a

(exp.l1/30/2009) No. OMB Approval 2506-0145

U. S. Department of Housing and Urban Development Office of CommunityPlanning and Development

Report (APR) Annual Progress

for SupportiveHousingProgram ShelterPlusCare
and Section8 Moderate Rehabilitation for SingleRoom Occupancy Dwellings (SRO) Program

HUD-40i 18

o Publi c r e p o r t i n g b u r d e n tb r th is co lle ctio n l in lb r m a tio nis e sti mated anil iompleting and reviewing the collectionof inforntatlon This agencymay sources,gatheringand marntaining tire data needed, existingrJata searching displaysa I'a1idOlt{B colltro of to is and a persor.r not requrreci respondto, a col'lection infonnation unlessthat collection conducr or sponsor, 'ror

General Instructions and Report (APR) is a reportingtool that HUD usesto lrack programprogress Purpose. The Annual Progress assistance ftiirding. and accomplishments infonn the Department'scompetitiveprocessfot'homeless grants must submit 2 APR'S to HUD n'ithin 90 davs alter assistance of Filing Requirements.Recipients HUD's homeless to the end of each operating vear. One copy of the reporl must be subnritted the CommunityPlanningandDeveloprnent for (CPD) Division Director in the local HUD Field Office responsibie managing grant. The othercopy mustbe subrmtted the Attn: APR Data Editor, Room 7261,451 7'hSfteet, to HIJD Headquarters, Departmentof Housing and Urban Development, SW, Washington, DC. 20410. Failure to submit an APR rvi1ldelay receivinggrant funds and may resultin a determination of lack of capacityfor future funding. An APR must be submittedfor eachoperatingyear in which HUD fundingis provided. are that receivedSHP ftinding for new consfirrction, acquisition,or rehabilitation requiredto operate their facilities for Grantees year and everyyearthroughout 20 years. the 20 years. They must subnritan APR 90 days after the end ofthe first operating Care (S+C),a separate APR mustbe A separate reportmust be submittedfor eachHUD grantreceived. For SheiterPh-rs submittedfor eachS*C component. (seeExtension For thosegrantees receiving an extension, separate a report coveringthat period must be submitted below). an Recordkeeping. Grantees nust coilect and maintain informationon eachparlicipantin orderto complete APR. Optional manuallyor to designa cornputerized worksheets aftached.The worksheets systern to are may be usedto record inforrnation to shouldnot be subnritted HUD with the APR. Store.and tabulatethe information. The u,orksheets Organization of the Report. The APR is organizedin the foliowing maluler: in persons self-sufficiency, the Part I: Project Progress. This portion of the report describes progress moving homeless to documenting servicesreceived,listing project goals,and accountingfor beds/units. by receivingfundingunderSHP, S+C, Part II: Financial Information. This portion of the report is completed all grantees and SRO. numbereverypage sequentially.Mark any questions that do Final Assembly of Report. After the entire report is assembled, for not appiy to your program with "N/A" for not applicable. (SeeSpecialInstructions SSOProjectsbelow.) type is definedbelorv. Note that a client'sclient/household Definitions of Client/Ilousehold Types. Each client4rousehold to householdcompositionat theprogram etxttydate closest the start of the shouldbe basedon the client's age and"/or [pe operating year. at or Families - A family is a householdcomposedof tr.vo more relatedpersons, leastone of who is a child accompanied by an adult or a juvenile parent. not not accompanied children,includingpregrant worrren accompanied other by by Singles not in Families - Persons youthpresent youth, are singlesnot in families. When two adultsor two unaccompanied children and unaccornpanied status shouldbe togetherfor services,eachpersonshould be countedin singlesnot il families.. Clients' household year. This deterrnined basedon their householdcompositionat the program enffy dateclosestto the startofthe operating as not meansthat pregnantwonen expectedto give birth during their programstay shouldstill be counted singles in families. of Adults in Farnilies - Within a family, an adult is any persou l8 yearsof age or older. For the purposes APR reporting, composition the determination whethera personis an adult in family shouldbe madebasedon their age andhousehold of year. at the program entry date ciosestto the start ofthe operatin-q by Children in Families - Children in Famrliesare definedas childreuunderthe age of 18 accompanied oneor more adrrlrs(nalent.relative or in famrliesalso includeboth a juvenile parentand theparent'schild(ren). Children -guardian). a For the purposesof APR reporting.tlie determilation of rvhether pelsonis a child in family shouldbe madebasedon tlreireoernd lrnlcsfusld to of year. For example, conpositionat the programenfiy dateclosest the star-t the operatitrg
HUD-4O I 8 I

year or at program entry (if they enteredduring clielts u{ro are lessthan 18 yearsof age on the first clayofthe operating rlre v PLr qr r l15 .,",') shonldbe countedas children evenif they tum i B duringthe coulse of the operatingyear. Lr r L nnerntinoe q r / in Personsin Families - Persons lanriliesincludesadultsin families and childrenin families.

