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HomeMy WebLinkAboutExhibit 5` Tali inf HUD Annual Progress Report (HUD -40118) Miall"'- ade Homeless Trust Jun 14, 2C ATTACH MENTODGo"ern Ment ShelterPoint SkanPoint 1r epo �s Admin rielp Lo;_`! Report Options: Select- !' Unduplicated Provider Miami -Dade County Government Operating Year Date Range 05/01/2006 to 05/31/2005 (mm/dd/yyyy) Legal Adult Age 1B (as defined by foster care law in your state) haps: vvr-w 4).serv.1cept.com/mjami,/scripts/sv prep orthud.php 6114/ r)nF -Or -Select- 2. Persons Served during the Number of Singles Number. of Adults Number of Children in Number of operating year. Not in Families in Families Families Families a. Number on the first day of the 0 I p 0 operating year: I D. b. Numberentering program during the 0. 0 0 operating year. 0 G Number who left the program during 0 0 0 the operating year. 0 d. Number in the program on the last day 0 0 0 of the operating year. (a+b-c=d) 0 Number of Singles 3. Project Capacity. Number of Adults Number of Children in. Number of Not in Families in Families Families Families a. Number on. last day (from 2d, columns 0 1 and 4) 0 4. Non -homeless persons. (Sec. 8 SRO projects only) How many Income -eligible non -homeless persons were housed by the SRO program during the operating year 0 S. Age and gender. IAge Male Female Other/Nbt given Single Persons (from 2b, column 1) a. 62 and over 0 0 0 b. 51 -61 D 0 p c. 31 -50 0 0 0 =_130 0 0 0 e. 17 and under 0 0 0 Not given 0 0 0 -Persons in Families (from 2b, columns 2 & 3) f. 62 and over 0 0 0 g. 51 -61 0 0 0 IF h- 31 - 50 0 0 p haps: vvr-w 4).serv.1cept.com/mjami,/scripts/sv prep orthud.php 6114/ r)nF fi. 18 - 30 �j. 13 17 ' 0 0 + 0 ,k. 6 12 I 0 0 j 0 !. 1 0 0 0 M. Under 1 I 0 0 0 Not given ) 0 + 0 I 0 6a. Veterans Status. A veteran is anyone Aho has ever been on active military duty sta us. 6b. Chronically Homeless. How many participants vaere chronically homeless individuals? 7. Ethnicity. a. Hispanic or Latino t b. Non -Hispanic or Non -Latino 8. Race. a. American Indian or Alaskan Native I C b. Asla n 0 c. Black or African American 0 d. Native Hawaiian or Other Pacific Islander 0 e. White 0 f. American Indian/Alaskan Native & White 0 g. Asian & White0 h. Black/African American &. White 0 "i. American Indian/Alaskan Native & Black/African American 0 j. Other.Multi-Raclal 0 k. Other/Unknown (all that do not Match) 9a. Special Needs. 0 Al( Chronic a.- Mental illness 0 :0 b. AJcohol abuse 0 :0 c. Drug abuse 0 :0 d. HIV/AIDS or related diseases 0 0 e. Developmental disability 0 0 f. Physical disability 0 0 g. Domestic violence 0 0 h. Other (please specify) 9b. Disabled. 0 0 How many of the participants are disabled? 10, Prior Living Situation. 0 MAllCh,,onc a. Nonhousing (street, park, car, bus station, etc.) b. Emergency shelter c_Transitlonal housing for homeless persons Id. Psychiatric facility e. Substance abuse treatment facility If. Hospital g. Jail/prison h. Domestic violence situation i. Living Nvith relatives/friends j. P.ental housing https:/h.�r�in' scrvicept.com/nliami/scriL�ts/svpre.l)orthud.Dhr, "' - k. Other (please specify) ( 11. Amount and Source of Monthly Income at Entry and Exit. Amount I A. Monthly Income at Entry 1 0m B. Monthly Income at Ez a. Less than 1 month All Chronic All Chronic a. No Income b. g1-150 0 0 0 0 + H 0 0 c- $151 $ 250 0 0 0 D d.$$251 $500 0 0 0 0 e. $501 - $1000 0 0 D p If. $1001 - $1500 0 0 0 0 g. $1501 - $2DD0 h- $20DD + 0 0 0 0 0 0 0 0 Source C. Income Sources at Entry D. Income Sources at Exit 0 All Chronic All Chronic a. Supplemental Security Income (SSI) D 0 I 0 0 b. Social Security Disability Insurance (SSDI) D 0 0 0 c. Social Security 0 0 0 0 d- General Public Assistance 0 0 0 0 e. Temporary Aid to Needy Families (.TANF) 0 0 0 0 f. State Children's Health Insurance Program (SCHIP) i 0 0 0 0 g. Veterans benefits 0 0 0 0 h. Employment Income 0 D 0 0 i. Unemployment Benefits 0 D 0 0 j. Veteran's Health Care 0 0 0 0 k. Medicaid 0 0 0 . 