2015 HUD CoC Competition Evaluation Instrument



Similar documents
Changes in the HUD Definition of Homeless

Quality Data Assures Quality Decisions. Acknowledgements: Symmetric Solutions, Inc. prepared this document under the direction of

CoC Debriefing Summary FY 2013

SOUTHERN NEVADA COC APPLICATION PROCESS

Supportive Housing Program (SHP) Self-Monitoring Tools

2014 SOUTHERN NEVADA CONTINUUM OF CARE (COC) LOCAL PROJECT APPLICATION INSTRUCTIONS. July 31, 2013

Homelessness in Greater New Orleans: A Report on Progress toward Ending Homelessness May 2012

SWAP (System-Wide Analytics and Projection) Tool: 2016 Emergency Shelter Program Performance Analysis

Resource Allocation and Monitoring Strategies

CoC SuperNOFA Addressing HUD Priorities for a Competitive Proposal

Chicago Continuum of Care (CoC) Orientation

Senate Bill (SB) 855: Housing Support Program Orange County Application

HPRP Grantee Monitoring Toolkit

The President s 2016 Budget: Fact Sheet on Homelessness Assistance

Emergency Solutions Grants Program. Eligible Expense Guide

System Performance Measures An introductory guide to understanding system-level performance measurement

New York City Department of Homeless Services Audit Services Directive Number 1 Audit Protocols For Human Services Contracts

U.S. Department of Housing and Urban Development. Community Planning and Development

RECOVERY HOUSING POLICY BRIEF

Supportive Services for Veteran Families (SSVF)

A Quick Summary for Domestic Violence Advocates

CRITERIA FOR RESIDENCY AT APARTMENTS RESIDENT SCREENING AND SELECTION PROCESS

A Homeless Prevention System for London Ontario

Pre-Application for Waiting List Section 8 Housing Choice Voucher (HCV) Program

Supportive Housing Collaborations Miami Dade Examples

Coordinated Assessment-Centralized Intake System (CA-CI) for Homeless Services and Housing. System Assessment Part I DRAFT

ART GALLERY INDEX April 18, 2014

Renewal Project Application

Long-Term Homeless Definitions and Eligibility Questions

EMERGENCY SOLUTIONS GRANT PROGRAM

Data Quality Plan Louisiana Service Network Data Consortium

Before Starting the Project Application

Chicago Homeless Management Information System (HMIS) Privacy Packet

Length of stay numbers are approximate and were calculated using a weighted average over multiple programs. 97

DEPARTMENT OF HUMAN RESOURCES FAMILY INVESTMENT ADMINISTRATION TEMPORARY CASH ASSISTANCE MANUAL COMAR SUPPORTIVE SERVICES 1300

EMERGENCY SOLUTIONS GRANTS PROGRAM (ESG) ELIGIBLE EXPENSE GUIDE

2016 Homeless Count Results Los Angeles County and LA Continuum of Care. Published by: Los Angeles Homeless Services Authority May 4,


Continuum of Care - Veterans Integration

TIPS AND TRICKS FOR USING THE HRE VIRTUAL HELP DESK

Standardized Performance Measures

MAG Continuum of Care Regional Committee on Homelessness HUD McKinney-Vento Homeless Assistance Funding Program Performance Monitoring Methodology

Ending Family Homelessness through Housing First (Rapid Rehousing)

HOUSING AUTHORITY OF THE CITY OF AUSTIN. Community Service and Self Sufficiency Requirement

MEDICAL CASE MANAGEMENT SERVICES

MEMORANDUM NOTE DE SERVICE

Human Services Management Program

HIV/AIDS Housing Inventory

HMIS Annual Assessment Form

St Johns County CoC Governance Charter St Johns County Continuum of Care St Johns County Continuum of Care Board Purpose of the CoC and CoC Board

TENANT SELECTION CRITERIA

HOUSING AUTHORITY OF THE CITY AND COUNTY OF DENVER VIOLENCE AGAINST WOMEN ACT PROCEDURE

EMERGENCY SOLUTIONS GRANT (ESG) SHELTER PROGRAM AWARD TRAINING

Coordinated Entry & Housing Resource Centers Alameda County 2016 Initial Design Report COMMENT DRAFT

DENVER HOUSING FIRST COLLABORATIVE COST BENEFIT ANALYSIS AND PROGRAM OUTCOMES REPORT. Jennifer Perlman, PsyD, and John Parvensky