temrs are applied differently Other Key Delinitions. The following tem$ areused in the APR. As indicated,in some cases, dependingon rvhether fundingis from SHP, S+C, or SRO. the Chronically homeless person - HLrD definesa clu'onicallyhomeless personas "an nnaccompanied homelessindividual ,,vitha disablingconditionr.vho eitherbeencontinuouslyhomeless a year or more OR has had at leastfour (4) has for episodes in ofhomelessness the pastthree(3) years." To be considered chronically homeless, person a musthavebeenon the streets in an emergency or shelter(i.e., not in fransitionalhousing)during thesestays. HUD's definition of a chronicallyhomeless personis basedon the following components: . Unaccompaniedhomelessindividual: an unaccompanied homeiess individual has the samecharacteristics of a Singlenot in a Family (described above). r Disabling condition: seethe instructions under disablingcondition(below) to deterrnine whethera client is disabled. Did not leave the program - This term refels to clientswho were in the program on the last day of the operatingyear. Disabling condition - HUD definesa disablingcondition as: (1) A disabilify as definedin Section223 of the Social SecurityAct; (2) a physical,mental,or emotionalimpairmentwhich is (a) expectedto be of long-continued and indefinite duration,(b) substantially impedes individual's abiiity to live independently, an and (c) of such a naturethat suchability could be improvedby more suitablehousingconditions;(3) a developmental disability as defined in section 102 of the Developmental DisabilitiesAssistance and Bill of Rights Act; (4) the disease acquiredimmunodefrciency of syndlomeor any conditionsarisingfrom the etiologicalagencyfor acquiredimmunodeficiency slmdrome;or (5) a diagnosable substance abusedisorder. Entered the program - Enteredthe programrefers to the first day a client receivesservices.For a residential program, this datewould represent first day of residence the program'shousing. For services, the in this datemay represent day the of program enrollment,the day a servicewas provided, or the frst date of a period of continuousparticipationin a service (e.g..daily.weekly,or monthly). For S+C and SRO programs, programentry date is the datethat the participantstartsto receive rental assistance. the For provided prior to this point arerecognizedas necessary outreactvenrollment are eligible to count as S*C, services for and match. An Extension APR appliesto SHP and S+C grantees and receivedan extensionof tlieir grant term from that requested the HUD field office. The only differencebetweenan APR for the extension period and the regularAPR (besides the page. Grantees amountof time covered)is the signature shouldcircle "yes" to indicatethe APR is for an extension period and circle the operatingyear for which the report is an extension. For example,if the granteeis extendingyear3, the granteeshould submit an APR as usual for year 3 and submit anotherAPR for the extension period, indicating the page. secondis an extension and also circling year 3 on the signafure Grantee meansa direct recipientof the HUD award. Left the program - Left the programrefersto the last day a client receives services.For a residentialprogram,this date u'ould represent last day of residence the pro-qram's the housing. For services, exit date may represent last day in the the a service lvasprovidedor the lastdateofa periodofcontinuous service.Ifa client leaves programtemporarily the (e.g., for a hospitalization) is expected returnrvithin 30 days,do not count that client as having ieft the progran. but to Fnt Q+c hr^o,',m< the programexit daterefersto the datethe participantstopsreceivingrental assistance is not and expectedto returil to S+C assisted housing. If the participantreturnsto S+C assisted housingrvithin 90 days.the person should not be considered exitrrg fiom the program. If the personreturnsto S+C assisted as housingafter 90 days,that personis considered new participani. The worksheetis designed capture a to tl.risinformation.
J

HUD-40118

Nlatch for S+C is the value ofsupportive services in receivedby participants the S+C project which, in the aggregate, must at leastequal the value of the S+C rental assistance provided over the life of the project. For SHP,matchis cash usedto provide the grantee'sportion of acquisition,rehabilitation, new consfiuction,operations and supportive ser-v-ices expenses. Operating year - For SHP programs,the first operatingyear beginsafter development activitiesfor acquisition, rehabiiitation, and new cons[uction are complete,after a copy of the Certificateof Occupancy sentto the local HUD is office, and when the first participantis acceptedinto the project. For projectswithout acquisition, rehabilitation, new or conshuction, operatingstartdatebegins rvhenthe granteeaccepts hrst participant. For dedicated the the HMIS projects, the operatingyear beginswhen any eligible cost includedin the approved project budgetis incurred. For S+C (SRA, PRA and TRA components), first operatingyear beginson the dateF{UD signsthe grantagreement. the For S+C/SRO and for Sec.8 SRO, the first operatingyear beginswith the effectivedateof the HousingAssistance payments (HAp) Contract. To deterrnine which operatingyear to circle on the APR cover page,be-ein countingfrom the initial grant operating start dateand include renewalgrants. For example,a project receivingan initial grant for threeyearsand a reneivalgrant for two yearswould circle years 1, 2, and 3 respectivelyon the APR cover sheetfor the initial grant and wouid circle 4 and 5 respectively the renervalgrant. For any future renervalgrants,the grantee for rvouldbegin by circling 6 on the ApR cover sheet. Participants - The term participantrefers to Singlesnot in Familiesand Adults in Famiiiesas definedabove. participant doesnot include chiidren or caregiverswho live rvith the adultl assisted. Project Sponsor meansthe organizationresponsible carryilg out the daily operationof the project,if the for organization an entity other than the grantee. is

struct

unlessa written agreement been reachedwith thefield off,rce has conceming whichquestions be anslvered estimates. can usine or in rare instances, skipped. Below is an exampleof how ilformation could be derivedin a large, single-service SSO project: A staff member could be assignedto collect informationfrom the organizations housingthe parlicipants.The -erantee/sponsor staff person would contact these individual organizations to request information regarding the personsin ttraifaclity that use the service.For participantsiiving on the street,the grantee/project sponsor may provide estimates. Information could be collectedfor eachparlicipant or for participants receivingservices a point-in-time. If estimates at or point-in-timecountsare used,the method used must be described the APR and the documintationkept on file. in As with all projectsfunded under HUD's homelessness grants,grantees assistance operatingSSOprojectsare expected to compieteall APR questionsthat are applicableto them. Note that all projectshavebeenawardedfundsas result a of respondingto the program goals of assistinghomeiess pel'sons obtain/remain pennanenthousingand increase in their skills and income. The APR documentstheir progless in meetingthesegoals. In somecircumstances field offices and grantees may sign a wriften agreement concerningquestions that canbe a'sweredusing estimates, in rare instances, or skipped. See the specialinstructions below for reporting on ipecial flpes ofprojects, suchas outreachonly projects"projectsproviding servicesto children only, and transporlation, medical,dental,andother single,shortduration serwice projects. SSO pro-qrams a third prioriry for local HtrIIS implementation. are following emer-qency shelters, h"ansitional housingprogram-s, outreachprograms> pennanentsupportivehousingprograms. Once SSOpro-qrarns includedin the HMIS, SSOgrarrrees and are will be able to answerall APR questions using their HMIS data. SSO grantee that are not yet participatingin HN,IIS ."ilIt need s to collect datato answerthe APR questionsusing the specialinshuctionsprovided above. Outreach Only Projects. Projectswhich are solely devotedto slreetoutreach and connection housingand seruices to are not requiredto ftack participantsbeyond theit contactwith personson the street. It is sufficientfor these proiectsto enter
HUD-10118

