CCUSA 2017 Annual Survey. Performance and Program Detail Questions

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1 CCUSA 2017 Annual Survey Performance and Program Detail Questions When the agency profile has been completed, a number of overall program aims will have been identified. The responded will received the following performance and program detail questions for each program aim for which at least one program has been inventoried. Overall Aim: Meet basic needs and close emergency financial gaps. Did your agency provide benefits screening in 2017? Did your agency provide emergency financial assistance for utilities (e.g. gas, electric, oil, phone) in 2017? [If Yes] How much utility assistance did your agency provide in 2017? o Number of payments o Total dollar number of payments Did your agency provide emergency financial assistance for rental payments in 2017? o [If Yes] How much rental assistance did your agency provide in 2017? o Number of payments o Total dollar number of payments

2 How many adults did your agency assist in completing SNAP applications in 2017?

3 Overall Aim: Increase access to nutritious food. What is the unduplicated count of people who received food services at your agency (e.g. congregate dining/soup kitchens, home delivered meals, food banks/pantries, etc.) in 2017? Please report the number of sites, clients, and meals for your prepared meal programs: Please make sure all boxes are filled. Enter the number "0" where applicable if necessary. Sites Meals Clients Congregate dining Home-delivered meals Afterschool meals Child care center meals Adult day care center meals Summer lunch program Child and adult care food program (CACFP)

4 Q60.3 Please report the number of sites and clients served by your food distribution programs: Please make sure all boxes are filled. Enter the number "0" where applicable if necessary. Sites Clients Food banks Food pantries Other (government bulk distribution, donated food, SHARE, Second Harvest, food coops, voucher) Did your agency provide healthy eating education programs in 2017? [If Yes]How many people were served by your heathy eating education program in 2017?

5 Overall Aim: Increase income and financial self-sufficiency. Do you use a self-sufficiency matrix (such as the Arizona self-sufficiency matrix) to measure progress of clients (1=In Crisis 2=Vulnerable 3=Safe 4=Stable 5=Thriving) in your comprehensive case management program or other self-sufficiency programs? How many people were enrolled in 2017 in programs for which you used the self-sufficiency matrix to track progress toward self-sufficiency? Out of the ${Q61.2/ChoiceTextEntryValue}, What percentage reached safety (3) or better (e.g. stability (4), or thriving (5)) at program discharge on each of the following self-sufficiency dimensions? Access to Services Income Employment Education Housing Food Physical Health Mental Health Did your agency provide services that lead to employment or better employment? [If Yes] How many people received employment services from your agency? Among the {Inset answer choice from question above} that received employment from your agency, what percentage of those achieved full-time employment? Among the {Inset answer choice from question above} that received employment from your agency, what percentage were employed above minimum wage?

6 Among the {Inset answer choice from question above} that received employment from your agency, how many earned a GED, diploma, certification or credential while in the program? Do you provide vocational training or industry recognized credentials or certificates? [If Yes] Please list those programs here: o Program 1 o Program 2 o Program 3 o Program 4 o Program 5 Do you have a target wage for clients who receive employment services? What is the wage per hour? What percentage were employed at that wage at discharge? What percentage were employed at that wage at follow-up?

7 Overall Aim: Increase access to stable, affordable housing Permanent housing is housing for which there is no time limit on how long you can reside in the housing or receive the housing assistance. Please indicate number of total permanent housing units occupied or available for occupancy by type of dwelling. Please make sure all boxes are filled. Enter the number "0" where applicable if necessary. Single Room Occupancy : Multifamily Dwellings : Single Family Dwellings : Boarding Homes, Rooming Houses, or Group Homes : Manufactured Homes (or Mobile Home) : Other (Please specify) : Total : Please indicate number of affordable permanent housing units for the following populations in 2017 and the total number of people served in those units. Low income families Persons who are physically challenged Seniors Formerly homeless individuals and families Veterans Mixed/multiple categories Total Units People Served Which of the following apply to your portfolio of housing projects. Please select all that apply. Market rate housing Below market based housing (e.g. for seniors, people with disabilities) Tenant-Based subsidized housing Project-Based subsidized housing Assisted living housing (e.g. nursing homes, long-term care facilities, special care facilities) None of these

8 Q62.4 Please identify the unduplicated number of households on waiting lists for permanent housing units. o # of HH on Waiting Lists This question applies to your development pipeline. Does your agency have any permanent housing units authorized for construction or under construction? o I don't know [If Yes] You've indicated that your agency has permanent housing units authorized for construction. Please provide the following information regarding these housing units: Seniors Family Special Needs Other (please specify) Total projects Total units

