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HomeMy WebLinkAboutCounty of Fresno - HHAP Manual Reporting FormSELECT JURISDICTION TYPE:CountyNot FundedNot FundedFor this report, All Projects refer to all HHAP-funded projects inclusive of project type (except Coordinated Entry).Project Types refer to the HMIS Universal Project Types. All HHAP-funded projects must be categorized into a Project Type.In the "All Projects" tab (red tab) enter the counts of persons served across ALL HHAP projects. In the "Outcomes" and "Supplemental Outcomes" tabs (yellow tabs) enter the Exit Destination for clients across ALL HHAP projects. Enter the counts of persons served within various HHAP project types on the corresponding HMIS project type tab (orange tabs). Use the arrows at the bottom left to scroll through all tabs.Note: Coordinated Entry will not be included in this report For each Project Type, What kind of report are you submitting?:Homelessness PreventionPH - Housing OnlyFresno CountyTYPE NAME OF JURISDICTION:Not FundedNot FundedNot FundedNot FundedPH - Permanent Supportive Housing (disability required for entry)PH - Housing with Services (no disability required for entry)PH - Rapid Re-HousingFor any questions, please email HCFC at hcfc@bcsh.ca.gov and write "HHAP Annual Report" in the subject lineHOMELESS HOUSING, ASSISTANCE AND PREVENTION (HHAP) PROGRAMMANUAL REPORTING FORMNot FundedEmergency ShelterTransitional HousingStreet OutreachServices OnlySafe HavenDay ShelterOtherNot FundedNot FundedManual Reporting Not FundedNot Funded•Click the Gray Box, then click the arrow to the right to view the drop down list. •You must select the juristiction type before selecting the name of the jurisdiction.•Click the gray box, then click the arrow to the right to view the drop down list. •From the drop-down list select "Manual Reporting Form", "APR", or "Not Funded" •Only select "APR" if you have project types where all persons served with HHAP funds can be counted and you will follow the optional step. MANUAL REPORTING FORM ALL PROJECTS (EXCEPT COORDINATED ENTRY) 61 61 0 0 1 25 0 60 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Adults 61 61 0 0 Children 0 0 0 Client Doesn't Know/ Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 0 0 0 0 For PSH & RRH - the total persons served who moved into housing 0 0 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Total Households 60 60 0 0 0 Number of chronically homeless persons Q8a. Households Served Heads of households and adult stayers in the project 365 days or Number of parenting youth under age 25 with children Number of adult heads of household Number of child and unknown-age heads of household This reporting form aligns with the HUD HMIS APR Programming Specifications: https://files.hudexchange.info/resources/documents/HMIS- Programming-Specifications.pdf Please refer to the Performance Metrics Detailed Instructions for additonal guidance on completing this form. If possible, use an APR that includes all HHAP funded projects to help you complete this form. Please report information in the space provided. Do not fill in boxed that have been blacked out. Number of adults (age 18 or over) Number of children (under age 18) Q7a. Number of Persons Served Number of youth under age 25 Number of adult and head of household leavers Number of stayers Number of adult stayers Number of persons with unknown age Number of leavers Number of adult leavers Total number of persons served Q5a. Report Validations Table Number of veterans APR Question 5a. Report on persons served on all HHAP-funded projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHHP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 7a. Report on persons served on all HHAP-funded projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 8a. Report on households(HHs) served on all HHAP- funded projects •Add HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding For PSH & RRH - the total persons served who moved into housing 0 0 0 0 0 All Persons Contacted First contact - NOT staying on the Streets, ES, or SH First contact - WAS staying on the Streets, ES, or SH First contact - Worker unable to determine Once 46 0 31 0 2-5 Times 4 0 3 0 6-9 Times 0 0 0 0 10+ Times 0 0 0 0 Total Persons Contacted 50 0 34 0 All Persons Contacted First contact - NOT staying on the Streets, ES, or SH First contact - WAS staying on the Streets, ES, or SH First contact - Worker unable to determine Once 25 0 17 0 2-5 Contacts 1 0 1 0 6-9 Contacts 0 0 0 0 10+ Contacts 0 0 0 0 Total Persons