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Total number of records for All Clients
Total number of records for Adults Only
Total number of records for Unaccompanied Youth
Total number of records for Leavers
Average Number of Persons
7. HMIS or Comparable Database Data Quality
8. Persons Served During Operating Year by Type
9. Households Served During the Operating Period
Households
January
April
July
October
Point-in-Time Count of Persons on the Last Wednesday in
Total Without ChildrenWith Children
and AdultsWith Only Children
Total Without ChildrenWith Children
and AdultsWith Only Children
Point-in-Time Count of Households on the Last Wednesday in
Number of Households Served During the Operating Period
Total Without ChildrenWith Children
and AdultsWith Only Children
January
April
July
October
Total Without ChildrenWith Children
and AdultsWith Only Children
HUD CoC APRQuarterly Performace Report
Question 7
Number of Persons in Households Served During Operating Period
Average Number of Persons Served Each Night
Total
Questions 8-9
With Only ChildrenWith Children
and AdultsWithout ChildrenTotal
Adults
Children
Don't Know/Refused
Missing Information
15a. Gender - Adults
15b. Gender - Children
16. Age
17a. Ethnicity
Under 5
5-12
13-17
18-24
25-34
35-44
45-54
55-61
62+
Total
Male
Female
Transgender
Don't Know/Refused
Information Missing
Information Missing
Male
Female
Transgender
Other
Don't Know/Refused
Number of Persons in Households
Ethnicity
Questions 16 - 17
Age
Number of Persons in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Other
Don't Know/Refused
Gender of Children
Number of Childrens in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Information Missing
Number of Adults in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Question 15
Gender of Adults
18b. Physical and Mental Health Known of Conditions at Entry
17b. Race
18a. Physical and Mental Health Types of Conditions at Entry
Mental Illness
Alcohol Abuse
Drug Abuse
Chronic Health Condition
HIV/AIDS and Related Diseases
Developmental Disability
Physical Disability
Don't Know/Refused
Information Missing
White
Asian
Black or African-American
American Indian or Alasks Native
Native Hawaiian or Pacific Islander
Multiple Races
Don't Know/Refused
Information Missing
None
1 Condition
Non-Hispanic/Non-Latino
Hispanic/Latino
Don't Know/Refused
Total
Total
Total
Information Missing
2 Conditions
3+ Conditions
Condition Unknown
Number of Persons
Total Without ChildrenWith Children
and AdultsWith Only Children
Number of Known Conditions
Known Physical and Mental Health Conditions
Number of Persons in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Questions 18-19
Race
Number of Persons in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total Without ChildrenWith Children
and AdultsWith Only Children
Don't Know/Refused
Don't Know/Refused
19a. Victims of Domestic Violence
19b. When Past Domestic Violence Occurred
20a 1. Residence Prior to Program Entry - Homeless Situations
20b 2. Residence Prior to Program Entry - Institutional Setting
Psychiatric hospital/facility
Substance abuse treatment facility/detox
Hospital (non-psychiatric)
Jail, prison, juvenile detention
Foster Care
Total
Information Missing
Emergency Shelter
Transitional Housing for Homeless
Place not ment for habitation
Safe Haven
Residence Prior to Program Entry - Institutional Setting
Number of Adults and Unaccompanied Youth in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Question 20
Residence Prior to Program Entry - Homeless Situation
Number of Adults and Unaccompanied Youth in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Information Missing
6 to 12 months
More than a year ago
Number of Adults and Unaccompanied Youth in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Less than 3 months
3 to 6 months
Number of Adults and Unaccompanied Youth in Households
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Yes
No
Past Domestic Violence Experience