Victim Services Programs. Core Service Definitions

Homelessness Prevention & Rapid Re-housing: Community Perspectives

Integrated Care for the Chronically Homeless

Housing Trust Fund, Ending Long-Term Homelessness Initiative Fund & Housing with Supports for Adults with Serious Mental Illness

HMIS Data Quality Plan

This application meets the screening requirements for the following areas:

SAMPLE SUPPORTIVE HOUSING INTAKE/ASSESSMENT FORM

Homeless Count and Characteristics Survey Results. South Plains Homeless Consortium. January 22, 2015

Complete Program Listing

Virginia Preschool Initiative. Guidelines for the Virginia Preschool Initiative Application

Terraces at Lawson Creek Resident Selection Criteria

SOCIAL SERVICE SPECIALIST

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Social Worker - King County Step-Up Program

Maximize treatment completion and abstinence for individuals with drug and/or alcohol dependencies, and connect them to follow-up treatment services.

Closing the Front Door: Creating a Successful Diversion Program for Homeless Families

REQUEST FOR PROPOSALS (RFP) APPLICATION GUIDEBOOK HOMELESSNESS PREVENTION AND RAPID RE-HOUSING PROGRAM (HPRP)

Orange County Investment in Programs to Prevent and End Homelessness Review and Recommendations. Barbara Poppe and associates

New Hampshire HMIS Governance Model

Criminal Justice Policy Development Committee Policies and Procedures

The Road Home. Spokane Regional Ten-Year Plan to End Homelessness Annual Update. July 2010

Fidelity to Housing First

2015 Results Los Angeles Continuum of Care. Published by: Los Angeles Homeless Services Authority May 11, 2015

MAYOR S HOUSING THE HOMELESS TASK FORCE REPORT

EveryOne Home Property Management Partner Guidelines

SCHOOL READINESS PROVIDER MONITORING TOOL

HOMESTUDY PROCEDURES

PERFORMANCE BASED CONTRACTS EXAMPLES FROM COLUMBUS, OHIO

PLEASE SUBMIT ONLY ONE (1) APPLICATION PER HOUSEHOLD EVEN IF YOU ARE INTERESTED IN MORE THAN ONE (1) PROPERTY. THANK YOU.

Released: March 1, 2011

Network Monitoring Handbook

Calgary Singles Acuity Scale Toolkit

SUPPORTIVE HOUSING OPTIONS NYC

Kansas State Department of Education STATE PLAN FOR THE EDUCATION FOR HOMELESS CHILDREN AND YOUTH PROGRAM

Standards for the School Social Worker [23.140]

HOUSING AUTHORITY OF THE CITY OF SAN BUENAVENTURA

IHCDA Tenants Guide to Section 42

PLEASE SUBMIT ONLY ONE (1) APPLICATION PER HOUSEHOLD EVEN IF YOU ARE INTERESTED IN MORE THAN ONE (1) PROPERTY. THANK YOU.

HOPWA DESKTOP & SITE VISIT MONITORING TOOL Texas Department of State Health Services (DSHS) HIV Care Services Group

Certified Peer Counselor Training Application

Targeting Plan and Key Program Operating Assistance: Basic Procedures and Requirements

Taking research to practice: Program design and evaluation LESSONS FROM THE DOORWAY PILOT

It begins in sections A, B, C and D with the basics -- goals, eligible participants, types of projects allowed, and eligible spending categories.

McKinney Vento Homeless Assistance Act

Affordable Housing Opportunities

Transcription:

2015 HUD CoC Competition Evaluation Instrument For all HUD CoC-funded projects in the Chicago Continuum of Care [PROJECT COMPONENT]