Engaged 26 0 18 0 Rate of Engagement 52.00% 0.00% 53.00% 0.00% Total Without Children With Children and Adults Unknown Household Type Male 39 39 0 0 Female 21 21 0 0 Trans Female (MTF or Male to Female) 1 1 0 0 Trans Male (FTM or Female to Male) 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 Data Not Collected 0 0 0 Subtotal 61 61 0 0 Q10a. Gender of Adults Q10b. Gender of Children Q9b. Number of Persons Engaged (ES Night By Night and Street Outreach Only) Q9a. Number of Persons Contacted (ES Night By Night and Street Outreach Only) •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HEAP funding. Include this estimated count. APR Question 10a. Report on persons served on all HHAP-funded projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 10b. Report on persons served on all HHAP-funded projects APR Question 9a. Report on persons/households(HHs) served on all HHAP funded projects •Add persons/HHs served in every HHAP funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HEAP funding. Include this estimated count in the total. APR Question 9b. Report on persons/households(HHs) served on all HHAP funded projects •Add persons/HHs served in every HHAP funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count in the total. Total With Children and Adults With Only Children Unknown Household Type Male 0 0 0 0 Female 0 0 0 0 Trans Female (MTF or Male to Female) 0 0 0 0 Trans Male (FTM or Female to Male) 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 Data Not Collected 0 0 0 0 Subtotal 0 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Male 0 0 0 0 0 Female 0 0 0 0 0 Trans Female (MTF or Male to Female) 0 0 0 0 0 Trans Male (FTM or Female to Male) 0 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Subtotal 0 0 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type White 49 49 0 0 0 Black or African American 7 7 0 0 0 Asian 0 0 0 0 0 American Indian or Alaska Native 2 2 0 0 0 Native Hawaiian or Other Pacific Islander 2 2 0 0 0 Multiple Races 1 1 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 61 0 0 0 Q12a. Race Q10c. Gender of Persons Missing Age Information projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 10c. Report on persons served on all HHAP-funded projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 12a. Report on persons served on all HHAP-funded projects •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. Total Without Children With Children and Adults With Only Children Unknown Household Type Non-Hispanic/Non- Latino 33 33 0 0 0 Hispanic/Latino 28 28 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 61 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type 12-17 0 0 0 0 18-24 0 0 0 0 Client Doesn't Know/ Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 0 0 0 0 0 Q27a. Age of Youth Q12b. Ethnicity APR Question 12b. Report on persons/households(HHs) served on all HHAP funded projects •Add persons/HHs served in every HHAP funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count in the total. APR Question 27a. Report on persons/households(HHs) served on all HHAP funded projects •Add persons/HHs served in every HHAP funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count in the total. MANUAL REPORTING FORM ALL PROJECTS (EXCEPT COORDINATED ENTRY): OUTCOMES Total Without Children With Children and Adults With Only Children Unknown Household Type Moved from one HOPWA funded project to HOPWA PH 0 0 0 0 0 Owned by client, no ongoing housing subsidy 0 0 0 0 0 Owned by client, with ongoing housing subsidy 0 0 0 0 0 Rental by client, no ongoing housing subsidy 0 0 0 0 0 Rental by client, with VASH housing subsidy 0 0 0 0 0 Rental by client, with GPD TIP housing subsidy 0 0 0 0 0 Rental by client, with other ongoing housing subsidy 1 1 0 0 0 Permanent housing (other than RRH) for formerly homeless persons 0 0 0 0 0 Staying or living with family, permanent tenure 1 1 0 0 0 Staying or living with friends, permanent tenure 0 0 0 0 0 Rental by client, with RRH or equivalent subsidy 0 0 0 0 0 This reporting form aligns with the HUD HMIS APR Programming Specifications: https://files.hudexchange.info/resources/documents/HMIS- Programming-Specifications.pdf Please refer to the Performance Metrics Detailed Instructions for additional guidance on completing this form. If possible, use an APR that includes all HHAP funded projects to help you complete this form. Please report information in the space provided. Q23c. Exit Destination - All persons Permanent Destinations APR Question 23c. Report exits of