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Annual Reexamination

These procedures apply to Shelter Plus Care (S+C) participants only. Shelter Plus Care (S+C) participants be sure to use the S+C Statement of Understanding, HAP Contract and Housing Worksheet.


Part One: Reexamination Notification


Step One: Reexamination Information

  • Send EIV, CBMS and Family Support Registry to the agency (DOLE reports will be provided for S+C participants)
  • Mail the 120-day letter to the participant informing him/her that it is time to begin the annual reexamination process. The agency and landlord receive a copy.


Step Two: Reexamination Letters and Packets

Agency Residential Coordinator

Approximately 120 days prior to the reexamination effective date:

  • Review the income, assets and expenses information listed on the most recent 50058.
  • Create an annual reexamination letter for each participant on the reexamination list.

Assemble the reexamination packet. Include in the packet:

(Also see Forms Checklist)
Verification forms (as applicable) examples include:
Verification of Disability or other third party verification (if applicable and if participant does not receive SSI/SSDI) 
Verification of Student Status form (for household members 18 years and older)
For participants who need to re-verify their reasonable accommodation be sure to include:
Renting From a Relative (if applicable)

Other miscellaneous forms may include:

Any missing documentation from the participant’s file (examples- birth certificates, Social Security cards, etc.)
Zero Income Reporting Forms (if applicable)
Declaration of 214 Status form (for any household member turning 18 y/o)

If there is a person in the household who has turned 18 years since their last annual reexamination, request that the person provide their Colorado photo identification card.

  • Make a copy of the Annual Reexamination Letter. Mail the letter and the reexamination packet to the participant. File the letter in the participant’s file.
  • If the participant’s lease is expiring, contact the landlord to determine if a new lease or lease renewal will be signed. If so, complete a new HAP Contract to coincide with the lease or lease renewal.
  • For rent increases, review the following documentation from the landlord
                   Request for Tenancy Approval or other written notification. The landlord must provide this documentation at least
                   60 days prior to the effective date of the increase.

Part Two: Completing the Annual Reexamination


Step One: Document Review


Agency Residential Coordinator


Once documentation is received, complete the following steps:


Review all forms requiring signature to ensure they are properly completed and updated:


Family Reporting Form including the Supplement to Application (all family members age 18 and over)
DOH Authorization for Release of Information (all family members age 18 and older)
Declaration of 214 Status form (for any household member turning 18 y/o)
Shelter Plus Care Statement of Understanding (all family members age 18 and over)


  • Make sure all forms are completed in their entirety.
  • Confirm that the participant has reported the income status of every family member.
  • Review the following items based on the most recent 50058 for each participant:
                       Family members
  • Compare the pages of the 50058 to the participant’s submitted information to determine any changes in income or family composition.
  • Compare the submitted information to information reported on the CBMS, EIV, DOLE (if applicable) and Family Support Registry reports.


Step Two: Unreported Income/Unauthorized Household Members


Agency Residential Coordinator


If there is a difference that is not explained by the participant’s submitted documentation, contact your DOH representative.

Step Three: Review Family Composition


Part Three: Verifications


Obtaining Verification of Income/Assets/Expenses


Agency Residential Coordinator


If the participant provides original documentation:


  • If the family provided original documentation of its income/assets and/or expenses, calculate the income based on these documents. Compare these figures to the EIV, DOLE, CBMS and/or Family Support Registry reports.


If the participant did not provide original documentation:


  • Email, mail or fax third party verification forms directly to the income/asset/expense source. (Do not give the third party verification to the tenant to deliver.) Attach a release of information to each verification request. Make sure the verification states that the verification must be returned within 10 business days. Request the information to be dated within the last 120 days.
  • If the verification is not received within the required time frame, go to the next level of verification. See HUD’s Verification Hierarchy.
  • Track your attempts at obtaining verification on the Action Identifier and Verification Tracking Sheet.

Part Four: Rent Calculations


Step One: Calculating Rent Portions


Agency Residential Coordinator



Step Two: Data Entry


Once all paperwork is received and complete, it is time to enter the participant’s information into the Elite computer system. (Agency Residential Coordinators who do not have access to Elite will skip this step.)

  • Enter all data in the computer system. (See Elite Manual.)
  •  Make sure the HAP payment and participant portion matches your calculation worksheet.
  • Once finished, press the “Validate 50058 Submission Data” button.


Step Three: Submit paperwork to DOH representative


Agency Residential Coordinator


Fax, mail or email the following paperwork to your assigned DOH representative as required.

All verification form(s)

Shelter Plus Care Housing Application and Worksheet (HAP) (for Agency Residential Coordinator who do not have Elite access)
Medical Calculation form (if applicable)
Shared Housing Worksheet (if applicable)
Request for Tenancy Approval (for rent increases)
Copy of Lease (if applicable)
Lease Addendum (if applicable)
Renting From a Relative (if applicable)

Step Four: Paperwork received from DOH

Agency Residential Coordinator

  • File the Rent Change Notice received from your DOH representative for the annual reexamination that has been completed in participant’s file.
  • If a new HAP Contract has been executed and DOH mailed you the HAP with the required SHHP signature, perform the following action:
                    Make a copy of the Shelter Plus Care HAP Contract   
                    Mail one copy of the HAP (Part B and C of the HAP stapled to the signed HAP
                    Part A) to the landlord.
                    Attach Part B and C of the
Shelter Plus Care HAP Contract to the signed Part A
                    HAP and file in participant’s file.
Part C Tenancy Addendum to the lease.


Step Five: File Organization


Agency Residential Coordinator


Once the reexamination has been entered in Elite and sent to DOH, it is time to organize the participant’s file. Refer to DOH’s file organization policy.

Failure to Provide Required Documents


If the participant fails to return his/her reexamination packets within the specified time period, or returns partial information, take the following steps:

  • For participants who have failed to return a complete reexamination packet within 90 days of their reexamination effective date, complete the Missing Documentation Letter and send it to the participant along with the 90-Day Notification Letter.
  • For participants who have failed to return a complete reexamination packet within 60 days of their reexamination effective date. Complete the Missing Documentation Letter and send it to the participant along with the 60-Day Notification Letter.
  • If 30 days prior to the reexamination effective date and the participant still has failed to provide all documentation, DOH will send a 30-Day final notice to the participant. If the participant does not provide all documentation within 30 days, the participant’s housing will be terminated