General Instructions Each year, on behalf of the CoC Board, the Chicago Alliance to End Homelessness carries out an evaluation of all agencies and projects applying for renewal HUD Continuum of Care (CoC) funds. In 2015, all agencies receiving HUD CoC funding must submit an Evaluation Instrument. This includes projects formerly classified as Supportive Housing Program (SHP), and Shelter Plus Care (SPC). SHP and SPC programs fund Permanent Housing (PH), Transitional Housing (TH) and Supportive Service Only (SSO) programs. The 2015 Evaluation Instrument contains 2 sections, the Agency Component (worth 17 points) and the Project Component (worth 83 points). All agencies must submit one Agency Component, followed by Project Components for each project receiving HUD CoC funding that had a grant period operating between January 1, 2014 to December 31, 2014. Please note, all former Shelter Plus Care projects must submit an evaluation, regardless of renewal date. All agencies are required to utilize the 2015 Instruction Manual to complete the 2015 Evaluation Instrument. If you have questions, please email CoCPrograms@allchicago.org. Checklist for Submission This checklist is provided to aid you in ensuring your submission is complete. Please refer to the Instruction Manual for information on how to submit the Evaluation Instrument. Threshold Section Most Recently Submitted APR (e-snaps) HMIS Report B: 0625 - HUD CoC APR for the dates of January 1, 2014 to December 31, 2014 (NOTE: this report will be uploaded in Performance section, but is required to verify 80% capacity Threshold) Threshold Waiver Request explanatory letter for any response (if applicable) A. Project Certification Checklist attachments necessary for this section B. Project Operations 2015 Match and Leverage Spreadsheet D. Leading Practices Housing First attachments necessary for this section E. Project Performance and Consumer Outcomes SSO Functionality Worksheet (for SSO projects) HMIS Report B: 0625 HUD CoC APR for the dates of January 1, 2014 to December 31, 2014 (Excel Format Required) HMIS Report C: 0625 HUD CoC APR for the dates of January 1, 2013 to December 31, 2013 (Excel Format Required, t required for PSH/SH or SSO) C. HMIS HMIS Report A: 0625 - HUD CoC APR for the dates of January 1, 2014 to December 31, 2014 (PDF Format Required) F. System Priorities HUD Approved Budget Letter (if applicable) This page does not need to be submitted with the Evaluation Instrument. 1

Agency & Project Information Agency Name Project Name Project HUD Grant Number (for 2014) For Long Term Rental Assistance, please use City Grant Number Cover Page Primary Contact Information for Project Component Contact Name Contact Phone Number Contact Title Contact Address + City, St, Zip Contact Email Address Secondary Contact Information for Project Component (required) Contact Name Contact Phone Number Contact Email Address Other Contacts (feel free to list names and emails of up to 2 others you would like to receive information from the Alliance about this project) Contact Name Contact Name Contact Email Address Contact Email Address Project Component Page 1

Threshold Questions Threshold questions must be answered affirmatively, if applicable, in order to be considered for renewal funding. If the question is applicable, and if an agency cannot answer affirmatively, an explanatory letter must be submitted for review by a committee of the CoC Governing Board. That committee may request additional information, and will determine if the agency is eligible for a Threshold Waiver. 1. Project Utilization: Is your project at or above 80% capacity? For projects with beds, data will be taken from the HMIS Report B: 0625-HUD CoC APR, run for the dates of January 1, 2014 to December 31, 2014 (included with the Project Performance section). Agencies must be at or above 80% for all of the following: Average bed utilization rate The 4 point-in-time bed utilization rates Agency self-report - Please list the number of people this project should serve at a given time, according to your contract with HUD: All Projects must submit a 0625 - HUD CoC APR for 2014 in Excel format DV Projects: complete based on most recently submitted APR SSOs will be verified using self-report 2. Did your project submit the most recent APR to HUD in e-snaps? Attachment of most recently submitted APR Attachment of APR required 3. Does your agency participate in HMIS for this project? Participation is defined as making reasonable efforts to enter all Universal Data Elements (UDEs) for all clients. DV Exclusive Agency 4. Is the project operating consistently with Chicago s Program Models Chart (revised 2010)? If, please provide a detailed narrative explaining the components of the project requesting renewal funding and how those are consistent with the Program Models Chart. Narrative required if Project Component Page 2

5. Does this project serve families where there is at least one parent and one child? If, agency can move on to Threshold Question 6. Project does not need to submit explanatory letter if project does not serve families. If, please answer the following questions: 5A. Does the project accept all families with children 18 and under without regard to the age or gender of any child? 5B. Does the project ensure that a staff person has designated responsibility for ensuring that children are enrolled in school and connected to appropriate services in the community? 5C. Are the proposed laws related to providing education services to individuals and families? Question 5 is informational. If, answer questions 5A- 5C, which are Threshold questions. 6. Does this project agree to take measures to ensure that the address or location of any family violence shelter project in the Chicago CoC, that is assisted with HUD CoC funds, will not be made public, except with written authorization of the person responsible for the operation of such project? Project Component Page 3