persons/households(HHs) served on all HHAP-funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Rental by client, with HCV voucher (tenant or project based) 0 0 0 0 0 Rental by client in a public housing unit 0 0 0 0 0 Subtotal 2 2 0 0 0 Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 15 15 0 0 0 Moved from one HOPWA funded project to HOPWA TH 0 0 0 0 0 Transitional housing for homeless persons (including homeless youth) 0 0 0 0 0 Staying or living with family, temporary tenure (e.g. room, apartment or house) 1 1 0 0 0 Staying or living with friends, temporary tenure (e.g. room, apartment or house) 0 0 0 0 0 Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 31 31 0 0 0 Safe Haven 0 0 0 0 0 Hotel or motel paid for without emergency shelter voucher 2 2 0 0 0 Host Home (non-crisis)0 0 0 0 0 Subtotal 49 49 0 0 0 Foster care home or group foster care home 0 0 0 0 0 Psychiatric hospital or other psychiatric facility 0 0 0 0 0 Institutional Settings Temporary Destinations Substance abuse treatment facility or detox center 1 1 0 0 0 Hospital or other residential non- psychiatric medical facility 0 0 0 0 0 Jail, prison, or juvenile detention facility 0 0 0 0 0 Long-term care facility or nursing home 0 0 0 0 0 Subtotal 1 1 Residential project or halfway house with no homeless criteria 0 0 0 0 0 Deceased 0 0 0 0 0 Other 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected (no exit interview completed) 0 0 0 0 0 Subtotal 0 0 0 0 0 Total 52 52 0 0 0 Total persons exiting to positive housing destinations 21 21 Total persons whose destinations excluded them from the calculation 0 0 0 0 0 Percentage 40.00%40.00%0.00%0.00%0.00% Total Without Children With Children and Adults With Only Children Unknown Household Type Moved from one HOPWA funded project to HOPWA PH 0 0 0 0 0 Owned by client, no ongoing housing subsidy 0 0 0 0 0 Owned by client, with ongoing housing subsidy 0 0 0 0 0 Rental by client, no ongoing housing subsidy 0 0 0 0 0 Q25i. Exit Destination - Veterans Permanent Destinations Other Destinations APR Question 25i. Report exits of persons/households(HHs) served on all HHAP-funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Rental by client, with VASH housing subsidy 0 0 0 0 0 Rental by client, with GPD TIP housing subsidy 0 0 0 0 0 Rental by client, with other ongoing housing subsidy 0 0 0 0 0 Permanent housing (other than RRH) for formerly homeless persons 0 0 0 0 0 Staying or living with family, permanent tenure 1 1 0 0 0 Staying or living with friends, permanent tenure 0 0 0 0 0 Rental by client, with RRH or equivalent subsidy 0 0 0 0 0 Rental by client, with HCV voucher (tenant or project based) 0 0 0 0 0 Rental by client in a public housing unit 0 0 0 0 0 Subtotal 1 1 0 0 0 Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 0 0 0 0 0 Moved from one HOPWA funded project to HOPWA TH 0 0 0 0 0 Transitional housing for homeless persons (including homeless youth) 0 0 0 0 0 Staying or living with family, temporary tenure (e.g. room, apartment or house) 0 0 0 0 0 Staying or living with friends, temporary tenure (e.g. room, apartment or house) 0 0 0 0 0 Temporary Destinations Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 0 0 0 0 0 Safe Haven 0 0 0 0 0 Hotel or motel paid for without emergency shelter voucher 0 0 0 0 0 Host Home (non-crisis)0 0 0 0 0 Subtotal 0 0 0 0 0 Foster care home or group foster care home 0 0 0 0 0 Psychiatric hospital or other psychiatric facility 0 0 0 0 0 Substance abuse treatment facility or detox center 0 0 0 0 0 Hospital or other residential non- psychiatric medical facility 0 0 0 0 0 Jail, prison, or juvenile detention facility 0 0 0 0 0 Long-term care facility or nursing home 0 0 0 0 0 Subtotal 0 0 0 0 0 Residential project or halfway house with no homeless criteria 0 0 0 0 0 Deceased 0 0 0 0 0 Other 0 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected (no exit interview completed) 0 0 0 0 0 Subtotal 0 0 0 0 0 Total 1 1 0 0 0 Total persons exiting to positive housing destinations 1 1 0 0 0 Institutional Settings Other Destinations Total persons whose destinations excluded them from the calculation 0 0 0 0 0 Percentage 100.00%100.00%0.00%0.00%0.00% Total Without Children With Children and Adults With Only Children Unknown Household Type Moved from one HOPWA funded project to HOPWA PH 0 0 0 0 0 Owned by client, no ongoing housing subsidy 0 0 0 0 0 Owned by client, with ongoing housing subsidy 0 0 0 0 0 Rental by client, no ongoing housing subsidy 0 0 0 0 0 Rental by client, with VASH housing subsidy 0 0 0 0 0 Rental by