9 Overall Aim: Prevent/end homelessness or reduce harm for people experiencing homelessness How many year round beds does your agency provide of the following types for serving homeless and formerly homeless individuals? How many people did you serve with those beds in 2017? Please make sure all boxes are filled. Enter the number "0" where applicable if necessary. Number of Beds People Served Emergency Shelter Safe Have Transitional Housing Permanent Supportive Housing Rapid Re-Housing Other Temporary Housing Other Permanent Housing What percentage of clients were discharged from emergency shelters, safe havens and transitional housing to permanent housing? o % Discharged

10 Of those ${Q63.2/ChoiceTextEntryValue/1}%, what percentage of clients remained housed at follow-up? After 3 Months After 6 Months After 12 Months After 24 Months Did your agency provide rental assistance to help people stay in their homes? o I don't know How much rental assistance did your agency provide to help people stay in their homes? Number of Payments Total Dollar Amount Rental Assistance Given Q63.6 Did your follow up with clients who received rental assistance payments? o I don't know [If yes] What percentage of clients who received rental assistance remained housed at follow-up? After 3 Months After 6 Months After 12 Months After 24 Months

11 Overall Aim: Increase access to healthcare and improve physical and mental well-being. How many low-income people did your agency assist in insurance enrollment in these programs? Please make sure all boxes are filled. Enter the number "0" where applicable if necessary. CHIP : Medicaid : Medicare : Other health program (Please specify) : Total : Does your agency partner with health systems and/or hospitals in efforts to reduce hospital readmission? o I don't know Does your agency use a validated scale to measure changes in symptoms or functioning of behavioral/mental health clients? o I don't know [If yes] What percentage of your tested clients showed a reduction of symptoms or increase in functioning during treatment or at discharge? of patients

12 Overall Aim: Create new life opportunities to immigrants and refugees. How many refugees were assigned for resettlement by your agency in 2017? Out of the ${Q65.1/ChoiceTextEntryValue} refugees assigned for resettlement by your agency in 2017, how many employable refugee adults were served with employment services? Among the ${Q65.2/ChoiceTextEntryValue} employable refugee adults who were served, how many entered employment during the resettlement period? What was the hourly wage of refugees entering full-time employment? Among the ${Q65.3/ChoiceTextEntryValue} employable refugee adults who entered employment, how many refugees remain employed in a job the quarter after employment entry? With which of the following immigration legal services has your agency worked? Please select all that apply. Please refer to the chart above. Citizenship Affirmative Residence Victims of Abuse Asylum Deferred Action Waiver Removal Proceedings Other Services None of these/i don't know

13 You've indicated that your agency has worked with the following services. Please complete the following information. Citizenship Services Affirmative Residence Victims of Abuse Asylum Deferred Action Waiver Removal Proceedings Other Services # cases initiated # cases carried forward from prior years # of closed failed cases # of closed successful cases

14 Overall Aim: Recover from natural or man-made disasters. If a disaster event occurs in your community, does your agency provide disaster services? o I don't know Which of these types of disaster services did your agency provide in 2017? Please select all that apply. Response (i.e., feeding, sheltering, client intake, gift card distribution) Recovery (i.e., housing assistance, home repair, disaster case management) Preparedness (i.e., disaster education or other preparedness activities) Hazard Mitigation (i.e., strengthening vulnerable/poorly constructed homes, utility elevation, community planning) Our agency did not provide disaster services in 2017 Did your agency receive any funding other than CCUSA Disaster Grant funding for any of the disaster services you provided in 2017? o I don't know Which of the following dedicated resources does your agency have access to for providing disaster services? Please select all that apply. No dedicated resources for disaster services Access to a rainy-day emergency fund Financial donations and/or financial resources In-kind donations

15 Full-time or part-time staff dedicated to disaster services Volunteers Local parish engagement Other (Please specify) Is your agency part of a local/regional VOAD (Volunteer Organizations Active in Disaster) group?, as a leader, as a member o I don't know During the 2017 natural disasters, how many non-clients (i.e. those NOT counted in your agency s unduplicated client count) received immediate response services (e.g. food, shelter, water) from your agency?

16 Overall Aim: Cultivate children s emotional and intellectual development. Which of the following, if any, did your agency sponsor in 2017? Please select all that apply. Head Start Early Head Start Head Start-like programs None of these You've indicated that your agency sponsored the following program(s) in Please indicate the number of sites you have and the number of children served in each. # of Sites # of Children Head Start Early Head Start Head Start-like programs None of these

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