20b 3. Residence Prior to Program Entry - Other Locations
21. Veteran Status
22a 1. Physical and Mental Health Types of Conditions at Exit - Leavers
22a 2. Physical and Mental Health Conditions at Exit - Leavers
Rental by Client, with VASH subsidy
Owned by Client, no subsidy
Mental Illness
Alcohol Abuse
Drug Abuse
Chronic Health Condition
HIV/AIDS and Related Diseases
Developmental Disability
Physical Disability
Information Missing
Information Missing
Veteran
Not a Veteran
Rental by client, with other ongoing subsidy
Hotel/Motel paid by client
Staying or Living with Family
Staying or Living with Friends
Other
Don't Know/Refused
Owned by Client, with subsidy
Rental by Client, no subsidy
Residence Prior to Program Entry - Institutional Setting
Number of Adults and Unaccompanied Youth in Households
Total Without ChildrenWith Children
and Adults
Total
Total Adults Children With Only Children
Number of Known Conditions
Leavers - Total Number by Type
None
Total Adults Children With Only Children
Questions 21 - 22
Veteran Status
Number of Adults in Households
Known Physical and Mental Health Conditions
Leavers - Total Number by Type
Total Without ChildrenWith Children
and AdultsWith Only Children
Don't Know/Refused
With Only Children
PSH for Homeless Persons
Total
Program EntryIncome at
Entry
Income at
Exit
Less
Income at
Exit
Same
Income at
Exit
More
Income at
Exit
Unknown
Income
Change
23. Client Monthly Cash-Income Amount -Adult Leavers
Condition Unknown
Don't Know/Refused
Information Missing
Physical Disability
None
1 Condition
2 Conditions
Developmental Disability
22b 2. Physical and Mental Health Conditions at Exit - Stayers
Drug Abuse
Chronic Health Condition
HIV/AIDS and Related Diseases
Alcohol Abuse
Don't Know/Refused
Information Missing
Mental Illness
Total Adults Children With Only Children
Known Physical and Mental Health Conditions
Leavers - Total Number by Type
22b 1. Physical and Mental Health Types of Conditions at Exit - Stayers
1 Condition
2 Conditions
3+ Conditions
Total
Total
Questions 23 - 24
Client Monthly Cash - Income Amount
No Income
$1-150
$151 -250
$251-500
$501-750
$751-1,000
$1,001-1,250
$1,251-1,500
Total Adults Children With Only Children
Number of Known Conditions
Leavers - Total Number by Type
3+ Conditions
Number of Adult LeaversAverage Change ($)
of Monthly Income
per Adult
Condition Unknown
Program EntryIncome at
Entry
Follow-up
Total
Less
Income at
Follow-up
Same
Income at
Follow-up
More
Income at
Follow-up
Unknown
Income
Change
24. Client Monthly Cash-Income by Entry and Latest Status
25a 1. Cash Income Types by Exit Status - Leavers
Earned Income
Unemployment Insurance
SSDI
Veteran's Disability
Private Disability Insurance
$751-1,000
$1,001-1,250
$1,251-1,500
Client Monthly Cash - Income Amount by Entry and Latest Status
$1,501-1,750
$1,751-2,000
$2,000+
Don't Know/Refused
Total
Total
SSI
Total
Pension from Former Job
Child Support
Alimony (Spousal Support)
Other Source
Workers Compensation
TANF or Equilivalent
General Assistance
Retirement (Social Security)
Veteran's Pension
Number of Adult Stayers
Average Change ($)
of Monthly Income
per Adult
$1,501-1,750
Question 25
Cash-Income Sources
Type of Cash-Income Sources by Number of Persons - Leavers
Total Adults Children Age Unknown
No Income
$1-150
$151 -250
$251-500
$501-750
$1,751-2,000
$2,000+
Don't Know/Refused
25a 2. Cash Income by Exit Status - Leavers
25b 1. Cash Income Sources - Stayers
25b 2. Cash Income Number of Sources - Stayers
Veteran's Pension
Pension from Former Job
Child Support
Alimony (Spousal Support)
Other Source
Total
Workers Compensation
TANF or Equilivalent
General Assistance
Retirement (Social Security)
SSDI
Veteran's Disability
Private Disability Insurance
Total
Total
Cash-Income Sources
Type of Cash-Income Sources by Number of Persons - Stayers
Total Adults Children Age Unknown
Earned Income
Non - Cash Benefits by Number of Persons - Leavers
Total Adults Children Age Unknown
Question 26
Non - Cash Benefits