tive Servrce unlv (ssu) Programs. sso grantees should comprete questions, ail

E sti i n for m at iononqu e s ti o n s l -1 0 (s k i p p i n g q u e s ti onsl l -13and17). matesforquesti ons5-9areal l orved,gi vent hat personalquestions. participants may be reluctantto answer Answering the questionswill demonstratethat the granteeis serving the appropriatenumber of people, providing basic demographicinformation for Congress,demonstratingthat homelesspersonsare being served,demonstratingthe fypes of housingparticipants connected and the llpe ofservices they arereceiving. are to, Hotline Projects. Hotline services similar to outreach only projects, but contactbefweengranteeand participantis often are of very short duration - people enter and leave the program nearly simultaneously. It is sufhcient for theseproj ects to answer questions (skipping 10,and 14-19(skipping17). 1-5 4), Projects Providing Services To Children Only. Projectsthat provide child care,after schoolcare,counseling for children,etc. make an importantcontributiontowardmoving a family out of homelessness. While the main focus of the project is providing services the children,it is the adultswho arereportedon in questions to 6-16 of the APR. Like all otherprojects, this fype is also targetedtoward getting the families into housing and increasingthe families' incomes. Granteesmay skip question9; all other questions (except 17). shouldbe answered Transportation, Medical, Dental, and Other Single, Short-Duration Service Projects. Somegrantees provide a single service of fairly short duration focused ONLY indirectly on assistinghomelesspersonsto obtair/remain in permanent housingand increase their skills and incomes. It is sufficientfor theseprojectsto enterinformationon questions1-10 and 1419 (question 17 may be skipped). However, with fransportationservices,it is unreasonable think that someonewould have to to give their age, race, and ethnicity to a bus driver to get a ride a few blocks. For theseservices,provide a narrative, which gives the number of rides given during the operating year,.andprovides estimates on the above statisticsbased on the population that utilizes the service. Special Instructions For Safe Haven (SH) Proiects. Crrantees shouldrepofi on all participantsservedduring the operating year. Note: this is a changefrom prior instructions where granteeswere instructed to report on the first 25 participants served.

Special Instructions for HomelessManagement Information System(HMIS) Proiects.HMISgrantees

should filI out the cover sheetof the APR, Part II Financial Information, and the HMIS Activities section.

HUD-401 18

THIS PAGE - TO BE COMPLETEDBY ALL GEANTEES

Grantee:

Number or HUD Grant Project

of Citvand Countv San Francisco,

Sponsor: Project

artmentof HumanServices

cAO'1c50'1002
Name: Project

Corporation Development Neighborhood Tenderloin

Operating Ycar: (Circle the opelating yearbeing reportedon)

Sites TNDC Scattered

: ReportingPeriod (month/daylycar)

X r [: !: [+ []s !o U [s nq lto n r r fl r z fl r : [r + !r: nro nu f]ts []tq nz o

Indicatcif extension: ! Yes X No Indicateif renewal: I Yes X No for this protecl Previous GrantNumbers

from:9/1/06

to:B/31/07

for Check the component the programon which you are reportlng

Program(SHP) Shelter Plus Care (S+C) Housing Supportive tr fl n tr n N Housing Transitional Housingfor Homeless Permanent with Persons Disabiiities Safe Haven Housing Supportive Innovative Only Supportive Services HMIS
n X n n (TRA) RentalAssistance Tenant-based (SRA) RentalAssistance Sponsor-based (PRA) RentalAssistance Project-based (SRO) Single Room OccupancY

Section8 Moderate Rehabilitation X SingleRoom Occupancy (Sec.8 SRO)

this with a descriptionof population,number servedand accomplishments operatingyear) Summary of the project: (One or two sentences

period. The firstphaseof clients clientswho movedin withinthe lasttwo monthsof the operating This ApR captures provided to 15 units year,thisproject up thisoperating June 1,2007. During movedintothe CivicCenterResidence shelters were from the streetsor emergency singleadults.All of the participanis to housing homeless of permanent and/or HIV/AIDS. ab(use), substance to needsrelaed mentalhealth, withtwo or morespecial and are living
Name & Title ofthe Personwho call answerquestionsabout this report: Phone: (include areacode)

PlusCareProgramManager Shelter ShaneBalanon,

A ddr e s s :

(4 1 5 s 5 8 -1 9 8 0 )
Fax N umbcr:(i ncl udeal eacode)

Cityand Countyof San Francisco of Department HumanServices P.O.Box 79888 CA San Francisco, 94120 shane.balanon@sfgov.org E-mail Address

(415)558-2834

. Convictionmay resuitin c r i m i n a la n d / o rc i v i l p e n a l t i e s( 1 8 U . S . C.1 0 0 1 , faiseclaimsand statements. Wrrning: HUD will prosecute

I hereby certify thar all the tnformation stated herein is true and accurate.
1 0 10, l0l2; 3l U. S . C .3 7 1 9 ,3 E 0 2
Narrre& Title of AuthorizedGranteeOificial:

Manager Program PlusCare Shelter Balanon, Shane

Proiect SponsorOificial Na:.ne and Title of ALrtholrzed

& Siglature Date: X

HUD-40118

(EXCEPT HMIS) BY PARTI, TOBE COMPLETED ALL GRAI'ITEES

OI{ I]VSTRI]CTIONS PAGE3 OF THEAPR SEESPECIAL PLEASE GK4NTEES, SSO Part I: ProjectProgress
1.
a

comesfiom the mostrecentCoC ProjectedLevel of Personsto be servedat a given point in time. (Thisinfomration
1Cat10n. N umber-of S i ng)es ot N in Families t3 N umberof A dul tsi n Fami l i es N unrber of C hi l dren i n Fami l i es Nunrberof Fa mi l i es

Level Proiected
a. P e r s o n s t o b e s e r ve d a t a g ive n p o in t in tim e

PersonsServedduring the operating year.

Number of N S i ngl es ot i n Fami l i es N umbcrof A dul ts i n Fami l i es N umberof C hi l dreni n Fan.rilies Nuntberof Fa mi l i es

a.

Number on the first day of the operatingyear Number enteringprograrxduring the operatingyear Nurnberwho left the programduring the operatingyear Number in the program on the last day of the operatingyear (a+b-c)=d

0
4A t-

b
c

0
4A

d.

