommodate for these crisis impacts and be responsive to participants’ needs while working to quickly resolve their homelessness.

B. Harm Reduction

As part of the low-barrier Housing First approach to DHS programs, all programs must emphasize a harm reduction approach in service delivery, and when not foundational to the intervention type or a funding requirement, may not require participation in treatment or sobriety as a precondition to programming. Programs must seek to work with participants to reduce any negative consequences of their continued use of alcohol and/or drugs, non-compliance with medications, or other challenges. Whenever possible, programs must not terminate assistance based solely on a person’s inability to achieve sobriety or due to medication non-compliance. Efforts should include encouraging and supporting participants to reduce risky behaviors, while also assisting them to move into and stabilize in permanent housing.

C. Trauma-Informed Care

All DHS programs must incorporate trauma-informed care policies, procedures, and practices into their program design and delivery of services. Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual wellbeing.2 Trauma-informed care recognizes the frequency and impact of trauma and utilizes this lens for system and service design and delivery. The principles of trauma-informed care include: (1) ensuring physical and emotional safety for participants; (2) making decisions with participants and power- sharing; (3) ensuring participants have choice and control; (4) establishing trust through transparency; (5) including people with lived experience to promote safety, healing, trust, and collaboration; and

(6) ensuring services respond to the effects of systemic oppressions based on race, gender, disability, and other marginalized identities. Trauma-informed services create a culture of nonviolence, learning, and collaboration. Programs must develop and implement policies for

2 SAMHSA’s Trauma and Justice Strategic Initiative (2014) Substance Abuse and Mental Health Services Administration, https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4884.pdf. (Last Accessed April 2, 2024) https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4884.pdf training all staff on the effects of trauma and trauma-informed care practices.

D. Progressive Engagement

All DHS programs are intended to be participant-driven and tailored to each household’s needs.

Programs should not provide standard service packages that all participants receive regardless of their unique needs. Programs must apply progressive engagement approaches to their service delivery, providing individualized care plans and offering only as much assistance as each household needs for as long as is needed to help the household obtain and maintain stable housing. Progressive engagement seeks to maximize the household’s self-efficacy. By offering only the level of services needed to each household, progressive engagement also enables more households to be assisted with limited funds. Progressive engagement is flexible and can increase support when setbacks or new problems occur. Programs must regularly assess the service and financial needs of participating households when implementing progressive engagement in their programming.

E. Centering Racial Equity

To effectively address homelessness, DHS programs must acknowledge and address through their work the continuing role that structural, institutional, and individual racism plays in causing homelessness among Black, Indigenous, Latino/a/e, Asian, Pacific Islander, immigrant, and refugee communities, many of which are significantly over- represented in Washington

County’s homeless population. Eliminating racial and ethnic disparities requires that resources be targeted, and services be delivered in a manner that addresses these disparities. Individual organizations and the system of care must be accountable for providing equitable access to services and achieving equitable outcomes. To further the goal of achieving equity in all of

Washington County’s DHS programs, each program will be monitored for racial and ethnic disparities in access and outcomes and asked to develop an equity improvement plan as needed.

Culturally Specific Services

All DHS programs are expected to deliver services in a culturally responsive manner. Cultural responsiveness requires having cultural competency, meaning having the ability to relate respectfully to people from your own and other cultures. Culturally responsive services are affirming of and relevant to the beliefs, practices, culture, and language needs of diverse participant populations and communities. Programs may demonstrate cultural responsiveness by hiring diverse staff, providing language access, and/or culturally specific programming within a dominant culture organization.

Culturally Responsive Services

Many programs are also expected to deliver culturally specific services, as stipulated in their contract with DHS. Culturally specific services are community-based services that include culturally relevant and linguistically specific services and resources for culturally specific communities. They use language, structures, and settings familiar to the culture of the target population to ensure that services are delivered in an environment of belonging and safety for members of that community. It is important to note that any participant who meets programming eligibility can and should be served regardless of cultural background even in culturally specific services. Culturally specific service providers may target programming to specific populations but cannot exclude others from services.