Total Adults Children Age Unknown
No Sources
1+ Source
Don't Know/ Refused
Missing this Information
26a 1. Non - Cash Benefit Types by Exit Status - Leavers
Cash-Income Sources
Type of Cash-Income Sources by Number of Persons - Stayers
SSI
Age Unknown
No Sources
1+ Source
Don't Know/ Refused
Unemployment Insurance
Missing this Information
Cash-Income Sources
Type of Cash-Income Sources by Number of Persons - Leavers
Total Adults Children
VA Medical Services
TANF Child Care Services
TANF Transportation Services
Other TANF-Funded Services
Temporary Rental Assistance
Section 8 Housing/Public Housing
Other Source
26b 2. Non - Cash Benefit Sources - Stayers
No Sources
1+ Source
SNAP/Food Stamps
MEDICAID Health Ins
MEDICARE Health Ins
Badgercare
WIC
VA Medical Services
TANF Child Care Services
TANF Transportation Services
Other TANF-Funded Services
Temporary Rental Assistance
Section 8 Housing/Public Housing
Other Source
SNAP/Food Stamps
MEDICAID Health Ins
Badgercare
WIC
Adults Children Age Unknown
26b 1. Non - Cash Benefit Sources - Stayers
Total
Total
Client Non - Cash Benefits by Exit Status
Number of Non - Cash Benefits by Number of Persons - Leavers
Total
MEDICARE Health Ins
Total Adults Children Age Unknown
Client Non - Cash Benefits by Status
Number of Non - Cash Benefits by Number of Persons - Stayers
Total
Non - Cash Benefits
Non - Cash Benefits by Number of Persons - Stayers
Total Adults Children Age Unknown
Don't Know/ Refused
Missing this Information
No Sources
1+ Source
26a 2. Non - Cash Benefits by Exit Status -Leavers
Leavers
Stayers
Rental by Client W/Other Ongoing Subsidy
29a 1. Destination by Household Type and Length of Stay (All Leavers who stayed more than 90 Days)
Total
Owned by Client, w/no ongoing subsidy
Owned by Client, w/ongoing subsidy
Rental by Client, w/no ongoing subsidy
Rental by Client, w/ongoing subsidy
Rental by Client, w/VASH subsidy
PHS for Homeless Persons
Living w/Family, Permenant
Living w/Friends, Permenant
Less than 30 days
31 to 60 days
61 to 180 days
181 to 365 days
366 to 730 days (1-2 years)
1096 to 1460 days (3-4 years)
731 to 1095 days (2-3 years)
27. Length of Participation by Exit Status
Don't Know/ Refused
Missing this Information
Total
Number of Persons
Total Leavers Stayers
Total Without ChildrenWith Children
and AdultsWith Only Children
Temporary Destinations
Emergency Shelter
TH for Homeless Persons
Staying w/Family, Temporary
Number of Leavers in Households
Permanent Destinations
Total Without ChildrenWith Children
and AdultsWith Only Children
Average and Median Length of Participation in Days
Average Length Median Length
Question 29
More than 1825 days (>5 years)
Information Missing
1461 to 1825 days (4-5 years)
Question 27
Length of Participation by Exit Status
Total
Deceased
Other
Don't Know/ Refused
Information Missing
Rental by Client W/Other Ongoing Subsidy
29a 2. Destination by Household Type and Lengthof Stay (All Leavers who Stayed 90 Days or Less)
Safe Haven
Hotel/Motel, Paid by Client
TH for Homeless Persons
Staying w/Family, Temporary
Staying w/Friends, Temporary
Living w/Friends, Permenant
Total
Temporary Destinations
Total Without ChildrenWith Children
and AdultsWith Only Children
Living w/Family, Permenant
Rental by Client, w/ongoing subsidy
PHS for Homeless Persons
Owned by Client, w/ongoing subsidy
Rental by Client, w/no ongoing subsidy
Staying w/Friends, Temporary
Place not Meant for Human Habitation
Safe Haven
Hotel/Motel, Paid by Client
Total
Total
Foster Care
Psychiatric Facility
Substance Abuse / Detox Facility
Hospital (non-Psychiatric)
Jail or Prison
Total
Number of Leavers in Households
Permanent Destinations
Total Without ChildrenWith Children
and AdultsWith Only Children
Rental by Client, w/VASH subsidy
Other Destinations
Total Without ChildrenWith Children
and AdultsWith Only Children
Emergency Shelter
Place not Meant for Human Habitation
Owned by Client, w/no ongoing subsidy
Institutional Settings
Total Without ChildrenWith Children
and AdultsWith Only Children