client, with GPD TIP housing subsidy 0 0 0 0 0 Rental by client, with other ongoing housing subsidy 0 0 0 0 0 Permanent housing (other than RRH) for formerly homeless persons 0 0 0 0 0 Staying or living with family, permanent tenure 0 0 0 0 0 Staying or living with friends, permanent tenure 0 0 0 0 0 Rental by client, with RRH or equivalent subsidy 0 0 0 0 0 Rental by client, with HCV voucher (tenant or project based) 0 0 0 0 0 Rental by client in a public housing unit 0 0 0 0 0 Subtotal 0 0 0 0 0 Q27f. Exit Destination - Youth Permanent Destinations Temporary Destinations APR Question 25i. Report exits of persons/households(HHs) served on all HHAP-funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 0 0 0 0 0 Moved from one HOPWA funded project to HOPWA TH 0 0 0 0 0 Transitional housing for homeless persons (including homeless youth) 0 0 0 0 0 Staying or living with family, temporary tenure (e.g. room, apartment or house) 0 0 0 0 0 Staying or living with friends, temporary tenure (e.g. room, apartment or house) 0 0 0 0 0 Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 0 0 0 0 0 Safe Haven 0 0 0 0 0 Hotel or motel paid for without emergency shelter voucher 0 0 0 0 0 Host Home (non-crisis)0 0 0 0 0 Subtotal 0 0 0 0 0 Foster care home or group foster care home 0 0 0 0 0 Psychiatric hospital or other psychiatric facility 0 0 0 0 0 Substance abuse treatment facility or detox center 0 0 0 0 0 Hospital or other residential non- psychiatric medical facility 0 0 0 0 0 Jail, prison, or juvenile detention facility 0 0 0 0 0 Institutional Settings Long-term care facility or nursing home 0 0 0 0 0 Subtotal 0 0 0 0 0 Residential project or halfway house with no homeless criteria 0 0 0 0 0 Deceased 0 0 0 0 0 Other 0 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected (no exit interview completed) 0 0 0 0 0 Subtotal 0 0 0 0 0 Total 0 0 0 0 0 Total persons exiting to positive housing destinations 0 0 0 0 0 Total persons whose destinations excluded them from the calculation 0 0 0 0 0 Percentage 0.00%0.00%0.00%0.00%0.00% Other Destinations MANUAL REPORTING FORM ALL PROJECTS (EXCEPT COORDINATED ENTRY): SUPPLEMENTAL OUTCOMES Chronically Homeless Moved from one HOPWA funded project to HOPWA PH Owned by client, no ongoing housing subsidy Owned by client, with ongoing housing subsidy Rental by client, no ongoing housing subsidy Rental by client, with VASH housing subsidy Rental by client, with GPD TIP housing subsidy Rental by client, with other ongoing housing subsidy Permanent housing (other than RRH) for formerly homeless persons Staying or living with family, permanent tenure Staying or living with friends, permanent tenure Rental by client, with RRH or equivalent subsidy Rental by client, with HCV voucher (tenant or project based) Rental by client in a public housing unit Subtotal Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 6 Moved from one HOPWA funded project to HOPWA TH Transitional housing for homeless persons (including homeless youth) Staying or living with family, temporary tenure (e.g. room, apartment or house) Staying or living with friends, temporary tenure (e.g. room, apartment or house) Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 13 Safe Haven Hotel or motel paid for without emergency shelter voucher Host Home (non-crisis) Subtotal 19 Foster care home or group foster care home Psychiatric hospital or other psychiatric facility Substance abuse treatment facility or detox center 1 Hospital or other residential non- psychiatric medical facility Jail, prison, or juvenile detention facility Long-term care facility or nursing home Subtotal 1 Residential project or halfway house with no homeless criteria Deceased Other Destinations Supplemental Outcomes can likely be generated from your HMIS System. Please refer to the Performance Metrics Detailed Instructions for additional guidance on completing this form. If possible, use an APR that includes all HHAP funded projects to help you complete this form. Please report information in the space provided. Population of Interest Permanent Destinations Temporary Destinations Institutional Settings Report exits of persons/households(HHs) served on all HHAP- funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Other Client Doesn't Know/Client Refused Data Not Collected (no exit interview completed) Subtotal Total 20 Total persons exiting to positive housing destinations 7 Total persons whose destinations excluded them from the calculation 0 Percentage 35.00% White Black or African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Multiple