A. Project Certification Checklist/ Site Visit Requirements The certification checklist is a way for agencies to demonstrate compliance with the standards outlined by HUD and the Chicago CoC, without having to submit the extensive documentation required in the past. Each question in this section corresponds with another section of the tool, as identified in the table below for your reference. The certification checklist must be completed and signed by the Authorized Representative of the agency verifying the documents are in place. E-signature will be required for submission. Starting in 2015, the Alliance in conjunction with the HUD McKinney Vento (HMV) Committee will be conducting site visits to selected agencies and will request the supporting documentation to support a yes answer to any of these questions. Grant Management 1. The project draws down funds from HUD s Line of Credit Control System (LOCCS) at least quarterly. For SPC Projects only, the project submits monthly vouchering to DFSS. 2. The project has a tracking system in place that tracks the status of the award through the technical submission, grant agreement, development activities, start of operations, amendments, end of operations, and renewal. The tracking system also communicates dates of submission of APRs, audits, and required monitoring remedies/sanctions. 3. The project has been monitored by HUD within the last two years and is able to provide monitoring documentation (audit notification letter from HUD, HUD monitoring report, and all monitoring related correspondence between agency and HUD). N/A Agency has not been monitored by HUD Housing Quality and Standards 4. The project is able to demonstrate how it has used results of evaluations or audits within the past two years to improve project operations (this may include past Evaluation Instruments or HMIS data quality reports). 5. The project and its facilities meet the ADA requirements for accessibility that were in place at the time the project was awarded, including making reasonable accommodations to the building, common areas, living areas and bathrooms. (te that the ADA requirements were updated in 2010, but agencies are only required to comply with the standards in place at the time the project began, or at the time any of the units were rehabbed.) Project Component Page 4

6. The project is able to provide inspection forms regarding the regular Housing Quality Standards/Health and Safety Inspections (at the facility where services are provided). The project is able to demonstrate the frequency with which the inspections occur, title(s) of who conducts inspections. 7. The project is able to provide HUD approved documentation for the Environmental Review of all new and renewal units. 8. The project orients consumers to emergency evacuation procedures related to the project facilities. Best Practices 9. The project has documentation demonstrating the topics of staff diversity trainings (which may include topics such as race, cultural, religion, sexual orientation, gender, or age) attended by project staff within the last calendar year. 10. The project has documentation demonstrating the topics of staff development trainings (other than diversity trainings) attended by project staff within the last calendar year. 11. The project is able to demonstrate how the staff members who deliver services or case management for the project use motivational interviewing strategies with consumers. 12. The project is able to demonstrate how the staff members who deliver services or case management for the project use the stages of change model with consumers to ensure that services are appropriate and responsive to consumer needs. 13. The project is able to provide documentation of the evidence based practice model if the staff members who deliver services or case management for the project use other evidence based practice models with consumers. Resource Linkage 14. The project has access or linkage to specialized resources for consumers in the project to meet the unique needs of consumers with psychosocial barriers (i.e. substance use counseling, psychiatric services). Project Component Page 5

15. The project has direct access or linkage to specialized resources for consumers in the project to meet the unique needs of consumers with physical disabilities 16. The project has direct access or linkage to specialized resources for consumers in the project to meet the unique needs of consumers with communication barriers (i.e., interpreter, bilingual materials, Braille materials, Text Telephone TTY/TDD). Policies and Procedures 17. If the project works with landlords who use criminal background checks as barriers to entry, the project is able to provide a listing of specific felonies that bar entry. 18. If the project works with landlords who use credit checks as barriers to entry, the project is able to specify reasons that they bar entry (i.e. poor credit, hospital/healthcare bills, evictions, rental history). 19. The project proactively identifies and intervenes when behavioral or tenancy issues arise with consumers before they reach a level warranting discharge. The project will be able to demonstrate an example of an incident that illustrates this. 20. The project is able to provide a copy of the consumer handbook and/or orientation that demonstrates how the discharge policy is explained and is easily accessible to consumers. 21. The project s written discharge policies include all of the following: a. An internal, due process hearing or investigation prior to discharging the consumer. b. Assistance with locating other housing (for housing projects) or service (for SSO projects) options, if needed. c. A statement that the agency will make and document all reasonable attempts to avoid discharging consumers onto the street or without needed services. 22. The project has written eligibility criteria that are provided to consumers which are in line with the Housing First philosophy. Project Component Page 6