III. OVERARCHING PROGRAM EXPECTATIONS

A. System Coordination and Collaboration

Washington County aims to build a countywide system of care to address and prevent homelessness through an integrated network of services and support. All DHS providers are expected to:

• Partner with other providers and organizations as appropriate to create service alignment and coordination.

• Contribute to and participate in systemwide meetings and collaborative activities as appropriate.

• Participate in coordinated system planning and implementation.

• Develop and maintain relationships with providers and programs that provide complementary services to facilitate effective referrals and service connections. This includes but is not limited to culturally specific, domestic violence, and peer support services, physical health, behavioral health, and substance use disorder services, education, legal and employment services, and benefits navigation.

B. Community Connect System Participation

Washington County DHS, along with the Washington County Continuum of Care (CoC), has established a “Coordinated Entry System” called Community Connect. The purpose of

Community Connect is to match all households experiencing homelessness in need of stable housing to the most appropriate services available based on their unique resources and needs.

This system was adopted in 2013 as a response to the U.S. Department of Housing and

Urban Development’s (HUD) requirement that all communities receiving federal homelessness funding establish a system that will ensure that all persons seeking housing assistance have equitable access to limited local resources.

Through Community Connect people experiencing homelessness enter a coordinated system of care, where eligibility for resources is assessed, and referrals for housing and services are made.

The Community Connect system uses phased assessments to help determine programming referrals and inform service provision for participants referred to services. All Washington

County Community Connect access points utilize the same processes and assessments to ensure consistency throughout the county.

All DHS providers are required to participate in Community Connect in some capacity unless otherwise noted in their contracts. All participating programs serve as access points for the

Community Connect system. Participating housing providers also receive referrals through the system. Providers must meet the following requirements unless they are exempt from participation:

• Comply with all applicable procedures in the approved Washington

County Community Connect Procedures.

• Participate in Community Connect case conferencing and coordination activities as requested by Washington County DHS.

• Ensure all staff directly participating in Community Connect are trained in the use of the system, starting with the Community Connect Overview.

Providers that accept referrals and/or matches from Community Connect must do so in accordance with the guidance and policies set forth by the County. More information about the

Community Connect system can be found in the Community Connect Policy. Specific information for how each program type participates in the system and utilizes Community

Connect phased assessments is included in those sections of this Manual.

C. Homeless Management Information System (HMIS) Participation

To provide well-coordinated support for households and manage the limited resources available in the County, DHS providers must utilize the Portland Metropolitan Area (PMA)

Homeless Management Information System (HMIS) to track participant-level data. The PMA

HMIS serves as an administrative entity that governs HMIS for a multi-agency CoC including

Clackamas, Multnomah, and Washington Counties. If a program is exempt from participation in

HMIS for reasons of participant safety and confidentiality3, the provider must use the Portland

Metropolitan Area (PMA) approved comparable database, also available through the PMA

HMIS, to report on all required data.

All providers utilizing HMIS must meet the following requirements:

• Review and sign all relevant HMIS User Policy and Procedures forms and participate in required privacy and security training including HMIS Agency Participation Agreement and HMIS End User Agreement which was signed upon receiving access to HMIS.

• Inform participants of their data privacy rights and post a Privacy Notice in an area visible to provider participants, as required by the HMIS Policy and Procedures.

• Utilize HMIS to record participant-level information as required by current HMIS Policies and Procedures, including, but not limited to, HUD Universal Data Elements, Program

3 Washington County DHS adheres to federal requirements that prohibit Victim Services providers from entering data into HMS per 24 CFR 5.2007(c).

https://powerdms.com/courses/4637 https://www.washingtoncountyor.gov/housing/documents/cc-policy-and-standards/download?inline https://www.washingtoncountyor.gov/housing/documents/cc-policy-and-standards/download?inline https://powerdms.com/link/Was0439/document/?id=2820236 https://powerdms.com/link/Was0439/document/?id=2732149 https://www.hudexchange.info/programs/hmis/hmis-data-standards/standards/Universal_Data_Elements.htm https://www.ecfr.gov/current/title-24/part-5/section-5.2007#p-5.2007(c)

Specific Data Elements, and any financial assistance expended, as applicable.