0 I. Food Stamps 0 0 0 p m., Other (please. specify) 0 0 0 D n. No financial resources 0 0 12a. Length of Stay in Program. (Participants who left during operating year) 0 I D 11ttp5:/Axnilv3.service.pt.corn/miainiiscriptslsvpreporthud.php .-" ,'^ All "Chronic a. Less than 1 month 0 0 b. 1 to 2 months 0 I D c. 3- 6 months 0 D d. 7 months - 12 months 0 0 e. 13 months - 24 months f. 25 months - 3 years 0 0. 0 0 g. 4 years - 5 years .0 0 h. 6 years - 7 years 0 0 i. 8 years = 10 years 0 0 j. over 10 years 12b. Length of Stay in Program. 0 (Participants who did not leave during operating year) D All Chronic la. Less than I month b, 1 to 2 months 0 0 0 0 C. 3 - 6 months 0 0 d. 7 months - 12 months 0 0 e, 13 months - 24 months 0 0 If, 25 months - 3 years 0 0 g. a years - 5 years ` 0 0 11ttp5:/Axnilv3.service.pt.corn/miainiiscriptslsvpreporthud.php .-" ,'^ h. 6 years - 7 years t. I 0 0 i. 8 years - 10 years 0 0 j. over 10 year 13. Reasons for Leaving. a. Left fora housing opportunity before completing program b. Completed program c. Non-payment of rent/occupancy charge d. Non-compliance with project e. Criminal activity / destruction of property / violence f. Reached maximum time allowed in project g. Needs could not'be met by project h. Disagreement with rules/persons i. Death j. Other (please specify) k. Unknown/disappeared 14. Destination. PERMANENT (a - h) TRANSITIONAL (i - j) INSTITUTION (k - m) EMERGENCY SHELTER (n) OTHER (o - q) UNKNOWN is. Supportive Services Ia. Rental house or apartment (no subsidy) b. Public Housing c. Section 8 ,d. Shelter Plus Care e. HOME subsidized house or apartment If. Other subsidized house or apartment Ig. Homeownership h. Moved in with family or friends Ii. Tfansltional housing for homeless persons }. Moved in with family or friends k. Psychiatrlc hospital I. Inpatient alcohol/drug treatment facility rn. )all/prison n. Emergency shelter o. Other supportive housing p. Places not meant for human habltation (e.g. street) q. Other (please specify) r..Unknown No supportive services found. ServicePoint version 4.01.018 (db build #0723) Licensed to: Miami Dade Homeless Trust Q 1999-2006 Bowman Systems L.L.C. All Rights Reserved. All 0 0 0 0 0 0 0 0 0 0 0 Chronic 0 0 0 0 0 0 0 0 0 0 0 Chronic 0 0 0 9 0 0 0 0 0' 0 "D 0 0 0 0 0 0 0 I CPT only rc)2004 Artaerican fdedlcal Association. All Rights Res. -,rued. DSht ano DSM -Iv -TR are registered trademarks of the Arnercan Psychiatric Association, and are used vrlth permission herein. ICD -9-l-!-1 Ic11994 r4ationa! C=ent= -r for Health Statistics (ICD-9 i�:%World Health Organization). All Rights Reserved`. Taxon ri tc,)1933.2D03 information and Referral Federation of Las Angeles County, Inc. All Rights Reserved. 1 https:i/,,;�,".i-�,3.servicept..convmian-ii/scripts/svpreporthud.php 6/14/2006 -1CI-Ik-1EIN-r E ML-kNIJ-DADS COLNITY HO' TELESS TRUST PR0GRAAM RATING OF SATISFACTION INSTRt CTIONS Carefully read all of the instructions below BEFORd distributing the Program Bring of Satisfuctiun sun'eN' to }-our program participants. General Information The Program Rating of Satisfaction consists of 1 1 items which are used to detemnine u clients satisfaction �yith sentices they are receiving from a provider. It is to be completed by all program participa' S enL,auzd in services at a Trust -funded program. It must be completed - at a minimum - at time ot' dischar��e for all Participants. It is strongly recommended that a Program Rating of Satisfaction survey also be completed at intervals as may be applicable to the program; however. only the discharge survey must be forwarded to the Homeless Trust. Case