Explanatory notes: uhich clientsshouldbe countedas SinglesNot in Types in the GeneralInstructionsaboveto determine SeeDefinitions of CIient/Household in type that may Families,Adults in Families,and Children in Families. Note that this table doesnot accountfor changes client/household occurdu ring the co ur s eof t heoper at ingy earI.ns t ead, e a c h c l i e n t s h o u l d b e a s s i g n e d a s i n g l e c l i e n t , 4 r o u s e h o l d t y p e b a se d o n th e cl i e n t's age and/or householdcompositionat theprogram entty date closestto the start ofthe operatingyear. ln this rvay,eachclient is counted only oncein the table. to Use the following graphic and explanations determinewho should be countedin rows a-d:

Client program llrstdayof in on gpefating year,leflduring lhe

j qa Luu,,l

in on Clienl program firstday y a of oper ati ngear ndl as l y ear dayofoper ati ng c ounl i n 2a and2d.

i+ a--------------- ,
Clenl enlered 3nd lell I program before slart of i operatrngyear do nol counl rn i question 2

Client entered and leff program duilnq opefaling year: count in 2b end 2c. Client entered program during operati.rgyear and still in program on last day ofyear: cornt rn 2b and 2d.

Fi6t day oflhe operating year

Lasl day of lhe operalrng year

the Number on the first day of the operating year: This row includesall clientswho entered programbeforethe first day ofthe year. operatingyear and did not leavethe program until after the first day ofthe operating b. includes clients all who cntercd program or afterthe first the on Number entering the program during the operatingyear: This ror.v usethe day ofthe operatingyear,up to and including the last day ofthe operatingyear. For cilentswith multiple programentry dates, enrrr,.date clncest the startofthe operattng tn year.Do not count the clientmorethanonceevenifhe/sheentered progrant the morethan year. onceduringthe operatin_e on of Number lvho left during the operating year: This rorv includesall clientswho left the progran.r or afterthe first da-u" the operatingyear, up to and including the last day ofthe operatingyear. For clientswith multiple programexit dates,usethe exit date HUD-101 l8

year,Do not countthe clientmore than onceevenifhe/she exitedthe prog]ammore thanonceduring closest the end ofthe operating to year. the operattng d. Numb erin the pr ogr am ont helas t day of t heoper a t i n g y e a r : T h i s r o w i n c l u d e s a l l c i i e n t s w h o w e r e i n t h e p r o g r a m a s o fth e fi r st year. The numberof ,r^.,ur Lr r r nnotai;na.,ear who entered yearand who did not leavedurlng the operating during the operating or uay ^rtr.o uP! r 4lr r 15 / to basedon the responses rows 2a through 2c. For of the operatingyear is calculated clientsor familiesin the programon the last day eachcolumn, add the numberof clientsor families in row 2a to the number of clientsor families in row 2b and subtractthe number of 2d clients or families in rorv 2c. Therefore, -- 2a + 2b - 2c.

3.

Project Capacit-v.
Number of N S i ngl es ot i n Fanrilies Number of Adults rn Fami l i es N umberof C hi l dreni n Families Nunrberof Fa nri l i es

Number on the last day (from 2d, columns I and 4) Number proposedin application(from 1a, columns 1 and 4) Rate(divide aby b): % Capacity

1A tn

b.
C.

: 93%
::i %

Explanatory Notes: Row b refersto the most recentCoC applicationfor which the programis reporting

4.

persons. This questionis to be completedfor Section8 SRO projects. Non-homeless

personswere housedby the SRO programduring the operatingyear? non-homeless income-elieible Uo1a,1nunv

5.

Age and Gender. Of those who entered the project during the operatingyear, how many people are in the follorving age and gendercategories?
Single Persons(from 2b, column I
a.

Male 62 and over b.

c

Female

51-61 31-50 I 8-30

17 and under

1 z

Personsin Families(from 2b. columns2 & 3)

r
g

62 and over

h.
t.
't.

L
m.

5l 61 31-50 18-30 13-11 6-12 1-5 Under1

Notes: Explanatorl year.Onlyclients duringtheoperating the who entered program in and not only to Srngles in Families Persons Families refers Thisquestion be to Persons should equal the under Single ofclientsreported in counted thistable. Thetotalnumber can criteria be who meetthese be to under Persons Families in should equal thesumof reported of i 2b, in number reported question column . Thetotalnumber clients 2b. 2 columns and3 in question 6 Answer questions - 10 only for participants tvho entered the project during the operating year (fi'om 2b, columns1 & 2). not in Families and Adults in Families. It doesnot include chiidrenor caregjvers.NOTE: The term participant meansSingles for 8 and 10 below shouldbe the same;respondto eachof those questions all participants.Sonreof 7, The total lor questions, the APR will be askinginformationfor individualswho are chronicallv homeless. listed tliroughout questions t1.re

HUD-401 18

duty status. 6a. Veterzns Status. A veteranis anyonewho has ever been on actlvemilitary How many participantswere veterans?

l-o

conditionwho haseitherbeencontinuously individualwith a disabling homeless person. An unaccompanied 6b. chronically homeless T rse h ome lessfo ray ear or m or eoRhas hadat leas t f ou r ( 4 ) e p i s o d e s o f h o m e l e s s n e s s i n t h e p a s t t h r e e ( 3 ) y e ao b . c o n s i d e r e d shelter(i.e. not transitionalhousing)during chronicallyhomelessa personmust have been on the streetsor in an emergency see thesestays. For furthei discussionof the definition of chronic homelessness, Other Key Definitronsunder the GeneralInstmctions above. How many parlicipantswere chronically homelessindividuals?

7.
a

Ethnicity. How manyparticipantsare in the following ethnic categories? Hisoanic Latino or Non-Hispanic or Non-Latino

b.

t4

Explanatory Notes: Each participantshould be listed in only one category. The total number ofparticipantsin this table shouldequaithe numberofparticipants in question2b, columns I and2.

8.

are Race. How many participants in the following racial categories? AmericanIndian/Al askanNative b.
a. Aslan

d. f
g

B Iack/African American Native Hawaiian/OtherPacific Islander White American Indian/Alaskan Native & White

9 5

Asian& White
Black/African American & White American Indian/Alaskan Native & Black/African American Other Multi-Racial

h.
l.

Explanatory Notes: a race doesnot conespondto categories throughi shouldbe Each participantshould be listed in only one category. A participantw;hose in of participantsin this table shouldequalthe number of participants question2b, countedin j, Other Multi Racial. The total number categories. the to categories generate APR response columns I and2. If using HMIS data,you may combine HMIS race response

may havemore than one. 9a. Special Needs. How many participantshave the following? Participants Ifso, count them in all applicablecategories.For eachcondition, also indicatethe number that were chronically homeless. Chronic AII
a.

b. c d. f h.