• Create each service participant’s record in HMIS within two business days of the participant engaging in a covered program or completing initial screening through

Community Connect.

• Update the service participant’s record in HMIS within three days of any changes. This includes updates to (a) the participant’s standardized assessment, (b) the participant’s housing status, (c) services provided to the participant, and (d) financial assistance provided to the participant.

• Utilize program bed lists in HMIS to manage vacancies, fill vacancies, and manage

Community Connect lists by ensuring bed list data (entries/exits) is current and accurate.

• Regularly monitor HMIS data integrity and make data quality corrections as needed.

Providers are responsible for maintaining the quality of data entered in HMIS as described in the Washington County Data Quality Plan. Data quality is monitored for selected data elements, and programs should maintain data quality of 95% or better for each project.

D. Ethical Standards

It is the responsibility of all DHS providers to ensure that their agency adheres to ethical standards and that program-level policies and procedures support ethical practices.

Conflict of Interest Policy

All DHS providers are required to maintain a conflict of interest policy that indicates how programs will identify and address actual, potential, and perceived conflicts of interest.

Policies should include how agencies address dual relationships in which a professional either has a pre-existing role or assumes a second/additional role with a participant, including, without limitation, friend, employer, teacher, business associate, family member, or intimate partner. For example, a professional may presently be or have been in the past a friend and a business associate of the participant. The professional is thus said to have a dual relationship with the participant. The policy must include:

• How the agency will address dual relationships between staff and participants.

• Procedure to reassign participants with a dual relationship with one staff member to a different staff member within the provider agency whenever possible.

• Procedure to reassign participants to a new provider agency if a dual relationship cannot be removed, in alignment with Program Transfer policies.

• Length of time between a participant being served by the provider and employed by the provider and procedures to mitigate situations where conflicts of interest may arise.

• How the agency will address dual relationships between provider-owned units, staff-owned units, or dual relationships with landlords or property managers that participants are signing a lease with.

https://www.washingtoncountyor.gov/housing/homeless-services-division/documents/washington-county-hmis-data-quality-plan-v1pdf

• Process for notifying the county of a dual relationship.

Completing assessments and general HMIS data entry

• HMIS may not be accessed outside of the staff member’s normal scope of work.

• Only individuals that exist as participants under the provider shall be entered in HMIS or provided with a Community Connect assessment.

• Staff members must only enter participant information that is known to be completely accurate. While information is largely based upon what participants report, entering information that is known to be inaccurate is prohibited.

• HMIS data entry may never be completed by a staff member on their own HMIS profile or on profiles of participants they have dual relationships with consistent with the HMIS

Policies and Procedures.

• In the event a current staff member of a provider agency needs to complete a

Community Connect Phase 1 Assessment, the staff member shall be referred to an alternate Community Connect access point.

• In the event a participant with whom a staff member has a dual relationship needs to complete a Community Connect Phase 1 Assessment, whenever possible, the staff member must connect the participant to an alternate staff member within the provider agency who is trained to complete assessments or refer the participant to an alternate

Community Connect access point.

Confidentiality Policy

All DHS providers are required to develop and maintain up-to-date confidentiality policies that comply with all applicable federal, state, and local confidentiality protections for participants.

Policies must provide guidance and protections to avoid inadvertent disclosure of confidential information. Confidentiality policies should include definition of confidentiality, access information, use, storage and security, required staff training, and process for reporting a breach in alignment with the Critical Incident Policy. Providers are expected to follow DHS guidance and agree to confidentiality clauses in the HMIS User Agreement, as well as in case conferencing agreements.

Agencies may store records as hard files. If the provider uses hard files, the confidentiality policy must ensure appropriate safeguards are always implemented to secure information and the maintenance, retention, and disposal of hard files. Hard files must include an annually updated Release of Information (ROI) to allow the County to review the hard file and physical case notes.

Impartiality Policy

All DHS providers must maintain an impartiality policy that clearly states that the provider and its staff will:

• Not knowingly be a party to or condone any unethical or illegal activity.