23. The project has a written policy that states admission/tenant screening and selection practices promote the acceptance of applicants regardless of their sobriety or use of substance, completion of treatment and participation in services. 24. The project has a written policy that states taking psychiatric mediation and/or treatment compliance for mental illness are not a requirement for entry into or continued participation in the project. 25. The project has a written policy accepting all consumers regardless of criminal history to the project. 26. The project has a written policy accepting consumers regardless of rental history or past evictions. 27. The project has a written policy accepting consumers regardless of lack of financial resources. 28. The project has a written policy accepting consumers regardless of past non-violent rule infractions within the agency s own program and/or in other previous housing programs. 29. The project is able to provide a copy of the menu services which offers a variety of services that are flexible and appropriate for consumers in various stages of change. Checklist Continues on Next Page Project Component Page 7

30. For family projects, the project has policies that are in alignment with the following: a. The case management model includes developmentally appropriate intake and service planning for each member of the family as an individual (including bio psychosocial or other appropriate assessment). b. Services are delivered where the child is living or the project provides a space for home based, early childhood services. c. Facilitate on-site development screening for all children that enter the program. d. Actively assist the families in accessing child care. e. Has written procedures that require agency workers to provide guidance and support around enrolling children in pre-school or school. f. Connects families to Chicago Public School s Students in Temporary Living Situations liaisons and/or inform families of their homeless student rights. g. Assess, track and monitor the health of children in the program, including providing assistance with connecting to health care provider(s). h. The program s administrative, service-delivery, and living facilities utilize space and materials to promote healthy parent-child engagement that fosters healthier relationships. N/A Project does not serve families Certification By checking this box and entering the Authorized Representative s name in the space below, I certify (1) to the statements contained in the list of certifications above and (2) that the information throughout the application is true, complete, and accurate to the best of my knowledge and (3) all supporting documentation will be reviewed during a site visit conducted by HMV and the Chicago Alliance staff. Authorized Representative Signature (type name and title) Please refer to the detailed instructions for a definition of authorized representative. E-signatures are acceptable Project Component Page 8

B. Project Operations: 11 Points It is the priority of the Chicago CoC to ensure that all projects operate under the highest quality of industry standards, are meeting HUD requirements, providing staff with professional development opportunities and seeking to continually improve the operations of the project. 1. Was the project able to draw down from HUD and expend 100% of the funds for this project for the grant term that just ended? 3 points for 1A. If no, how much $ was unspent? 1B. If no, explain the reason for not expending 100% of the funds: 2. What dollar amount of match and leverage can the project provide for the upcoming award year? Attachment of 2015 Match and Leverage Spreadsheet required. Please refer to Instruction Manual for acceptable forms of match and leverage. The question will be scored on the ratio of match and leverage compared to the project dollar amount (including admin funds). te that projects will be required to provide this ratio of match and leverage at the time of the HUD application. N/A for LTRA or New If (or New), please answer questions to left Enter the ratio from the 2015 Match and Leverage spreadsheet -1 point for > 10% LTRA projects and New projects (that have not completed a full grant year) will not be scored Ratios 2:1 = 6pts 1.75:1 = 5pts 1.5:1 = 4pts 1:1 = 3 pts 0.75:1 = 2 pts 0.5:1 = 1pt Attachment required 3. Does the project conduct regular Housing Quality Standards/Health and Safety Inspections (at the facility where services are provided)? 4. Has the project completed the required Environmental Review(s) for the project? Requirements may vary based on project. See Instruction Manual for more details. 2 point for Unscored Project Component Page 9

C. Homeless Management Information System (HMIS) Implementation & Data Quality: 16 Points HMIS implementation, participation and data quality are priorities for both the CoC Governing Board and HUD. By implementing a system-wide HMIS, the Chicago homeless system will be able to provide continuous and accurate information on persons served by homeless assistance programs including whether the number served are increasing or decreasing. Accurate and timely data assists with determining whether the current approaches to ending homelessness are appropriately designed. HMIS will also provide system-wide data which will assist Chicago in measuring our success implementing the HEARTH Act and Plan 2.0. 1. Does this project exclusively serve victims of domestic violence? If yes, please answer 1A and 1B, then skip to Section D. A. Does this project meet HUD requirements by entering the HUD required APR data into a comparable database? B. If yes, what database? Informational question. 2. Has your agency complied with the requirements of the last 3 Quarterly Data Quality Assessment Process as administered by the HMIS Lead program at the CAEH? Check all that apply: 3 points per quarter for a total of 9 points a. June 2014 b. October 2014 c. January 2015 Evidence of participation is kept on file at the Chicago Alliance. In order to be considered participating, projects must have submitted required reports by the stated deadline. 3. Are you able to run and attach a copy of the HMIS report 0625 - HUD CoC APR for the dates of January 1, 2014 to December 31, 2014? Attachment of 0625 - HUD CoC APR (PDF File Format Required). Attachment Required: 2 points for attached report in PDF format Project Component Page 10