Mental illness Alcohol abuse

12
14 tl

11 I
Y

Drusabuse diseases HIV/AIDSandrelated

Develoomentaldisabilitv Phvsicaldisabilitv Domesticviolence Other (pleasespecify)

11

are 9b. How manyof theparticipants disabled?i4 ExplanatoryNotes: of meet whichparticipants HUD's definition "disabled," see"Dtsabling Condition" under OtherKey Definitions in the General To determine Instructions.

t HUD-101 8

the in slept 10. Prior Liying Situation. Horv man,v''participants in the follorvingplaces the rveekprior to entering projcct? (For cach in 2b, ofparticipants question place, The totalnumberofplrtictpantsin the "All" colutrrlshouldequalthe nunrber participant, one chgose one) sleptin the follori'ingplaces.(Choose participants horvmanychronically homeless columnsI and 2). Also, indicate Ail
a.

Chronic

b
C.

(street, park,car,bus station, etc.) Non-housinq Emerqencv shelter Trrnsition r lhous r ng hor r r t lesper s ons lor s Psvchiatric facilitv* Substance abuse treatrnent lacilitv* HosDital* + Jailr'prison Domestic violencesituation Lir inc, rvirhrelatives./fiicnos Rentalhousins Othe (pleasc r specifv)

8
6

6 5

d. e. f

c.
h.
l.

*rra nrrtininent nrnrnrrs11 institutron (psychiatric abuse treatment facility,hospital, lacility,substance orjail), but rvastherelessthan an facility, her'she 30 days and was living on the strcetor in emergcncyshelterbeforeenteringthe treatment shouldbe countedin either the street sheltcr or caregorl. rpproprirre. as

Complete questions 11 - 15 for all participants lvho left during the operating le:rr (from 2c. columns 1 and2). The tem-r participant means single persons and adults in families. It does not include children or caregivers. The term chronically homeless person means an unaccompanied homeless individual with a disabling condition rvho has either been continuously homeless for a year or more OR has had at least four (4) episodes of homelessnessin the pdst thee (3) years. To be considered cluonically homeless a person must have been on the sh'eetsor in an emergency shelter (i.e. not transitional housing) during these stays.

who left during the operaiingyear,how many 1 I . Amount and Source of Monthly Income at Entry and at Exit. Of thoseparticipants participantswere at eachmonthly income level and with eachsourceof income? AIso, pleaseplace the monthly incomelevel and each T so urceo fincome f or c hr onic ally hom eles s per s on s i n t h e c o n d c o l u m n o f e a c h c h a r t . h e n u r n b e r o f p a r t i c i p a n t s i n C h a r tAa n d B s shouldbe the same. All A. Monthly Income at Entrv No income Chonic At C. Income Sources Entrv
a.

r\ll

Chronic

a.

SecurityIncome (SSI) Supplemental

b c. d

sl 50
s15 - s250 $25 - s500 s50 - s 1,000 s1001s1500
s 1501- 0 0 $20 + 52001

b
c

Disability (SSDI) S o c al Security Income SociaiSecurity

General ublic Assistance P (TANF) TemporaryAid to Needy Fan.rilies (SCHIP) HealthInsurance StateChildren's Prosram VeteransBenefits EmploS.rnent Income UnemploymentBenefits VeteransHealth Care
Medi catd

d. e f
g

f
g

h.

h
l.

J k,

I
m..
n.

Food Stamps Other (pleasespecif_v) No Financial Resources

10

HUD-.10i l3

Atl
B. Monthly Income at Exit
a N o i n c o me

Chronic
at D. IncomeSources Exit
a.

Alt

Chrunic

Security Income(SSI) Supplernental Disability Income(SSDI) SocialSecurity SocialSecurity PublicAssistance General TemporaryAid to NeedyFarnjiies(TANF) StateChildrcn'sHealthInsurance Progrlm (SCHIP) Veterans Benefits Emplo;,mentIncome UnemploymentBenefits

b.
C.

s1-150

b.
c. d
e.

sr si- s 250
s 25I - S 5 0 0

d.
e.

s5 0- s r,000 r
s1001s1500 s1s01s2000
+ $2001

I
h.

I
g

h.

J
t.

VeteransHealth Care Medicaid Food Stamps Other (pleasespecify) No Financial Resources

l.
m. n.

Explanatorv Notes: Table A: Monthly income at entry refersto the participant's monthly income on the day heisheentered program(i.e., on the program the entry date or as close as possibleto that day). You should not report on income receivedbeforeenteringthe programor ir.rcome received during the progranlstay. Table B: Monthly income at exit refersto the participant'smonthly income on the day he/she left the program(i.e., on the programexit date or as close as possibleto that day). You should not report on income receivedduring the programstay. Table C: Income sourcesat entry refersto the participant's sourcesof income on the day he/sheentcred program(i.e., on the program the en tryda teo rasclo s eas pos s iblet ot hat day ) . Yous hou l d n o t r e p o r t o n s o u l c e s o f i n c o m e r e c e i v e d b e f o r e e n t e r i n g t h e p r og r a m o r i n co m e receivedduring the program stay. Participants with no income at the time of programentry shouldbe reportedin categoryn, No Financial Resources. Table D: Income sourcesat exit refersto the participant'ssourcesof income on the day he/sheleft the program(i.e., on the programexit date or as close as possibleto that day). You should not report on sourcesofincome receivedduring the programstay. Participants with no income at the time of pro-qram exit should be reportedin categoryn, No Financial Resources,

12a. Of thoseparticipantswho left during the operatingyear (fiom 2c, colunrns 1 and 2), how many were in the project for the following lan oth cn frirnp ?Alc a, pleas eplac et helengt hof st a y f o r c h r o n i c a l l y h o m e l e s s p e r s o n s w h o l e f t d u r i n g t h e o p e r a t i ng ye a r i n th e se co n d column. All
a.

Chronic

b
c.

d. e. f.
c.

