time in TH or other housing) Leave any Adoptive home (from foster care) Combined MI/CD treatment of these? Foster Home Home (0-3 Juvenile Detention Center Halfway House months County Jail Residence for people with physical ago) State or Federal Prison disabilities Mental Health Treatment Client doesn’t know Drug or Alcohol Treatment Client Refused Residence Place not meant for habitation to Emergency shelter, including hotel/motel paid w/ voucher Project Safe Haven Entry Interim Housing/Bridge Housing Foster care home or foster care group home (Where are Hospital or other residential non-psychiatric medial facility you Jail, prison or juvenile detention facility currently Long-term care facility or nursing home Psychiatric hospital or other psychiatric facility staying? ) Substance abuse treatment facility or detox center Hotel/motel paid for w/out emergency shelter voucher Owned by client, no ongoing housing subsidy Owned by client, w/ ongoing housing subsidy Permanent housing for formerly homeless Rental by client, no ongoing housing subsidy Rental by client, with VASH subsidy Rental by client, with GPD TIP subsidy Rental by client, with other ongoing housing subsidy Residential project or halfway house with no homeless criteria Staying or living in a family member’s room, apartment or Staying or living in a friend’s room, apartment or house Transitional housing for homeless persons (including homeless Don’t know How long have One night or less 1 month to 90 days Don’t know you stayed Two to six nights 90 days to one year Refused there? Over 1 week to under a month One year or longer Regardless of where they stayed last night – Number of Once 3 times Don’t Know times the client has been on the streets, in ES, or SH in Twice 4 or more Refused the past 3 years including today Total 1 month (this episode w/in 1st month) 10 number of 2 11 months 3 12 homeless 4 More than 12 months on the 5 Client know street, in ES 6 or SH in the 7 Client refused past 3 8 Data not collected years. 9 Is the client Chronically Homeless? Yes No Did you serve on No Yes, Reserves
time in TH or other housing) Leave any of these? (0-3 months ago) Adoptive home (from foster care) Foster Home Juvenile Detention Center County Jail State or Federal Prison Mental Health Treatment Drug or Alcohol Treatment Combined MI/CD treatment Home Halfway House Residence for people with physical disabilities Client doesn’t know Client Refused Residence to Project Entry (Where are you currently staying? ) Place not meant for habitation Emergency shelter, including hotel/motel paid w/ voucher Safe Haven Interim Housing/Bridge Housing Foster care home or foster care group home Hospital or other residential non-psychiatric medial facility Jail, prison or juvenile detention facility Long-term care facility or nursing home Psychiatric hospital or other psychiatric facility Substance abuse treatment facility or detox center Hotel/motel paid for w/out emergency shelter voucher Owned by client, no ongoing housing subsidy Owned by client, w/ ongoing housing subsidy Permanent housing for formerly homeless Rental by client, no ongoing housing subsidy Rental by client, with VASH subsidy Rental by client, with GPD TIP subsidy Rental by client, with other ongoing housing subsidy Residential project or halfway house with no homeless criteria Staying or living in a family member’s room, apartment or Staying or living in a friend’s room, apartment or house Transitional housing for homeless persons (including homeless Don’t know How long have you stayed there? One night or less Two to six nights Over 1 week to under a month 1 month to 90 days 90 days to one year One year or longer Don’t know Refused Regardless of where they stayed last night – Number of times the client has been on the streets, in ES, or SH in the past 3 years including today Once Twice 3 times 4 or more Don’t Know Refused Total number of months homeless on the street, in ES or SH in the past 3 years. 1 month (this episode w/in 1st month) 2 3 4 5 6 7 8 9 10 11 12 More than 12 months Client know Client refused Data not collected Is the client Chronically Homeless? Yes No Did you serve on No Yes, Reserves
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