management notes should indicate specifically why a Program Rating of Satisfaction was not obtained, if that is -the case (client went AWOL, institutionalized. etc.), and »-hat efforts Nacre made to obtain a survey in those instances. The Program Rating of Satisfac-tion is available in English, Spanish and Creole. Providers are responsible for reproducing the appropriate sue d providing an envelope (that seals) for each respondent. All .responses should be completed in ink If a participant cannot read; providers should encourage them to use the same process they use to have other information read to them. An employee ofthe agency that is not directly responsible for the client's care can read the form. This should be indicated in Section II. as a separate set of staff initials. Filling o-ut the form 1) A language appropriate survey and an envelope should be provided to all participants uho are required to complete the form. Only one forte per, family is required. The forth must be filled out in inl:. �} Section II of the Program Rating of Satisfaction is to be completed by staff prior to providing the survey document to the program participant. Staff initials refers to the initials of the case manager responsible for the client's sen�1 deliver}. If the survey must be read to the cl-lent, the initials of the staff person performing that function should also be included. In.no case should the participant's case manager read items aloud to th.e participant. 3) Section I of the Program Rating of Satisfaction Form is to be filled -out ONL7'' by the program participant. The program participant should be provided a private place and sufficient time to answer the survey. =1) Providers should reassure participants of the conf dentiality of their responses. Providers may wish to introduce the survey, as follows: "This sunvey is one way of helping us determine how well we are helping individuals that come to our agency for assistance. Please take a fe%v minutes after I leave to answer this very short survey as honestly as possible. Your responses are private and «e will not look- at them.. Please seal the envelope and gave it tonic v, -hen you are done (or: put it in the drop box)." S) The completed survey should be. placed in the envelope by the recipient and sealed. Providers are encourag-d to provide a "drop box" �i`ith a slot for completed forms. E) The sealed envelope(s) should be for yarded to the Miami -Dude County Homeless Trust on a monthly basis. i) The provider a`ency should maintain a log of how- many sun;cys are distributed: DETER TINATION OF MINJTML-M AVERAGE SCORE FOR CONSUMER SATISFACTIO'� SURVEY II/6/00 1 I was informed of my riahls and responsibilities I 0 1 was provided with information about different sen'ices that are available for me I was involved in making decisions about my care/service plan i J I j x.09 I was able to talk with staff when I needed to The.buildin.a and facilities have usually been clean, safe and b I comfortable I 4 I 5.1S IMy rights were respected and protected, including my right to File a Qrievnnce, if needed I N/A My case manaaerseems qualified to help me ] i —47. I would recommend this program to others S i 5.36 I am treated with respect by the staff The staff seems to care a bout whether I act better I -'0 I 5' l Program staff were };nowledgeable about available services that could help me 14 -3S RECOMMENDED 57.17 57.00 II/6/00 r N/f ANU-DADE COUNTY HOMELESS TRUST PROGR .M RATING OF SATISFACTION Section I..:TO BE COMPLETED BY PROGR4M PAPMCIPANT 1l!Strrlc1i0i1s: Please answer mclr question below by placing an /�V in /he spoce prol•ided. )'our responses ru these quevions have no bearing on your corrlinued particinarion ill the pro,rranl..ILL responses tire cun�rlrntiaL 'Vhy did you choose to enter the program (mark only