4. Do you have 5% or less missing values on the HUD required Universal Data Elements and Program Specific Data Elements in HMIS for the reporting period of January 1, 2014 to December 31, 2014? For assistance, please reference the HMIS Chicago Data Quality Report (not required to be attached). Information will be verified by the Alliance staff through ServicePoint. 5 points for all data elements missing less than 5% -1 point for each data element that has >5% missing values with maximum of 5 points deducted Project Component Page 11

D. Leading Practices Housing First and Consumer Focus: 12 Points As Chicago continues to implement its plan to end homelessness, it is a priority of the CoC Governing Board that projects continue to be innovative and flexible in their service delivery in order to meet the changing needs of all consumers who access the homeless service system. This section prioritizes the innovative and flexible delivery of services to consumers, with a focus on housing first and harm reduction principles. It is important that the Chicago Continuum of Care and its partners have non-restrictive admission and program retention requirements that are appropriate for the populations being served, including no sobriety requirements for persons using substances and inclusion of persons with criminal histories. 1. Does the project provide and explain the written eligibility criteria which are in line with the Housing First philosophy to consumers? 2. Does the project have an admission/tenant screening and selection practices that promote the acceptance of applicants regardless of their sobriety or use of substances, completion of treatment, and participation in services? 3. Does the project accept consumers who are diagnosed with or show symptoms of a mental illness? 3 points for 1 point for 1 point for 4. Does the project have and follow a written policy for the following statements: a. Stating that taking psychiatric medication and/or treatment compliance for mental illness is not a requirement for entry into or continued participation in the project? b. Accepting all consumers regardless of criminal history to the project? If no, please describe the funder policy limiting acceptance in the space provided: c. Accepting consumers regardless of rental history or past evictions to the project? d. Accepting consumers regardless of lack of financial resources to the project? e. Accepting consumers regardless of past non-violent rule infractions within the agency s own program and/or in other previous housing programs to the project? 1 point for each for a total of 5 points Question 4b: 1 point will be given for if funder policy is explained Project Component Page 12

5. Upon entry to the project, the project agrees to allow consumers to remain in the project even if they require an absence of 90 days or less due to the reasons outlined below. If other laws or funders of the project require less amount of time, but the project eligibility criteria does not, please select and describe the funder policy or law in the space below. a. Substance use treatment intervention b. Mental health treatment intervention 1/2 point for each for a total of 2 points 1/2 point will be given for if funder policy is explained c. Hospitalization d. Incarceration Law and/or Funder Policy Description, if applicable: Project Component Page 13

E. Project Performance and Consumer Outcomes: 32 Points It is the priority of the CoC Governing Board that all projects participating under the Plan and receiving HUD funding meet high standards for performance in identified priority areas including housing retention and acquisition of income and employment. This section uses the HMIS report 0625 - HUD CoC APR (to be submitted in EXCEL format) for the dates of January 1, 2014 to December 31, 2014 and APR Calculations Worksheet to assess the project s performance. Some questions may require the HMIS Report 0625 HUD CoC APR to be run for multiple years for comparison purposes. Questions in this section will be awarded points based on the percentile category, unless otherwise indicated. For details on the percentile categories, please review the Instruction Manual. 1. Please select the Chicago Program Model type for this project: Interim Housing (complete Questions 2-4 and 17-20) Permanent Housing with Short-Term Supports (complete Questions 5-7 and 17-20) Permanent Housing for Youth Project Based (complete Questions 8-10 and 17-20) Permanent Supportive Housing & Safe Havens (complete Questions 11-13 and 17-20) Supportive Service Only (complete Questions 14-20) INTERIM HOUSING: 17 Points Answer Questions 2-4, then skip to Question 17 2. Of the consumers who left the project, what percentage of consumers went into permanent housing? HUD CoC APR. Please reference the detailed instruction 3. Did the project increase the number of consumers placed into permanent housing compared to the previous year, or does the project currently operate at 95% or above in placing consumers in permanent housing? Question will be scored using data from HMIS Reports: 0625 - HUD CoC APR. Please reference the detailed instruction % N/A Leavers 95%+ Increased Points by Percentile 7 points for 90th 6 points for 80th 5 points for 70th 4 points for 60th 3points for 50th 2 points for 40th 1 point for 30th 0 points for <30 th Points by Percentile 5 points for 95%+ 4 points for 90 th 3 points for 80 th 2 points for 70 th 1 point for 60 th 0 points for <60 th Project Component Page 14