• Not directly or indirectly seek personal gain which would influence, or appear to influence, the conduct of their duties.

• Not exploit professional relationships for personal or financial gain.

• Be alert to the influences and pressures that interfere with the professional discretion and impartial judgment required for the successful performance of their work.

E. Equal Access and Non-Discrimination

Non-Discrimination

All DHS providers must ensure no eligible person is unlawfully discriminated against in their access to services. To achieve this, providers must:

• Establish and follow a written non-discrimination policy.

o At a minimum, the policy must state that the provider will not discriminate against applicants or participants in any service based on race, ethnicity, religion, national origin, disability, sex, gender identity, age, sexual orientation, marital status, or familial status.

o This policy must be made available to program participants at enrollment.

• Comply with all Federal, State, and local laws, rules, and regulations related to nondiscrimination, including but not limited to the Fair Housing Act, Americans with

Disabilities Act, Violence Against Women Act, Civil Rights Act, and Age Discrimination

Act.

• Provide all program services free of charge to all participants. (Important note:

Participants in housing programs may be required to pay a rent contribution depending on the program type and the participant's income. This is not considered a charge for services.)

Equal Access and Gender Identity

All DHS providers must ensure that services are provided in a manner that does not discriminate based on gender identity, in accordance with the following guidelines:

• Ensure all persons who are eligible to receive services are served within a facility that serves the gender with which that person identifies. This right is absolute, regardless of sex assigned at birth, and regardless of whether they have undergone medical treatment to align their physical bodies with their gender identity. Persons who do not identify as male or female have the right to be served wherever they feel safest.

Facilities that are legally permitted to segregate participants by sex must serve all participants who identify with that gender.

• Ensure all persons receiving services have access to bathrooms consistent with their gender identity and the right to safety and privacy.

• Ensure all persons receiving services have the right to be referred to and addressed by the name and/or gender pronouns with which they identify (including in HMIS participant records), regardless of the name and gender marker on their identity documents.

Providers may not ask for proof of gender, nor require that a person’s gender match the sex listed on legal documentation. Providers cannot deny services to participants because their appearance or behavior does not conform to assumed gender stereotypes.

Language Access

All DHS providers must have a language access policy and ensure that verbal communication and written materials are provided for participants who need them in their primary, or preferred, language. Examples of how providers may meet this requirement include, but are not limited to:

• Written translation services coordinated and funded by DHS.

• Interpretation services provided by a third-party interpretation service contracted by the provider.

• An interpreter provided by the participant, such as a relative or friend. (Important note:

the use of minors as interpreters is strongly discouraged, except in emergencies or at the individual's request.)

• Interpretation or written translation completed by provider staff with verified competency in languages other than English.

Providers must also have a documented process for:

• Providing information for participants who are not sufficiently proficient in English or hearing impaired through written materials in their primary, or preferred, language and/or through using an interpreter in a language the individual is sufficiently proficient in to access and participate in services.

• When it is necessary for the provider to utilize interpretation services from a third- party contractor to provide access to services in languages beyond the staff’s capacity.

Providers are encouraged to hire staff with language capabilities that support the populations they serve. Washington County recommends providers (1) maintain a personnel policy that supports this need and (2) include language skill requirements or preferences when applicable in job postings and compensate bilingual staff for their language skills.

Civil Rights Complaints

Washington County strives to treat all people with dignity and respect. It is the County’s policy to prevent and remediate discrimination based on any identity protected by federal, state, or local civil rights laws. All people are to receive quality services and benefits and have opportunities for meaningful engagement in DHS programs and activities. Washington County has standards for fair treatment and equal protection for all people accessing DHS programs, activities, benefits, and services. The Washington County Fair Treatment, Equal Protection, and https://www.washingtoncountyor.gov/oeice/documents/fair-treatment-equal-protection-nondiscrimination-policy-procedure/download?inline

Nondiscrimination Policy (#212) outlines the protections and procedures involved in enforcing these rights for all participants of County-funded services. Participants do not lose their civil rights because they were or are experiencing homelessness and have enrolled in or are applying to County-funded programs. All staff of DHS programs must understand participants’ rights under the law and how to move forward in assisting them if their rights are being or have been violated. As contractors, all DHS programs are governed by this policy.