Lessthan 1 month 1 to 2 months 3 - 6 months 7 months- l2 ntonths

l3 months 24 months
2 5n ron t hs - 3v eals 4yerrs- 5y ear s 6vea rs - Tv ear s Eve ars - l0v ear s Over I 0 vears

h i

Explanatory Notes: Cornpute eachparticipant's progranr len-eth entrydateandprogram ofstay usingthe participant's exit date. Ifthe participant only one has progranl exit date during the operatingyear, calculatelensth ofstav by subtractingthe programentry datefrorl the programexir date. Ifthe participanthas rrrultipleprogram exit datesdurin-ethe operatingvear, calculatethe lengthofstay for eachproglam stay (by subtracting the program entry date from the programexit date for eachprogramstay) and add them together producea cumuiativelength ofstay. Each to

l1

HUD-101i8

numberofparticipants in the first coiumn ("A11")should rvith only one length ofstay category.The total participantshouldbe associated I and 2' .qruf ift. numberof participantsin question2c, columns I and 2)' how long did not leave during the operatingyear (from 2d' columns tr2b, Length of Stay in Program. For thoseparticipantswho homelesspersonswho did not leave during the for chronicrlly have they beenin the project? A1so,pleaseplace the l.,.rgth column' yerr in the second operating -rtoy Chronic All
a.
than 1 monlh

b.
c. d f

i to 2 months 3 - 6 months 7 months- 12 months 13 months- 24 months 2 5mo nth s - 3Year s 4 ye ars-5y ear s 6yea rs-T y ear s 8 vears 10 years Over l0 vears

14

11

s.
h.
I

Explanatory Notes: last day of the operatingyear' To calculate length of stayusing the participant'sprogramentry dateand the Computeeachparticipant,s with only one participant shouldbe associated operatingyear' Each length ofstay, subtractthe programentrydate from the lusi day oithi in column ("ALl") shouldequal the numberof participants question2d' numberof parlicipantsin the first length of stay category. The to"tal columnsI and 2. year (liom 2c, columns1 and2), how many left project during the operating 13. Reasonsfor Leaving. of thoseparticipantswho left the onlv the prinrary rc,son. The total number of participants ,*ronr, ittclude for the following reasons? If a participant left foriiltipl. placethe primary 1 and2' Also, please in shouldequalthe number of participants question2c, columns in the hrst coiumn (..A11,,) year in the secondcoiumn' left the project during the operating reasonfor chronicallv homelessp..ron, who All
a.

Chronic

L.ft fot u houting opportunitybefore completingprogram Completedprogram Non-pa;'rnent of rent/occupancycharge with Project Non-compliance Cri-i*t of *tiuity i destruction property / violence allowed in project neached maximum time Needscould not be met bY Project with rules/Persons Disagreement Death Other (pleasesPecifY)

b.

d.
c.

I
a

h,

1.

Unknown/disaPPeared

1]

HUD-40118

o p e r a t i n g v . - t r 'o - 2 c , c o l u m n s 1 a n d 2 ) , h o w m a n y 1 e f t f o r t h e f o l 1 ow i n g 14. Destination. personswho left during the operatingyear in the second of pleaseplacethe destinaltion chronically homeless destination?Also, column. All Chronic PERMANENT (a-h)
a.

Rental houseor apartment(no subsidy) Public Housing Section8 ShelterPlus Care houseor apartment HOME subsidized housc or apartment Other subsidized Homeownership Moved in with lamily or friends persons Transitionalhousing for homeless Moved in with family or friends hospital Psychratric facility Inpatient alcohol or other drug treatment Jail/prison Emergencyshelter Other supportivehousing Placesnot meantfor human habitation(e g. street) Other (pleasespecify) Unknown

b
c.

d.

f
o

h. TRANSITIONAL (i-j)
t

(k-m) INSTITUTION

1,

I
m. EMERGENCY SHELTER (N) n. o.
P.

OTHER(o-q)

q LINKNOWN
I

Explanatory Notes: combine categories provided.The response upon leaving the programusing the categories taentlfy eachparticipant'sdestination etc.). transitional, ,,destination" public housing,homeownership,etc.) and "tenure" (e.g.,pemranent, rental houseor apartment, ie.g., before categodes and be sureto look at all ofthe response the most appropriateresponse, and tenureto determine Considerboth destination category. The table below provides a brief descriptionof eachresponse making a selection. participantis undereach destinationcategoryin either the first column of the table or in both colunrnsif the Enter the numberof participants participants the ftrst column in ho..l.rr. Only one reasonfor leaving shouldbe recordedper participant.The total number of chronically (,,A11") shouldequalthe number of participantsin question2c, columns 1 and 2.

Tenure
Permanent
a.

o.

Destination Rental house or apadment (no subsidv) Publichousing Section8 ShelterPlus Care

Description or Participantis moving to an apartment housewithout any subsidy. u P a r r i c i p a nits m o v i n qt o a p u b l i ch o u s i n g n i r . Participantwill use a housing choicevoucher(formerly known as a Section8 voucher)to rent ahouse or apartmnt. Participantis moving to a unit fundedby the ShelterPlus Care Drosram(e.e.,TBA. SRA, PRA, Section8 SRO). providedby the Participantis moving to a unit with rental assistance proqram(tenant-based project-based assistance). or HOME by Participantis moving to a unit subsidized someprogramother than public housing,housing choicevoucherprogram(formerly Section8), ShelterPlus Care,or HOME. Participantis moving to a unit that he/shehaspurchased to Participantis moving in with family or friendsand expects live there for 90 daysor more. Parlicipantis moving into a untt funded by a transitionalhousing people (e.g.,transitionalhousingfundedthrough program for homeless the SupportiveHousing Program).

d.

o ho H OMEs u b s i d i z e d u s e r aDartment
f. Other subsidizedhouse or apartment

h Transitional

Homeownership Moved in with famiiy or friends Transitionalhousing for homeless people

Movedin with familyor fiiends

Institution k hospital Psvchiatric

to at.rd in is Participant moving with familyor friends expects live there 90 than days. Iess
hospital. is Participant movins to a psvchiattic

13

HUD-401 l8

Tenure I
m n.
o.