4. What percentage of consumers who departed the project into permanent housing in the previous year retained permanent housing at the 6-month followup? AGENCY SELF REPORT: To calculate the answer to the question, please provide the number of consumers that were still permanently housed at 6-month follow-up: HUD CoC APR and agency self-report. % te: Agency Self Report Required on 6-month follow-up in the space to the left. Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th PERMANENT HOUSING WITH SHORT-TERM SUPPORTS: 17 Points Answer Questions 5-7, then skip to Question 17 5. Of the consumers who left the project, what percentage of consumers exited to permanent housing and/or assumed responsibility for their lease? HUD CoC APR. Please reference the detailed instruction % N/A Leavers Points by Percentile 7 points for 90th 6 points for 80th 5 points for 70th 4 points for 60th 3points for 50th 2 points for 40th 1 point for 30th 0 points for <30 th 6. Did the project significantly increase the number of consumers placed in permanent housing compared to the previous year, or does the project currently operate at 95% or above in placing consumers in permanent housing? Question will be scored using data from HMIS Reports: 0625 - HUD CoC APR. Please reference the detailed instruction 95%+ Increase 5% Points by Percentile 5 points for 95%+ 4 points for 90 th 3 points for 80 th 2 points for 70 th 1 point for 60 th 0 points for <60 th Project Component Page 15

7. What percentage of consumers, who departed the program to permanent housing, retained permanent housing at the 6-month follow-up? AGENCY SELF REPORT: To calculate the answer to the question, please provide the number of consumers that were still permanently housed at 6-month follow-up: HUD CoC APR and agency self-report. % te: Agency Self Report Required on 6-month follow-up in the space to the left. Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th PERMANENT HOUSING for YOUTH PROJECT BASED: 17 Points Answer Questions 8-10, then skip to Question 17 8. Of the consumers who left the project, what percentage of consumers went into permanent housing? HUD CoC APR. Please reference the detailed instruction % N/A Leavers Points by Percentile 7 points for 90 th 6 points for 80 th 5 points for 70 th 4 points for 60 th 3points for 50 th 2 points for 40 th 1 point for 30 th 0 points for <30 th 9. Did the project significantly increase the number of consumers placed in permanent housing compared to the previous year, or does the project currently operate at 95% or above in placing consumers in permanent housing? Question will be scored using data from HMIS Reports: 0625 - HUD CoC APR. Please reference the detailed instruction 95%+ Increase 5% Points by Percentile 5 points for 95%+ 4 points for 90 th 3 points for 80 th 2 points for 70 th 1 point for 60 th 0 points for <60 th Project Component Page 16

10. What percentage of consumers, who departed the program to permanent housing, retained permanent housing at 6-month follow-up? AGENCY SELF REPORT: To calculate the answer to the question, please provide the number of consumers that were still permanently housed at 6-month follow up: HUD CoC APR and agency self-report. % te: Agency Self Report Required on 6- month stay in the space to the left. Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th PERMANENT SUPPORTIVE HOUSING & SAFE HAVEN: 17 Points Answer Questions 11-13, then skip to Question 17 11. What percentage of the total consumers served remained permanently housed either in the project, or in another permanent housing option? HUD CoC APR. Please reference the detailed instruction % Points by Percentile 7 points for 90th 6 points for 80th 5 points for 70th 4 points for 60th 3points for 50th 2 points for 40th 1 point for 30th 0 points for <30 th 12. What percentage of the total consumers served remained for at least 12 months in your permanent housing project? HUD CoC APR. Please reference the detailed instruction % Points by Percentile 5 points for 95%+ 4 points for 90 th 3 points for 80 th 2 points for 70 th 1 point for 60 th 0 points for <60 th 13. Of the consumers who left the project, what percentage of consumers went into permanent housing? HUD CoC APR. Please reference the detailed instruction % N/A Leavers Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th Project Component Page 17