Any individual may make a complaint if they believe that Washington County has unlawfully discriminated against them in the provision of or denial of any service, benefit, program, or activity provided by the County directly or through contractors, service providers, or grantees, because of their race, ethnicity, religion, national origin, disability, sex, gender identity, age, sexual orientation, marital status, familial status, or any other basis recognized under federal, state or local law. Washington County also prohibits retaliation against any person who complains or participates in any investigation of discrimination.

Washington County will address any complaints received arising out of or based on allegations of workplace discrimination, harassment, and retaliation among contractors will be addressed in accordance with the Washington County Human Resources Policy (#301) and in partnership with the Office of Access and Opportunity.

F. Compliance with VAWA

The Violence Against Women Act (VAWA) is a federal law that protects individuals who are survivors of domestic violence, dating violence, sexual assault, and stalking regardless of sex, sexual orientation, or gender identity. VAWA includes housing protections for survivors who are applying for or residing in “covered housing programs”. In Washington County, covered programs include any housing provided through the Housing Authority (HAWC) [e.g., Regional

Long-Term Rental Assistance (RLRA) Vouchers & Housing Choice (HCV) Vouchers], Rapid

Rehousing (RRH), Housing Case Management Services (HCMS), other Permanent Supportive

Housing (PSH), HOPWA housing, shelter, transitional housing, and other interim housing.

Under VAWA, survivors cannot be subject to adverse decisions regarding housing assistance because of violence or abuse committed against them or for reasons related to previous experiences of violence or abuse, including eviction history, bad credit, criminal history, etc.

Survivors seeking assistance may not be denied admission or assistance based on anything related to their experience of violence or abuse. Once housed, if violence occurs, the survivor may not be forced to move, evicted, or terminated as a result of the violence or abuse. The housing provider must allow for emergency transfers between programs or to a new unit within the same program or lease bifurcation so that the survivor can assume the lease if they choose to.

https://www.washingtoncountyor.gov/oeice/documents/fair-treatment-equal-protection-nondiscrimination-policy-procedure/download?inline https://www.washingtoncountyor.gov/hr/documents/workplace-discrimination/download?inline https://www.washingtoncountyor.gov/oeice

DHS providers must also facilitate transfers and maintain policies and procedures regarding emergency transfers for program participants experiencing domestic violence. HUD has provided a template for an emergency transfer plan and occupancy rights: VAWA Forms.

DHS providers are expected to be aware of VAWA housing protections that apply to participants, apply them in their covered programs, and help educate participants about those protections. HUD has provided several resources for providers and survivors on their website:

Violence Against Women Act (VAWA – HUD.GOV)

Providers must also understand the services of the local Victim Services Organizations and be familiar with how to make a referral for participants who want/need them. Local Washington

County Victim Services providers include:

Domestic Violence Resource Center

24-Hour Crisis Line

503-469-8620 | 1-866-469-8600

Family Justice Center

735 SW 158th Ave, Suite 100 Beaverton, OR 97006

Walk-In Hours Monday-Friday 8:30am - 4:00pm

G. Requirements for Services Sites

All DHS providers must provide services in clean, safe, and well- maintained facilities that comply with the following minimum requirements. All sites providing services to participants must meet all applicable inspection requirements and receive all applicable permits. Providers are responsible for ensuring that facilities are maintained in compliance with all applicable local, state, and federal regulations, including building, health, and fire codes, including building structures, all internal spaces, fixtures, and furnishings, and all external grounds, structures, and amenities.

Providers must develop policies and procedures for responding to natural disasters to safeguard staff and participant safety and security. Policies and procedures must include plans for the safe evacuation of participants and staff in case of natural disasters and for sheltering-in-place if evacuation is not possible or safe. All staff must be fully trained on the disaster procedures.

Providers must have policies and procedures, train staff, and maintain a sufficient supply of

First Aid supplies to ensure the appropriate handling of health-related events in their programs.

Individual program medical and health protocol policies and procedures must be submitted to the County for review.

Service sites are subject to review at any time by DHS staff or any other County department.

Any concerns or findings around site cleanliness or safety from any County department(s) must be corrected within the timeframe prescribed.

https://www.hud.gov/vawa#VAWA-Forms https://www.hud.gov/vawa#VAWA-Forms https://www.hud.gov/vawa https://www.dvrc-or.org/ https://www.fjcwc.org/

Site Specific Requirements

All DHS providers that run site specific programs including Access Centers, Emergency Shelter, and Transitional Housing are required to follow site specific requirements.

Heating, Cooling, and Ventilation

Sites must ensure that each room or space has a natural or mechanical means of ventilation.

The provider must make every attempt possible to ensure that the interior air is free of pollutants at a level that might threaten or harm the health of participants, staff, and visitors.

Providers must maintain heating and cooling systems in proper operating condition.

Maintenance and Repair

Providers must maintain the facilities, including all internal and external areas of the site(s), to ensure the safety and security of participants, staff, and visitors. Providers must have policies and procedures regarding the maintenance of the site; they must cover all aspects of the building and property including roofs, floors, walls, plumbing, electrical, waste disposal, appliances, elevators, landscaping, and pest control. These policies and procedures must also outline the housekeeping and maintenance plan, including the protocols for preventing and controlling pest issues.

The policies and procedures must explain the process for reporting maintenance concerns and responding to those concerns promptly. Emergency maintenance concerns must be addressed immediately. For maintenance and pest issues that affect multiple participants, such as bed bug infestations, policies should outline how participants will be notified when issues arise, as well as when and how people will be moved if needed. These policies and procedures must be clearly communicated to participants upon entry and/or posted in a location easily visible at the site.

Cleanliness

Providers must maintain policies and procedures regarding the housekeeping and cleanliness of the facilities, including cleaning bathrooms/toilet areas, hallways, and other common areas as frequently as necessary to maintain all common areas in a sanitary condition. Providers must maintain trash receptacles around the site, which are emptied regularly. The cleanliness procedures must also ensure that the facility is free of debris, clutter, and unsanitary items to limit safety risks. Further, any cleaning supplies and chemicals at the site must be clearly labeled, kept out of reach of participants, and stored separately from food items.

Providers must have policies and procedures that specify what areas of the site are open to participant use and expectations of participants for the maintenance of personal space and belongings. Noncompliance with maintaining personal space and belongings must not be the reason for exit unless there is a documented, repeated pattern of violation that impacts other participants. These policies and procedures must be clearly communicated to participants upon entry and/or posted in a location easily visible at the site.

Infectious Disease

Providers must maintain policies and procedures for preventing, responding to, and reporting outbreaks of infectious diseases that align with the recommendations of the CDC, State, and

County public health departments. The policies and procedures must address how the location will take steps to prevent the transmission of communicable diseases, as well as the process the location will take to support participants upon learning of an outbreak within the site-based location. The policies must address, as appropriate, ventilation, screening for infectious diseases at intake, distancing, masking if required, and cleaning routines.

In cases where minimum efforts can be made to protect other participants from transmission, having a communicable disease such as a cold should not be a reason to deny access. Some illnesses, such as the flu, may require quarantine or separation from the general population of the location for some time, and whenever possible staff should support the participant to access available medical care and alternative accommodations. Site-based locations must consult with the Washington County Public Health Division for guidance in cases where they are unsure of the best approach. Information on current disease control and prevention practices in the region can be found on the Washington County Public Health's Communicable Disease website.

Infection Prevention and Control Guidance for Site-Based Locations

The following steps can be taken to prevent illness from spreading within facilities:

• Hand and Respiratory Hygiene

Educate and encourage staff and participants to:

▪ Cover their mouth and nose with a tissue when coughing or sneezing. If a tissue is not available, sneeze into elbow, not hands.

▪ Throw away any used tissues in the nearest trash can.

