Physical Drug Abuse Yes Yes Mental Health Developmental Alcohol HIV/AIDS No No Chronic Health Condition Physical Drug Abuse Yes Yes Mental Health Developmental Alcohol HIV/AIDS No No Chronic Health Condition Physical Drug Abuse Yes Yes Mental Health Developmental Alcohol HIV/AIDS No No Chronic Health Condition Housing Referral Status (Assessment Disposition) Referred to emergency shelter/safe haven Referred to a homelessness diversion program Referred to transitional housing Unable to refer/accept within continuum; ineligible for Referred to rapid re-housing continuum projects Referred to permanent supportive housing Unable to refer/accept within continuum; continuum services unavailable Referred to homelessness prevention Referred to other community project (non-continuum) Referred to street outreach Applicant declined referral/acceptance Referred to other continuum project type Applicant terminated assessment Other/specify Housing Assessment at Exit Able to maintain the to new housing Moved in with Moved in with Moved to a housing they had at unit (answer family/friends on family/friends on a transitional or project entry (answer applicable question a temporary permanent basis temporary housing applicable question below) basis facility or program below) Client became homeless moving Client went to Client died Client doesn’t know Client refused – to a shelter or other jail/prison place unfit for human habitation If able to maintain the housing they had at project entry → selected above, answer the following questions: Without a subsidy With the subsidy With an Only with financial they had at subsidy acquired assistance other Subsidy project since project entry than a subsidy information: If unit selected With on-going subsidy Without an subsidy Moved to a new housing above, answer the following questions:
Physical Drug Abuse Mental Health Developmental Alcohol HIV/AIDS Chronic Health Condition Yes No Yes No Physical Drug Abuse Mental Health Developmental Alcohol HIV/AIDS Chronic Health Condition Yes No Yes No Physical Drug Abuse Mental Health Developmental Alcohol HIV/AIDS Chronic Health Condition Yes No Yes No Housing Referral Status (Assessment Disposition) Referred to emergency shelter/safe haven Referred to transitional housing Referred to rapid re-housing Referred to permanent supportive housing Referred to homelessness prevention Referred to street outreach Referred to other continuum project type Referred to a homelessness diversion program Unable to refer/accept within continuum; ineligible for continuum projects Unable to refer/accept within continuum; continuum services unavailable Referred to other community project (non-continuum) Applicant declined referral/acceptance Applicant terminated assessment Other/specify Housing Assessment at Exit Able to maintain the housing they had at project entry (answer applicable question below) to new housing unit (answer applicable question below) Moved in with family/friends on a temporary basis Moved in with family/friends on a permanent basis Moved to a transitional or temporary housing facility or program Client became homeless – moving to a shelter or other place unfit for human habitation Client went to jail/prison Client died Client doesn’t know Client refused → If able to maintain the housing they had at project entry selected above, answer the following questions: Subsidy information: Without a subsidy With the subsidy they had at project With an subsidy acquired since project entry Only with financial assistance other than a subsidy If Moved to a new housing unit selected above, answer the following questions: With on-going subsidy Without an subsidy