SUPPORTIVE SERVICE ONLY: 17 Points Answer Questions 14-20 14. What percentage of consumers who left the project was housed (including transitional and permanent arrangements)? HUD CoC APR. Please reference the detailed instruction % N/A Leavers Points by Percent Range 7 points for >90% 6 points for 80-89% 5 points for 70-79% 4 points for 60-69% 3points for 50-59% 0 points for <50% 15. Functionality 1: Using the same functionality measures used in the previous years, can you demonstrate maintenance or increase in the percentage of consumers increasing functionality? Question will be scored using the SSO Functionality Worksheet for this year. The Alliance will compare information based off SSO Functionality Worksheet submitted with the 2014 Evaluation Instrument. 16. Functionality 2: Using the same functionality measures used in the previous years, can you demonstrate a maintenance or increase in the percentage of consumers increasing functionality? Question will be scored using the SSO Functionality Worksheet for this year. The Alliance will compare information based off SSO Functionality Worksheet submitted with the 2014 Evaluation Instrument. 5 Points Increased 3 Points Maintained 0 Points Did not maintain or increase outcome Attachment required 5 Points Increased 3 Points Maintained 0 Points Did not maintain or increase outcome Attachment required ALL PROJECT TYPES: 15 Points Answer Questions 17-20 17. What percentage of consumers who were served through the project had employment income? HUD CoC APR. Please reference the detailed instruction % Points by Percentile 4 points for 90 th 3 points for 80 th 2 points for 70 th 1 point for 60 th 0 points for <60 th Project Component Page 18

18. What percentage of the consumers served in the project have non-cash benefits through mainstream resources? HUD CoC APR. Please reference the detailed instruction % Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th 19. What was the average overall change in monthly cash benefits/income of those consumers who left? HUD CoC APR. Please reference the detailed instruction 20. What percentage of consumers who exited the project exited to an unknown destination? HUD CoC APR. Please reference the detailed instruction $ N/A Leavers % N/A Leavers Points by Percentile 5 points for 90 th 4 points for 80 th 3 points for 70 th 2 points for 60 th 1 point for 50 th 0 points for <50 th 1 points for less than 10% 0 points for 10% or more Project Component Page 19

F. System Priorities: 12 Points The CoC Governing Board sets the priorities for the system, and most recently, the system priorities were endorsed with the passage of Chicago s updated plan to end homelessness, Plan 2.0. In Plan 2.0, specialized services for projects that serve families and/or youth came to light, and therefore, we added questions this year to demonstrate to agencies that these special services are important and may be required in the future. Additionally, many priorities are carried over from the original plan, like maintaining a high housing to service ratio, and targeting special populations. 1. Does this project seek to maintain or increase its housing to service ratio? Attached HUD Approved Budget Letter, if applicable. Evidence of maintaining or increasing housing to service ratio is held on file with the Alliance. 2. Does this project serve individuals and families that meet HUD s definition of chronically homeless? If, please complete 2A and 2B using the 2015 Chronic Homeless Report. If, please proceed to question 3. 2A: How many people have you served from January 1, 2014 to December 31, 2014 that meet HUD s definition of chronically homeless? 2B: How many total people did you serve from January 1, 2014 to December 31, 2014? N/A (for SSOs and LTRA projects) N/A (for HUD TH projects) % Divide A by B and enter percentage in the space above 4 points for Attachment required if recently obtained HUD Approved Budget letter 3.5 points for serving 70%+ chronic 2 points for serving 50%+ chronic Project Component Page 20

3. If the project serves individuals or people in families that meet any of the criteria below, please complete 3A and 3B. 3A: How many people have you served from January 1, 2014 to December 31, 2014 have the following conditions: i. Have a HUD-defined disability ii. Were formerly incarcerated (ex-offenders) iii. Are youth heads of households ages 14-24 % Divide the highest number in 3Ai - v by 3B and enter percentage in the space above 3.5 points for serving 70%+ special population 2 points for serving 50%+ special population iv. Are families v. Are veterans 3B: How many total people did you serve from January 1, 2014 to December 31, 2014? 4. Is the project actively retrieving referrals from the Centralized Referral System (CRS) to fill unit vacancies as required by the CoC? The Chicago Alliance will verify information with CRS managing entity. N/A IH, PH- Youth, SSO 1 Point for N/A for Interim Housing, PH for Youth Project- Based, and SSO Project Component Page 21