one boy): 0 I decided to come to this program on my own (through outreach. referral. etc. ) ❑ I was placed here through another program (court intervention, police, etc.) ac3lnsi m ',\ III 0 I had previously participated in this or a similar program and decided to return OPTIONAL Information: Name: Sex: ❑ male ❑ fema]e Today's Date: Please arrsWer the folloWrizg questions about the services }lou received. Mark [,VJ ontl' One box which best descrihesyour feelings abolrt each statement These questions are meant to Delp us ilrzprove the services provided, so we ask that you tell us how yozi really feel, wheilier or not it is good or bad 5rronglr I Agret 4gree a Disagree Disa,reeFragree Lirrle 4 Lirtra a ree 1 wa.s informed of my rights and responsibilities, [6] [�] [4] [3] [?] (1] including theaaency's grievance procedures I w2s provided with information about differentservices I [6]. [5] [ ] [3) (?] [I] that are available for me I was involved in making decisions about my I [6] f5] [a) [3) [3] [1) care/service Dian I was able to talk with staff when I needed to The building and facilities have usually been.clean, safe and comfortable My ri-hts were respected and protected,•includino my right to dile a grievance, if needed. Aly case manager seems qualified to help me I would recommend this program to others I am treated with respect by the staff The staff seems to care about whether I -Ze.t better Program staff were knowledgeable 2bout5vailable i services that could help me [6] [5) [4) [3) [2] [1) [6] [5). [a] [=] [2] [1] [6] .[o] [4) [3] [6] [5) [a) [3] ['-) [1) [6) [5] [4] f 1 [2) [1) [6] [5) [4] [3] '[2] rll [6] _[5] [4) [3) [? [1l [6] [5) [4] [3] [3) [I) Section II.: TO BE COMPLETED BY PROGRAM STAFF IPurpose of Evaluarion Current Level of Care provided D At Admission D' emeFgcncy housing I Prodder name. D At discharge -D transitional housing/tx Project Name: ❑Other:I ❑ transitional housina-non-ts Staff Initials: D permanent housing 1 ❑ services only Rt, I1/6"00 Forrrs/Drogramrarinp A41AATI-DADS COUNTY HOMELESS TRUST EVALUACIbN DE LA S.ATISF.ACCLON CON EL FROGR-Am.A Section I. C0.1PLET.ADA POR ELPARTICIP.ANTE DEL PROGRAMA Irrsrrucciones.• Porju��or coloque una crit_ �.\� err e/ espaciv prowsro para respnuder a las prc; tn,tus n cnnnll,/:,['11117. L ns respuestus que usred de a este euestionario no in/1uir617 rle forma o1runa snbre lu continuaci(il, de s,l parricinacil;n en elate pro,prama. TOD.- S las respuestas se rnarter7drdn conjdencialmente. ,;Por que decidi6 usted participar en el programa' (Marque una cosilla solamen(e): [ ] Lo decidi por mi cuenta (porque fui remifido o por medio de otro programa, etc.) [ ] Fui colocado aqui mediante orro programa (por intervention de los tribunales, la Policia, etc.) en conrra de mi voluntad [ J Ya habia participado en este programa o en uno similar v decidi re2resar Informaci6n OPOONAL: Nombre y apellido: Fech.a de hog: Genero: M [ ] F1 ] Porfavor responda a las pregunlas sig uientes acerca de los servicios que se le han presrado. I Idigrle cal Lina cru;; AY EY UAA SOL --I C.4SI11.4 POR PRE'GUA'T9 la- forma en que usred se siente acerca de coda una de las cuesi a,es descriias. Como sus respuestas a estas prep untas nos utwdardn a mejorar los servicios que prestan?as, le rogrlmos que "us 1101-a saber . cdma se sienreen d imaenuestroservco,noporra si usted los carsidera huenos o -malas. Section II.: COMPLETADA POR ENIPLEADOS DEL PROGRA,POA (completed -by program stam Purpose ofFva/uarioir Current Level of Care provided At Admission D emergency housingProvider Name: O At discharge D Transitional housinoltx Project Name: ------------- O Other: D transitional housing non -n Staff Initials: I D permanent housing I D services only t Aluc de De I :Igo de Algo en I En hjuI acuerdo acuerdo. acucrdo desaeuerdo .cn desacucrdo desacucrdo ormaron cuales eran mis derechosy [6] 15I [4] [3] [?] [1] flidades., entre ellos, los pr -de la enIra someter ue'as. informaci6n snbre los distintos servicios a los I Fdeatenc,6 [6] [s] [4] [3] [2] [!] derecho. en la toms de decisiones referentes a mi plan [6] [3] [4] [3] [2] [I] n �c sen icios. Pude hablarcon el personal cuando tuvenecesidad de [6] [5] [4] .