Races Client Doesn't Know/Client Refused Data Not Collected Moved from one HOPWA funded project to HOPWA PH Owned by client, no ongoing housing subsidy Owned by client, with ongoing housing subsidy Rental by client, no ongoing housing subsidy Rental by client, with VASH housing subsidy Rental by client, with GPD TIP housing subsidy Rental by client, with other ongoing housing subsidy 1 Permanent housing (other than RRH) for formerly homeless persons Staying or living with family, permanent tenure 1 Staying or living with friends, permanent tenure Rental by client, with RRH or equivalent subsidy Rental by client, with HCV voucher (tenant or project based) Rental by client in a public housing unit Subtotal 2 Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 12 3 Moved from one HOPWA funded project to HOPWA TH Transitional housing for homeless persons (including homeless youth) Staying or living with family, temporary tenure (e.g. room, apartment or house) 1 Staying or living with friends, temporary tenure (e.g. room, apartment or house) Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 25 2 1 2 1 Safe Haven Hotel or motel paid for without emergency shelter voucher 2 Host Home (non-crisis) Subtotal 40 5 1 2 1 Foster care home or group foster care home Psychiatric hospital or other psychiatric facility Substance abuse treatment facility or detox center 1 Hospital or other residential non- psychiatric medical facility Jail, prison, or juvenile detention facility Long-term care facility or nursing home Race Permanent Destinations Temporary Destinations Institutional Settings Report exits of persons/households(HHs) served on all HHAP- funded projects •Add the exits of persons/HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Subtotal 1 Residential project or halfway house with no homeless criteria Deceased Other Client Doesn't Know/Client Refused Data Not Collected (no exit interview completed) Subtotal Total 43 5 0 1 2 1 0 0 Total persons exiting to positive housing destinations 18 3 0 0 0 0 0 Total persons whose destinations excluded them from the calculation 0 0 0 0 0 0 0 0 Percentage 41.86% 60.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Non-Hispanic/ Non- Latino Hispanic/Latino Client Doesn't Know/ Client Refused Data Not Collected Moved from one HOPWA funded project to HOPWA PH Owned by client, no ongoing housing subsidy Owned by client, with ongoing housing subsidy Rental by client, no ongoing housing subsidy Rental by client, with VASH housing subsidy Rental by client, with GPD TIP housing subsidy Rental by client, with other ongoing housing subsidy 1 Permanent housing (other than RRH) for formerly homeless persons Staying or living with family, permanent tenure 1 Staying or living with friends, permanent tenure Rental by client, with RRH or equivalent subsidy Rental by client, with HCV voucher (tenant or project based) Rental by client in a public housing unit Subtotal 1 1 Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 7 8 Moved from one HOPWA funded project to HOPWA TH Transitional housing for homeless persons (including homeless youth) Staying or living with family, temporary tenure (e.g. room, apartment or house) 1 Staying or living with friends, temporary tenure (e.g. room, apartment or house) Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 15 16 Safe Haven Hotel or motel paid for without emergency shelter voucher 1 1 Host Home (non-crisis) Subtotal 24 25 Foster care home or group foster care home Psychiatric hospital or other psychiatric facility Substance abuse treatment facility or detox center 1 Permanent Destinations Temporary Destinations Institutional Settings Ethnicity Other Destinations Report exits of persons/households(HHs) served on all HHAP-funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Hospital or other residential non- psychiatric medical facility Jail, prison, or juvenile detention facility Long-term care facility or nursing home Subtotal 1 Residential project or halfway house with no homeless criteria Deceased Other Client Doesn't Know/Client Refused Data Not Collected (no exit interview completed) Subtotal Total 26 26 0 0 Total persons exiting to positive housing destinations 11 10 0 0 Total persons whose destinations excluded them from the calculation 0 0 0 0 Percentage 42.31% 38.46% 0.00% 0.00% Male Female Trans Female (MTF or Male to Female) Trans Male (FTM or Female to Male) Gender Non- Conforming (i.e. not exclusively male or female) Client Doesn't Know/Client Refused Data