Destination

Description

or alcohol otherdrug Inpatient facilitv treatment

Jail/Prison shelter Emergency Other supportivehousing

facility. alcohol drugtreatnent or to is Participant moving an inpatient

Participantis movins to a iail or prison. people. shelterfor homeless Participantis moving to an emergency housingthat doesnot correspond Participantis moving into supportive (a-h) and is not transitional housingcategories to any ofthe permanent * people(i). suchas Section I I housing. 8 housingfor homeless Participantis movrngto a placenot meantfor humanhabitation,such as a car, park. sidewalk,or abandoned buildine. Participantis moving to a placethat doesnot correspond any of the to catesories above(a-p). This response categoryshouldbe usedifyou are unsureaboutwhere the participant moving or ifthe participanthasdisappeared there is and is no way to find out where he/she is.

Emergency Shelter Other

n Y'

Placesnot meant for human habitation

q. Unknown

(please specify) Other

Unknolvn

*HUD encouragesprograms to lintit the use of the "Otlter Supporlive Housing" APR responsecategory). Progrants should report destinations to housittg that are pennanent or transitional in APR categories (a) through (lr) or in categories(i) through (j), respectively. Exits to enxergency shelters should be reported itt category (tt).

15. Supportive Services. Of thoseparticipantswho !g[ during the operatingyear(fiom 2, columns I and 2), how many received the placethe supportiveservices following supporliveservices during their time in the project? Also, please receivedfor chronically homelessparticipants may havereceived who left during the operatingyear in the secondcolumn. Participants multiple services and all servicesshould be reportedin the table. . All
a.

Chronic

Outreach Case management Life skills (outsideof casemanagement)

b.

A u-

Alcohol or drus abuseservrces Mental health services

c.

f.

HIV/AIDS-related services
Other health care services

c.
h.

Education placement Housing

Employment assistance Child care

J
L

Transportation
m. Legal

Other(please specify)

t4

HUD-40118

Technical year for objectives thisoperating (fromyourapplication' list yourmeasurable 16. overalr proeramGoals.Underobjectives, the in progress, your describe progress meeting objectives' iirtedbelow. under of or Submission, ApR) for each thethreegouls year' for objectives thenextoperating the specify measurable V.ur;sObjectives, NextOp.ruting Under
L. Residential StabilitY see attachment Objectives:

Progress:

Next OperatingYear's Objectives:

b.

Skillsor Income Increased see Objectives: attachmeni

Progress: Year'sObjectives: NextOperating

GreaterSelf-determination see Objectives: attachment

Progress: Year'sObjectives: NextOperating

proiects do llc. answer (SHP-SSO 17b. answer sRo recipients 17a. answer s+c recipients 17. Beds. srrprecipients not com4lete this question)
a. for rlls projectunder 'current Level' and under 'New Effort'? SHp. How many bedswere included in the appiicationapproved end of the operating year'! How many of theseNew Effort beds were actually in place at the

CurrentLevel

New Effort

New Effort in Place

of Number Beds: funds at the endllthe operating year? with project and b. S+C. How manybeds dwellinfilits werebeingassisted and otherfamilymembers, caregivers') (Includebedsfor ail participants,
NumberofBeds: Number of Dwelling Units: 14 14

c.SRo 'Howma ny dwellingunit s wer ebeingas s is t e d a t t h e e n d o f t h e o p e r a t i n g y e a r ? personswho qualify for assistance') (Include units occupiedby*"in place" non-homeless Number of Dwelling Units:

15

HUD-10118

Information Part II: Financial

18. SupportiveServices. was spentduring services this For Suppql1lvg_H_A_UglglsF{!), exhibit provides informationto HUD on how SHP funding for supportive IncludeHMIS costsunder"Other". services. supportive the operatingyear. Enterthe amountofSHP funding spenton these from all plus Care(S+C),this exhibittracksthe supportive services Specifythe valueofsupportive matchrequirement. services For Shelter shouidkeep that all homelesspersonsreceivedduring the operating year. (S+C grantees sources that can be countedas match on documentation file, including source,amount, and type of supportiveservices.) received during the byhomelesspersons For Section 8 SRO, this exhibit plovides information to HUD on the value of suppofiiveservices operating year.

Suppofiive Services
a.

Dollars

Outreach Casemanagement Life skills (outsideof casemanagement) Alcohol and drue abuseservtces Mental health services

b
c.
d.

f
o

services AIDS-related. Other health care services Education Housingplacement

h,

J
t.

Employmentassistence Child care Transportation

m. n
o.

Legal Other (pleasespecify) TOTAL (Sum of a through n)

aggregate Will provide in matching theAPR due 8/31/09.

Cumulative amountof match provided to date for the Shelter Plus Care Program under this grant

to

HUD- 401r 8

19. Supportive Housing Program: Leasing, Supportive Services, Operating Costs, HNIIS Activities and Administration AII granG-sreceivingfunding underthe SupportiveHousing Programmust completethesechartseach operatingyear.For expansion for facilitv,only the peopleand expenditures the additional homeless ofa pre-existing projects: IfSHP grantfundsarefor the expansion to ofresources usedis not required be Documentation or as expansion rnaybe included, in the originalapplication any grantamendments. made by inspection HUD andAuditors. Do not includeany expenditures rvith this reportbut shouldbe kept on file for possible submitted beforethe SHP qrantwas executed. during the operatingyear for eachactivity. Summary of Expenditures. Enterthe amountofSHP grant funds and cashmatch expended total shouldbe the sameas the SHP suDDortive This tableshouldadd up both horizontally vertically. The SHP supportive services and services Question18. in CashMatch SHP Funds Total Expenditures Leasing b.
c. d. e.

Supportive Services OperatingCosts HMIS Activities Administration Total

f,

Note: Paymentsof principal and intere on any loan or mortgagemay not be showr as an operatingexpense. st

Sourcesof Cash NIatch. Enter the sources cashidentified in the CashMatch column.above.in the follorvine catesories.Use additional of sheets. necessarv. as Amount
a

Grantee/proj sponsorcash ect Local government(please specify)

b.

Stategovemment (please specify)

u.

Federalgovernment(please specify)

Development BlockCrant(CDBG) Community

Foundations(pleasespecify)

f.

(please specify) Private cashresoLlrces

charge fees Occupancy / Total

t/

h.