▪ Wash hands frequently with soap and water. Especially after using the toilet; before, during, and after meal preparation; before and after eating; after blowing their nose, coughing, or sneezing; and after touching garbage.

Make hand washing stations with soap and water available. When soap and water are not available, hand sanitizer with at least 60% alcohol can be used.

▪ Always wash hands with soap and water during food preparation, after handling vomit or feces, or if there are any known or suspected gastrointestinal illnesses in the facility. Hand sanitizer is not effective against germs that cause gastrointestinal illness.

Make masks available to staff and participants, especially when respiratory illness activity is high in the community or when people have been ill at the https://www.washingtoncountyor.gov/disease-control https://www.washingtoncountyor.gov/disease-control https://www.cdc.gov/clean-hands/about/?CDC_AAref_Val=https://www.cdc.gov/handwashing/when-how-handwashing.html facility.

Consider posting signs around the facility to remind staff and participants to wash their hands and cover their coughs and sneezes.

• Cleaning and Disinfection

Set schedules for routine cleaning and disinfection of high traffic areas and frequently touched items such as pens, tables, phones, counters, door handles, and stair rails.

Clean any surfaces when they are visibly dirty.

Increase cleaning and disinfection if there have been ill staff or participants at the facility.

Always follow the manufacturer’s instructions for using the product to ensure it is used safely and effectively.

• Improve Indoor Air Quality

Bring as much fresh air into the facility as possible by opening doors and windows and/or using exhaust fans.

If the facility has central heating, ventilation, or air conditioning (HVAC), set the fan to the “on” position instead of “auto”.

Use portable high-efficiency particulate air (HEPA) cleaners. When HEPA cleaners are placed between beds, the exhaust flow should be directed between beds and not across from one participant toward another.

Consider having group activities outside when weather, outdoor air quality, and space allow.

• Handling Laundry and Personal Belongings

Wear disposable gloves when handling items such as used bedding, dirty laundry, or someone else’s personal belongings. Wear disposable gloves and a gown when there are known gastrointestinal illness or scabies in the facility.

Do not shake out used bedding or laundry.

After handling soiled items, remove and throw away gloves and perform hand hygiene with soap and water right away.

Store clean bedding or laundry separate from dirty bedding and laundry.

• Be Prepared to Respond to Illness and Outbreaks

Identify local healthcare facilities to refer participants to when they are ill, including urgent care facilities and emergency departments.

Maintain a supply of personal protective equipment (PPE), including masks, gloves, gowns, and face shields.

Ensure staff know how to put on and remove PPE properly.

Identify a dedicated space (isolation space) where participants can stay when they are ill that is away from any communal sleeping, dining, or other gathering areas.

▪ Ideally, ill participants should stay in a separate room or section of the https://www.cdc.gov/natural-disasters/communication-resources/wash-your-hands-poster.html https://www.cdc.gov/flu-resources/php/resources/cover-your-cough-health-care-poster.html https://www.cdc.gov/hygiene/about/when-and-how-to-clean-and-disinfect-a-facility.html?CDC_AAref_Val=https://www.cdc.gov/hygiene/cleaning/facility.html https://www.cdc.gov/infection-control/media/pdfs/Toolkits-PPE-Sequence-P.pdf location until they are well.

▪ When possible, ill participants should have a dedicated bathroom and dedicated entrance/exit.

Keep track of participants who stay at the location each day and night, ideally with a list of people by room or by bed. This includes participants who are temporarily there, such as walk-up beds and emergency beds or day use.

• When Staff, Volunteers, or Participants are Sick

New participants should be screened for infectious disease at intake.

Encourage staff, volunteers, and participants to report any new or worsening symptoms or illnesses. Consider regularly screening staff, volunteers, and participants for symptoms.

Staff and volunteers should return home when ill and remain home until they are well. Participants who are ill should be provided a dedicated space to stay away from any communal sleeping, dining, or other gathering areas, when possible.