Not Collected Moved from one HOPWA funded project to HOPWA PH Owned by client, no ongoing housing subsidy Owned by client, with ongoing housing subsidy Rental by client, no ongoing housing subsidy Rental by client, with VASH housing subsidy Rental by client, with GPD TIP housing subsidy Rental by client, with other ongoing housing subsidy 1 Permanent housing (other than RRH) for formerly homeless persons Staying or living with family, permanent tenure 1 Staying or living with friends, permanent tenure Rental by client, with RRH or equivalent subsidy Rental by client, with HCV voucher (tenant or project based) Rental by client in a public housing unit Subtotal 2 Emergency shelter, including hotel or motel paid for with emergency shelter voucher, or RHY- funded Host Home shelter 10 5 Moved from one HOPWA funded project to HOPWA TH Transitional housing for homeless persons (including homeless youth) Staying or living with family, temporary tenure (e.g. room, apartment or house) 1 Staying or living with friends, temporary tenure (e.g. room, apartment or house) Place not meant for habitation (e.g., a vehicle, an abandoned building, bus / train / subway station / airport or anywhere outside) 22 9 Safe Haven Hotel or motel paid for without emergency shelter voucher 1 1 Host Home (non-crisis) Subtotal 34 15 Temporary Destinations Institutional Settings Other Destinations Gender Permanent Destinations Report exits of persons/households(HHs) served on all HHAP-funded projects •Add the exits of persons/HHs served in every HHAP- funded project •If you can count persons/HHs served by funding source, include exit count in the total. •If you can’t count persons/HHs served by the funding source, estimate exits based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total exits to each destination by 20% or .20). Include this estimated count in the total. Foster care home or group foster care home Psychiatric hospital or other psychiatric facility Substance abuse treatment facility or detox center 1 Hospital or other residential non- psychiatric medical facility Jail, prison, or juvenile detention facility Long-term care facility or nursing home Subtotal 0 1 Residential project or halfway house with no homeless criteria Deceased Other Client Doesn't Know/Client Refused Data Not Collected (no exit interview completed) Subtotal 0 0 Total 36 16 Total persons exiting to positive housing destinations 14 7 Total persons whose destinations excluded them from the calculation 0 0 Percentage 38.89% 43.75% Other Destinations MANUAL REPORTING FORM 61 61 0 0 1 25 0 60 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Adults 61 61 0 0 Children 0 0 0 0 Client Doesn't Know/ Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 61 0 0 0 For PSH & RRH - the total persons served who moved into housing 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Total Households 60 60 0 0 0 Heads of households and adult stayers in the project 365 days or Q7a. Number of Persons Served Q8a. Households Served Number of child and unknown-age heads of household Number of persons with unknown age Number of leavers Number of adult leavers Number of adult and head of household leavers Number of stayers Number of adult stayers Number of veterans Number of chronically homeless persons Number of youth under age 25 Number of parenting youth under age 25 with children Number of adult heads of household Number of children (under age 18) PROJECT TYPE: STREET OUTREACH Q5a. Report Validations Table Total number of persons served Number of adults (age 18 or over) This reporting form aligns with the HUD HMIS APR Programming Specifications: https://files.hudexchange.info/resources/documents/HMIS- Programming-Specifications.pdf Please refer to the Performance Metrics Detailed Instructions for additional guidance on completing this form. If possible, use an APR that includes all HHAP funded projects to help you complete this form. Fill out this sheet for the Street Outreach Project Type, DO NOT fill out for individual projects. Please report information in the space provided. Do not fill in boxed that have been blacked out. APR Question 5a. Report on persons served on all HHAP-funded projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 7a. Report on persons served on all HHAP-funded projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 8a. Report on households(HHs) served on all HHAP- funded projects in this project type •Add HHs served in every HHAP-funded project •If you can count HHs served by funding source, include this