2015 HUD CoC Competition Evaluation Instrument

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2015 HUD CoC Competition

Evaluation Instrument

For all HUD CoC-funded projects in the Chicago Continuum of Care

[PROJECT COMPONENT]

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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 [email protected].

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 “No” response (if applicable)

A. Project Certification Checklist

No attachments necessary for this section

B. Project Operations

2015 Match and Leverage Spreadsheet

C. HMIS

HMIS Report A: 0625 - HUD CoC APR for the

D. Leading Practices – Housing First No 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, Not required for PSH/SH or SSO)

F. System Priorities

HUD Approved Budget Letter (if applicable)

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Cover Page Agency & Project Information

Agency Name Project Name

Project HUD Grant Number (for 2014) For Long Term Rental Assistance, please use City Grant Number

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 Email Address

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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:

Yes No

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

Yes No

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.

Yes No No–DV Exclusive Agency

4. Is the project operating consistently with Chicago’s Program Models Chart (revised 2010)?

If Yes, please provide a detailed narrative explaining the components of the project requesting renewal funding and how those are consistent with the Program Models Chart.

Yes No

Narrative required if Yes

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5. Does this project serve families where there is at least one parent and one child?

If No, agency can move on to Threshold Question 6. Project does not need to submit explanatory letter if project does not serve families.

If Yes, 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? Yes No 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? Yes No 5C. Are the proposed laws related to providing education services to individuals and families? Yes No

Yes No

Question 5 is informational.

If Yes, 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?

Yes No

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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.

Yes No

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.

Yes No

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).

Yes No 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).

Yes No

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. (Note 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.)

Yes No

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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.

Yes No

7. The project is able to provide HUD approved documentation for the Environmental Review of all new and renewal units.

Yes No

8. The project orients consumers to emergency evacuation procedures related to the project facilities.

Yes No

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.

Yes No

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.

Yes No

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.

Yes No

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.

Yes No

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.

Yes No

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).

Yes No

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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).

Yes No

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.

Yes No

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).

Yes No

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.

Yes No

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.

Yes No

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.

Yes No

22. The project has written eligibility criteria that are provided to consumers which are in line with the Housing First philosophy.

Yes No

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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.

Yes No

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.

Yes No

25. The project has a written policy accepting all consumers regardless of criminal history to the project.

Yes No

26. The project has a written policy accepting consumers regardless of rental history or past evictions.

Yes No

27. The project has a written policy accepting consumers regardless of lack of financial resources.

Yes No

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.

Yes No

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

Yes No

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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.

Yes No 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

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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?

1A. If no, how much $ was unspent?

1B. If no, explain the reason for not expending 100% of the funds:

Yes No N/A for LTRA or New If No (or New), please answer questions to

left

3 points for Yes -1 point for

> 10%

LTRA projects and New projects (that

have not completed a

full grant year) will not

be scored

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). Note that projects will be required to provide this ratio of match and leverage at the time of the HUD application.

Enter the ratio from

the 2015 Match and

Leverage spreadsheet

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)?

Yes No

2 point for Yes

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.

Yes No

Unscored

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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? Yes No

B. If yes, what database?

Yes No

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:

a. June 2014 Yes No b. October 2014 Yes No c. January 2015 Yes No

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 points per quarter for a

total of 9 points

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).

Yes No

Attachment Required: 2 points for

attached report in PDF

format

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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.

Yes No

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

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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?

Yes No

3 points for Yes

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?

Yes No

1 point for Yes

3. Does the project accept consumers who are diagnosed with or show symptoms of a mental illness?

Yes No

1 point for Yes

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? Yes No

b. Accepting all consumers regardless of criminal history to the project?

Yes No

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? Yes No

d. Accepting consumers regardless of lack of financial resources to the project? Yes No

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? Yes No

1 point for each Yes for

a total of 5 points

Question 4b:

1 point will be given for No if funder policy is explained

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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 No and describe the funder policy or law in the space below.

a. Substance use treatment intervention Yes No b. Mental health treatment intervention Yes No c. Hospitalization Yes No

d. Incarceration Yes No

Law and/or Funder Policy Description, if applicable:

1/2 point for each Yes for a total of 2 points 1/2 point will be given for No if funder policy is explained

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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, 2014and 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?

Question will be scored using data from HMIS Report: 0625 - HUD CoC APR. Please reference the detailed instruction manual.

% N/A – No 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 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 manual.

Yes–95%+

Yes–Increased No

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

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4. What percentage of consumers who departed the project into permanent housing in the previous year 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:

Question will be scored using data from HMIS Report: 0625 - HUD CoC APR and agency self-report.

%

Note: 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?

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?

Yes–95%+

Yes–Increase 5%

No

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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:

% Note: Agency Self Report Required on

6-month follow-up in the space to the

left.

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?

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?

Yes–95%+

Yes–Increase 5%

No

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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:

% Note: Agency Self Report Required on 6-

month stay in the space to the left.

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?

% 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?

% 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?

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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)?

Points by Percent Range 7 points for >90%

6 points for 80-89%

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.

Yes No 5 Points – Increased 3 Points – Maintained 0 Points – Did not maintain or increase outcome

Attachment required

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.

Yes No 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?

% 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

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18. What percentage of the consumers served in the project have non-cash benefits through mainstream resources?

% 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?

$ N/A – No 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 20. What percentage of consumers who exited the project

exited to an unknown destination?

1 points for less than 10%

0 points for 10% or more

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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.

Yes No N/A (for SSOs and LTRA projects)

4 points for Yes Attachment required if recently obtained HUD Approved Budget letter

2. Does this project serve individuals and families that meet HUD’s definition of chronically homeless?

If Yes, please complete 2A and 2B using the 2015 Chronic Homeless Report.

If No, 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?

Yes No N/A (for HUD TH projects)

% Divide A by B and enter percentage in the space

above

3.5 points for serving 70%+ chronic 2 points for serving 50%+

chronic

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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 iv. Are families

v. Are veterans

3B: How many total people did you serve from January 1, 2014 to December 31, 2014?

% 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

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.

Yes No

N/A – IH, PH- Youth, SSO

1 Point for Yes N/A for Interim Housing,

PH for Youth Project- Based, and SSO