▪ If no appropriate space can be identified, staff must contact the

Washington County Contract Administrator

Report any suspected or confirmed outbreaks to Washington County Public

Health and Washington County Homeless Services as soon as possible and follow any additional guidance and recommendations provided by Washington County

Public Health.(See “When and How to Contact Washington County Public Health and Homeless Services”)

Support participants to access medical evaluation, testing, and treatment as needed.

▪ For non-emergent medical care, support participants to see their primary care provider or an urgent care facility.

▪ For medical emergencies, call 911 or send the participants to the emergency department.

Increase routine cleaning and disinfection throughout the facility

▪ Check that your disinfectant product is listed on the Selected EPA-

Registered Disinfectants and ensure it is effective against the germs causing illness within your facility.

▪ Always clean up any vomit or diarrhea right away. Wear gloves, gown, and a face mask. Thoroughly wash your hands with soap and water immediately after.

Sites must monitor and keep track of ill individuals.

If Access Centers experience an outbreak, the provider must post a potential exposure notice that includes the dates of potential exposure and what symptoms participants should be aware of.

• When and How to Contact Washington County Public Health and Homeless Services https://www.epa.gov/pesticide-registration/selected-epa-registered-disinfectants https://www.epa.gov/pesticide-registration/selected-epa-registered-disinfectants https://www.oregon.gov/oha/ph/DiseasesConditions/CommunicableDisease/Outbreaks/Documents/cleanup.pdf

To report and outbreak, contact Washington County Public Health at (503) 846-

3594 or cd@washingtoncountyor.gov and Washington County Housing Services at homeless_services@washingtoncountyor.gov.

Please cc the Washington County Contract Administrator and complete a Critical

Incident Report.

Contact Public Health and Homeless Services anytime there is a suspected or confirmed outbreak at your facility, including:

▪ Two or more staff and/or participants with gastrointestinal (GI) illness within 3 days of each other.

▪ 10% of staff and/or participants ill with RSV, influenza, or COVID-19 within 7 days of each other (with at least three people ill).

▪ Unusually high absenteeism by staff complaining of related symptoms.

▪ Two or more hospitalizations and/or deaths among participants or staff with severe or similar symptoms.

▪ Lice, scabies, and bed bugs are not reportable to Public Health; however, Public Health will provide supportive guidance if contacted. Site based locations are encouraged to create a shower and laundry procedure for these conditions.

What to expect after reporting to Washington County Public Health and

Homeless Services:

▪ You may be asked to provide information such as names and dates of birth of people who are ill (if known), what symptoms are being reported and when they began, any illness that have been confirmed through testing or by a healthcare provider, and details about the facility’s layout.

▪ Washington County Public Health will provide additional disease specific guidance or interventions to help prevent additional illness among staff and participants.

▪ Depending on the type of illness, Washington County may monitor your facility for a period of time.

Healthcare providers and laboratories are required to report certain illnesses to

Public Health. If Public Health receives a report of a staff or participant with a reportable condition, Public Health may reach out to the location to learn if others in the facility have been ill and provide any necessary guidance.

▪ The level of required intervention will vary depending on the disease. Be prepared to cooperate with Public Health and follow any guidance provided.

Weapons and contraband

For the safety of program participants, providers are permitted to prohibit the possession and/or use of weapons, alcohol, and/or illegal drugs on the site. Providers must, however, mailto:cd@washingtoncountyor.gov mailto:homeless_services@washingtoncountyor.gov establish Harm Reduction policies, practices, and procedures designed to minimize negative consequences resulting from participants’ use or possession of contraband items as referenced.

Harm Reduction is not intended to prevent the termination of a participant whose actions or behavior constitute a threat to the safety of participants and/or staff. Providers must maintain policies and procedures that clearly outline expectations around weapons, drug and alcohol use and possession onsite, and property searches related to suspected violations of these policies and procedures.

Medication Management

Unless licensed to do so, Providers may not administer medication and must not require participants to turn over their medication to be managed by program staff. Providers must have policies and procedures regarding expectations for how participants manage and secure their prescription and non-prescription medications.

Providers must provide options for a lockable storage area for medications and consistent access to safe and secure refrigeration for medications that require temperature control.