count in the total. For PSH & RRH - the total persons served who moved into housing 0 0 0 0 0 All Persons Contacted First contact - NOT staying on the Streets, ES, or SH First contact - WAS staying on the Streets, ES, or SH First contact - Worker unable to determine Once 47 0 31 0 2-5 Times 4 0 3 0 6-9 Times 0 0 0 0 10+ Times 0 0 0 0 Total Persons Contacted 50 0 34 0 All Persons Contacted First contact - NOT staying on the Streets, ES, or SH First contact - WAS staying on the Streets, ES, or SH First contact - Worker unable to determine Once 25 0 17 0 2-5 Contacts 1 0 1 0 6-9 Contacts 0 0 0 0 10+ Contacts 0 0 0 0 Total Persons Engaged 26 0 18 0 Rate of Engagement 52.00% 0.00% 53.00% 0.00% Total Without Children With Children and Adults Unknown Household Type Male 39 39 0 0 Female 21 21 0 0 Trans Female (MTF or Male to Female) 0 0 0 0 Trans Male (FTM or 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 Data Not Collected 0 0 0 0 Subtotal 61 61 0 0 Q10a. Gender of Adults Q10b. Gender of Children Q9a. Number of Persons Contacted (ES Night By Night and Street Outreach Only) Q9b. Number of Persons Engaged (ES Night By Night and Street Outreach Only) APR Question 9a. Report on persons/households(HHs) served on all HHAP-funded night-by-night emergency shelter projects •Add persons/HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count. APR Question 9b. Report on persons/households(HHs) served on all HHAP-funded night-by-night emergency shelter projects •Add persons/HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count. this count in the total. •If you can’t count HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count. APR Question 10a. Report on persons served on all HHAP-funded projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 10b. Report on persons served on all HHAP-funded projects in this project type Total With Children and Adults With Only Children Unknown Household Type Male 0 0 0 0 Female 0 0 0 0 Trans Female (MTF or Male to Female) 0 0 0 0 Trans Male (FTM or Female to Male) 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 Data Not Collected 0 0 0 0 Subtotal 0 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type Male 0 0 0 0 0 Female 0 0 0 0 0 Trans Female (MTF or Male to Female) 0 0 0 0 0 Trans Male (FTM or Female to Male) 0 0 0 0 0 Gender Non- Conforming (i.e. not exclusively male or female) 0 0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Subtotal 0 0 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type White 49 49 0 0 0 Black or African American 7 7 0 0 0 Asian 0 0 0 0 0 American Indian or Alaska Native 2 2 0 0 0 Native Hawaiian or Other Pacific Islander 2 2 0 0 0 Multiple Races 1 1 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 61 0 0 0 Q12a. Race Q10c. Gender of Persons Missing Age Information projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 12a. Report on persons served on all HHAP-funded projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. APR Question 10c. Report on persons served on all HHAP-funded projects in this project type •Add persons served in every HHAP-funded project •If you can count persons served by funding source, include this count in the total. •If you can’t count persons served by the funding source, estimate based on the proportion of HHAP funding. (Example: HHAP accounts for 20% of total funding for a project with pooled funding – multiply the total people served by the project by 20% or .20). Include this estimated count in the total. Total Without Children With Children and Adults With Only Children Unknown Household Type Non-Hispanic/Non- Latino 33 33 0 0 0 Hispanic/Latino 28 28 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 61 61 0 0 0 Total Without Children With Children and Adults With Only Children Unknown Household Type 12-17 0 0 0 0 18-24 0 0 0 0 Client Doesn't Know/ Client Refused 0 0 0 0 0 Data Not Collected 0 0 0 0 0 Total 0 0 0 0 0 Q12b. Ethnicity Q27a. Age of Youth APR Question 27a. Report on persons/households(HHs) served on all HHAP funded projects in this project type •Add persons/HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count in the total. APR Question 12b. Report on persons/households(HHs) served on all HHAP-funded projects in this project type •Add persons/HHs served in every HHAP-funded project •If you can count persons/HHs served by funding source, include this count in the total. •If you can’t count persons/HHs served by the funding source, estimate based on the proportion of HHAP funding. Include this estimated count in the total.