HUD-4OI l8

20. Supportive Housing Program:

Acquisition, Rehabilitation, and Nerv Construction

must completethesecharlsin the year one APR Ail grantees that receivedSHP funds for acquisition,rehabilitation,or new construction only. Th ise xh ibitwil l denr ons t r at et oHUDt hat t hegr a n t e e h a s c o n t r i b u t e d e n o u g h c a s h t o a t l e a s t e q u a l i y m a t c h t h e a l r ou n to fSH Pfu n d s to Documentation that matchingfundswereprovidedis not required be subrnitted for spent acquisition, rehabilitation, new construction. or q,ith this reportbut should be kept on file for possible inspectionbv HUD and Auditors. Summary of Expenditures. Enter the amount of SHP grant funds and cash matchexpended during the operatin_e for eachactivity. 1,ear SHP Funds
a.

CashMatch

Total Expenditures

Acquisition Rehabilitation New construction Total

b.
c.

d.

Cash Match. Enter the sourcesof cashidentjfied in the Cash Match column, above,in the following categories. Use additionalsheets, necessary. as

Amounl
Granteeiproject sponsorcash b. Local govemment(pleasespecify)

Stategovemment(pleasespecify)

d.

(pleasespecify) Federalgovernment Block Grant (CDBG) CommunityDevelopn-rent

e.

(pleasespecify) Foundations

(pleasespecify) Private cashresources

charge/fees Occupancy h Total

18

H U D - 4 O1 IS

IIOR HMIS ACTIWTIES OIVLY

21. For SupportiveHousine (SHP) - HNIIS Activities during the operatingyear. Enter was spent services to infonnation HUD on how SHP-HMISfundingfor supportrve This exhibitprovides the amountof SHP-HMIS fundrnsspenton theseactivities.

FIMIS Activities Only

Dollars

ent
Centrrl Server(s) Computersand Printers Personal Networking Securily Suhtotal

So
Software/ User Licenstng Software installation Suooort and Maintenance Supporling Software Tools Subtotal

Sewices
Trainine bv Third Parties Hostins / TechnicalServices Programming: Customization Programming: SystemInterface Proeramming:Data Conversron and SetuP SecurityAssessment On-line Connectivity (InternetAccess) Facilitation Disasterand Recovery Subtotal

Personrrct
/ ProjectManagement Coordination Data Analysis Programmrng and Training TechnicalAssistance Administrative Suppod Staff Subtotal

HMIS Costs Space

a.nd

OperationalCosts T o ta l

l9

H U D - 4 01 8 1

year' during the operating implemented and/orchanges any Describe problems

Technical Assistanceand R.ecommendations If adviceor assistance? so, pleasedescribe' Basedon your expe'ence during the last year, are there any areasin which you needtechnical

20

HUD-401I 8

TNDC - ScatteredSites c A O 1c 501002 Operating Period: 911/06 8l3ll07 ResidentialStability: Objective:70%o participants of will remain in S+C housingfor at ieastone year. Progress: Wiil report in next year's APR. The hrst parlicipantsmoved in 611101 . Next OperatingYear's Objective:70o/o olpafiicipants will remain housedfor at leastone year Objective:35ok of pafiicipantswill remain in S+C housing for at leasttwo years. Progress: Will report in next year's APR. The first parlicipantsmoved h 611101 . Next OperatingYear's Objective:70o/o participantswill remain in S+C housingfor at leasttwo years. of Objective: 100% of participants will pay some rent during the operating year. Progress: Achieved: 100% (14114)of parlicipantspaid somerent duringthe operating year. Next OperatingYear's Objective: 100% of participantswill pay somerent during the operating year. IncreasedSkills or Income: Objective:25Yoof pafi)cipants will enteror continuepad- or fuli-time employment vocationalprogramduring the or
nnar ot inr . . ^- -

Progress: Not Achieved: llo/" (1/9) of participantsdeemedable to work, entered continuedpart- or full-time or emplol.rnent or vocational program during the operating year. Next Operating Year's Objective: 25%o participants will enter or continuepart- or full-time employmentor of vocational program during the operating year. Objective: 15% will either enter or continue in an educational program during the operatingyear. Progress: Will report in next year's APR. The first participantsmoved i\ 61110l . Next Operating Year's Objective: 15% wlll either enter or contimre in an educationalprogram during the operating year. Objective: 50% will obtain/sustain SSI, 5% will obtainy'sustain benef,rts, VA 15% will obtain/sustain GA, and 5% will obtain/sustain employment. Progress: Will report in next year's APR. The first participantsmoved in 611101 . Next OperatingYear's Objective:50% will obtain/sustain SSI, 5% wiil obtain/sustain benefrts,15% will VA obtain/sustain GA, and 5% wlll obtain/sustainemployment. Objective: 50% of participants on GA at their date of entry into the program will have moved on to SSIiVA/SS/SSDI/SSA,if eligible, or obtain employment incomeby the end of the operatingyear. Progress: Wiil report in next year's APR. The first participantsmoved 1n611107 . Next OperatingYear's Objective: 50% of participantson GA at their dateof entry into the programwill havemoved on to SSi/VA/SS/SSDVSSA,if eligible, or obtain employrnentincomeby the end of the operatingyear. Objective: 80% will either securerepresentative payee services, pay rent on time on their own. or Progress:Exceeded:100% (14114)either securedrepresentative payeeservices, paid rent on time on their or,r,n. or Next OperatingYear's Objective: 80% will either securerepresentative payeeservices, pay rent on time on their or own. Greater Self-determination : Objective: 40o% thosewith drug and/oralcohol addiction wili be cleanand sober. of Progress:Will reporl in next year's APR. The first participantsmoved in 6lll07 . Next OperatrngYear's Objective:40% of those with drug and/oralcoholaddictionwili be cleanand sober. Objective: 35% of residentswiil participatein residentmeetingsduring the operatingyear.

Attachment -1 -

Progress:V/ill report in next year's APR. The fust participants moved in 6/1107 . Next Operating Year's Objective: 35% of residentswill participate in residentmeetingsduring the operating year. Objecfive: 65% willpartrcipatein peer/social activities. Progress:Will report in next year's APR. The first participants moved h 6ll/07. Next Operating Year's Objective: 65% wtll participate in peer/social activities. Objective: 75% wlll sustain or renew communicationswith friends and/or family members. Progress:Will report in next year's APR. The fust participants moved in6/I/07. Next Operating Year's Objective: 75%o wlll sustainor renew communicationswith friends and/or family members. Objective: 20% wlll engagein volunteer activities. Progress:Will report in next year's APR. The frst participants moved in 6/1/07. Next Operating Year's Objective: 20%;" will engagein volunteer activities.

Attachment - 2-