How to Verify Household Member’s Need for a Live-In Aide

Last month, the Insider discussed how to determine whether an absentee's confinement in a hospital or nursing home is temporary or permanent. Problems with noncompliance can arise if you don't count the income of an absentee who should be considered a member of the household. Because of this, you may treat the household as being within the income limits when it's not.

Similar to the need for a resident to seek professional help at a hospital or nursing home, disabled or elderly household members may ask your permission to let a “live-in aide” move into their units. HUD describes a live-in aide as “a person who resides with one or more elderly persons, near-elderly persons, or persons with disabilities.” A live-in aide is a person who resides with a disabled resident for the sole purpose of providing supportive services to that resident. The aide must be essential to the care and well-being of the resident, may not be obligated for the support of the resident, and would not live in the unit were it not for the needs of the resident [HUD Handbook 4350.3, par. 3-6]. Federal law requires you to consider and, if the household member's claim is legitimate, grant the request for a live-in aide as a “reasonable accommodation.”

Under HUD regulations, which tax credit rules require you to follow, a household that has a live-in aide gets a big benefit. The aide's income isn't included when you calculate the household's eligibility for tax credit housing. Because of this, it's important to verify requests to help prevent abuse. Without proper identification, you won't know if a request is legitimate or merely a backdoor attempt to get around tax credit rules.

For example, an unscrupulous household member might ask for a live-in aide so that a relative can move into the unit without having his or her income included when determining a household's eligibility. Although it's true that when the live-in aide a household wants to add is a relative, the household is more likely to be trying to use the request to skirt the official requirements for adding a household member. However, relatives can be—and often are—legitimate and effective live-in aides, notes tax credit expert Karen Graham.

To be able to grant permission to proper requests for a live-in aide and to weed out improper requests, you should get verification from the household member's health care provider, such as the member's doctor or social services staffer. To help gather the information from the health care provider, we've prepared a Model Form: Verify Live-In Aide Request with Health Care Provider.

Use Standard Form

You can get into fair housing trouble if you treat households' members inconsistently when they tell you they need a live-in aide. The Fair Housing Act (FHA) protects household members against housing discrimination based on their race, color, religion, national origin, sex, disability, and familial status (that is, families with children). And your state and municipality may protect households members based on additional characteristics, such as sexual orientation, age, and source of income (such as government assistance). If you apply your live-in aide policies and procedures more favorably to some households' members, other households' members may claim you illegally discriminated against them.

So it's important to act consistently with household members who tell you they need a live-in aide, advises Graham. One way to treat requests for live-in aides uniformly is to use a standard form.

Though many managers know they should verify a household member's need for a live-in aide, they usually just ask for a letter from a health care provider stating that the member needs a live-in aide. But this may not be the best way to get verification. The health care providers may not know what information federal law requires you to verify before you can allow a live-in aide to move into a unit. Therefore, their letters may leave out essential information.

For example, a health care provider may simply write and ask you to let a household member have a live-in aide, but not say that the household member is disabled. And if you allow a household to have a live-in aide without verifying the household member's disabled status, you're being unfair to other households at the site that would also like live-in assistance without having their eligibility affected.

It's much better to ask health care providers to fill out a standard form like our verification form. This ensures that you give the same treatment to all household members who make such requests and that you get all the information you need to evaluate requests.

What to Ask

Our form explains to the health care provider that the household member has asked management to allow him or her to have a live-in aide. It says that you'll consider the request if the household member is disabled and requires live-in assistance. Graham suggests verifying the following two points to determine whether a request to have a live-in aide is reasonable. That's important because the FHA requires you to grant only reasonable accommodation requests—such as requests for a live-in aide—from disabled household members.

Is household member disabled? The form asks if the household member meets the definition of “disabled” under federal law. The FHA protects anyone who has a “physical or mental impairment that substantially limits one or more major life activities; has a record of such an impairment; or is regarded as having such an impairment.” The FHA defines “physical impairment” as “any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting any of the major body systems.”

The form reprints the applicable definition from the federal regulations so that the health care provider understands what's being asked. Note that federal law bars you from requesting information about the nature or extent of the disability, or any other details about the household member's condition.

Does the household member need a live-in aide? The form asks if the household member needs a live-in aide in order to have the same opportunity that a nondisabled individual has to use and enjoy the site. The form makes it clear that you want the health care provider's professional opinion. Otherwise, some health care providers might ask you to allow a household member to have a live-in aide simply because they think it would be nice for the household member.

Evaluate Source's Response

If the health care provider answers no to one or both questions, you may reject the household member's request for a live-in aide.

If the health care provider answers yes to both questions, you must consider the request. You may not turn down the request as long as the live-in aide will live in the unit solely to provide supportive services and won't have the right to live in the unit if the household member who requires assistance moves out or dies.

In fact, HUD encourages federally assisted sites to obtain a signed agreement in the form of a lease addendum that denies occupancy of the unit to a live-in aide after the household member, for whatever reason, is no longer living in the unit [HUD Handbook, par. 3-6]. If you require such an agreement and the household member or live-in aide refuses to sign it, you could turn down the request. Otherwise, you should approve the request if a health care provider verifies the household member's need for a live-in aide. For an example of a lease addendum that you can adapt and use at your site, see our Model Agreement: Get Live-In Aide to Agree to Site Residency Terms.

Insider Source

Karen A. Graham, CPM, HCCP: President, Karen A. Graham Consulting LLC, 6883 Fox Trot Ct., Liberty Township, OH 45044; kgraham@kagcllc.com.

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