Deceased
Other
Don't Know/ Refused
Information Missing
2b. Earned Income Measure
1. Housing Stability
Total
36b. Transitional Housing ProgramsColumn (A): Actual # of persons in the
program for whom the measure is
appropriate
Column (B): Actual # of persons who
accomplished this measure
Total # of Leavers
Total # of Leavers who exited to a
permanent destination (Q29a1+2)
Question 36
36a. Permanent Housing Programs
1. Housing Stability
2a. Total Income Measure
Column (A): Actual # of persons in the
program for whom the measure is
appropriate
Total # of Clients Served (include Stayers
+ Leavers)
Total # of Adults served (include Stayers
+ Leavers)
Total # of Adults (between age 18-61)
(include Stayers + Leavers)
Column (B): Actual # of persons who
accomplished this measure
Add the # of Stayers and the # of
Leavers who exited to a permanent
destination (Q29a1+2)
Add the # of Adults (stayers + leavers)
who maintained or increased their
income (Q23+24)
Add the # of Adults (between 18-61)
(stayers + leavers) that either
maintained or increased their Earned
Income (Q23+24)
Psychiatric Facility
Substance Abuse / Detox Facility
Hospital (non-Psychiatric)
Jail or Prison
Total
Other Destinations
Total Without ChildrenWith Children
and AdultsWith Only Children
Total
Institutional Settings
Total Without ChildrenWith Children
and AdultsWith Only Children
Foster Care
2b. Earned Income Measure
2b. Earned Income Measure
Total # of Adults served (include Stayers
+ Leavers)
Add the # of Adults (stayers + leavers)
who maintained or increased their
income (Q23+24)
2a. Total Income Measure
Total # of Adults served (include Stayers
+ Leavers)
Add the # of Adults (stayers + leavers)
who increased their income (Q23+24)
2a. Total Income Measure
Total # of Adults (between age 18-61)
(include Stayers + Leavers)
Add the # of Adults (between 18-61)
(stayers + leavers) that increased their
Earned Income (Q23+24)
36e. Safe Haven Programs Column (A): Actual # of persons in the
program for whom the measure is
appropriate
Column (B): Actual # of persons who
accomplished this measure
Total # of Clients Served (include Stayers
+ Leavers)
Add the # of Stayers and the # of
Leavers who exited to a permanent
destination (Q29a1+2)
Total # of Adults served (include Stayers
+ Leavers)
Add the # of Adults (stayers + leavers)
who increased their income (Q23+24)
2a. Total Income Measure
Total # of Adults (between age 18-61)
(include Stayers + Leavers)
Add the # of Adults (between 18-61)
(stayers + leavers) that increased their
Earned Income (Q23+24)
36d. Supportive Services Only (SSO) ProgramsColumn (A): Actual # of persons in the
program for whom the measure is
appropriate
Column (B): Actual # of persons who
accomplished this measure
Total # of Leavers
Total # of Leavers who exited to a
permanent destination (Q29a1+2)
1. Housing Stability
1. Housing Stability
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
29a 1. Destination by Household Type and Length of Stay (All Leavers who stayed more than 90 Days)
Unknown Household
Type
Unknown Household
Type
29a 2. Destination by Household Type and Lengthof Stay (All Leavers who Stayed 90 Days or Less)
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
Unknown Household
Type
36b. Transitional Housing Programs
Column (C ): Actual % of persons who
accomplished this measure
Divide Column B by Column A
36a. Permanent Housing Programs
Column (C ): Actual % of persons who
accomplished this measure
Divide Column B by Column A
Unknown Household
Type
Unknown Household
Type
Divide Column B by Column A
Divide Column B by Column A
Divide Column B by Column A
Divide Column B by Column A
Divide Column B by Column A
36e. Safe Haven Programs
Column (C ): Actual % of persons who
accomplished this measure
Divide Column B by Column A
Divide Column B by Column A
Divide Column B by Column A
36d. Supportive Services Only (SSO) Programs
Column (C ): Actual % of persons who
accomplished this measure
Divide Column B by Column A