[3] [2] [IJ hacerlo. El centro y sus servicios por to general se han manteriido I [6) [s] [4] [3] [2] [ 1J lim ios, sin eli�ro accesibles. Se respetaron y protebieron mis derechos, entre ellos, mi [6] [-} [4] [ 3) [�] [1) derecho a someter ue'as si to considero necesario. Aparenfemente, la persona encargada de mi caso Babe to [6] [�] [] [;] [�] [1} que fiene ue hater ara avudarme. I'D les recomendaria este royecto a otras personas. [6 [5] [a) [3) [2] 1 Los em leados me trataron res etuosamente. [6] [5) [a) [3] [?] [1) Aparentemente,'a los empleados les interesa que yo [6] [3] [a) me'ore. I Los empleados sabian que servicios pbdian servirme de I [6] [3] [4] [3] [2] .. [ 1] avuda. Section II.: COMPLETADA POR ENIPLEADOS DEL PROGRA,POA (completed -by program stam Purpose ofFva/uarioir Current Level of Care provided At Admission D emergency housingProvider Name: O At discharge D Transitional housinoltx Project Name: ------------- O Other: D transitional housing non -n Staff Initials: I D permanent housing I D services only t MI-ANJI-DADE COURNTY HOMELESS TRUST P�A`OGR- TQ POU EVALYE SATIS:FAKSZ-ON Section 1. TOUT P_ATISIP.AN N'-;kN P«'0GRA1.1 SILA A FET PQU RA -NPL S.� .A Fnslrf�si blr: Tallpri reponn chak heksl on anbn la a epi fe t'an Ii h n'a f.�/ nnn espns ki rttl Irl. Rc>nnrrc urw hni. ro dap derallj.0 fason 17817 k0ntil71-e pnlisipe nan pwooranl silt) a. Toui.rcpo/ts)'o tip sekri, POUKI 11' CHWAZ1 PATISIPE NAN PIX'OGR01 SILA A (fe yon ti Ova nan ion Brenn bv+-a t): i) Se mwen ki chwazi vinn nan pwogrnm silo a (swn pa referans, s-wa pa s6vis espesy.if nsistans piblik etc.) (� Se pa chr,'a moven, se yon Ict pwogram ki voyern (znk tribinal, lapolis etc) JJ Mwen to deja patisipe nan yon pwogram konsa epi mwen Beside retounnen. Enfomasyon .pou bav si -w vle: Non: Dat Jodya: Seks [] Gason [] Fenn Tar7pri reponn keksyblz sila yo dapre sews w resci wa. Fe yon A-wa JxJ nan yvn sel li Aare epi clz wa�i repofls- kiAlis matche ave w. Kehs}orr silo po la pbu ede noa bav pi bon sevis, alb 170LI 111a17de 11011 brt_I' rC,JUIIS k!ells marche (1vL, elib017oupa. Yo fem konnen- tout dwa mwen yo ak responsabilite mwen vo ak kouman pou mwen plenven nan ajans la l'o to banm�ien enfbmasyon sou diferan sevis ke mwen kab jwenn Maven to patisipe nan tout desizyon sou planiftkasyon swenlsevis mwen Am 1}vave vo to toUJou dis onib pou mwen pale avek vo Kote a ak bil,ding yo to toujou byes p+vbp, konfbtab ak bon sekirife Tout dwa m to respekte ak pw6teje menrn d.wa m you mwen fe pote plent si nesese Moun kap okipe.1(2mwen an sanble li kalifye you li edem- Mwen to rekomande ptivoaram lila a bay lbt mown Amplwaye yo trete mwen ak respe Amplw2),e yosanbie yo vrernan enterese nan maven Amplwa)-e pe+'ogram la to been enf6me sou tout sevis ki to disponib you ede m. Bon jan dako d2k6 Dako tou piti Pa•finn twb da_};b Pa dako Pa dako ditou [6] [5] [4] [3] [2] [l] f6) [51 [`l] [3] [2] [1) [6] [5] 151 [4]. [3] [2) fl] [61 [5] [4] [3] [6) [5 [`I] [3] [2] [l] [6] [6] [4] [3] (2) [I) [6] [6] [5] 151 [a] [4] [3] 131 [2] [21 (lj [61 [5] [4] [1) [2) [1) [6) [5] [41 [3) [') [+1 [6] 151 [4j [3] [2) (i] .Section II.: TO BE COMPLETED BY PROGRAM STAFF J'1lrpose 01 Li'alllarioll Curren! Lei'el of Care prorided D At Admission D emersency housing ID At discharge D ransitional housinJt;; D Other: t D transitional housing/non-tx D permanent housing D services only R -.l 1/6%00 Fornsrorouanraono Provider Name: Project Name: _ Staff Initials: