Evaluation of the Rapid Re-Housing for Homeless Families Demonstration Program

Appendix D.
Item-by-Item Justification for
Follow-up Survey Instrument

Q#
A1

A1a

A2

A2a

A3

A3a

A4

A4a

A4b

A5

A5a

Question
How many adults, that is, people who are 18
years old or older, in your family are living
with you right now?
Please tell me the first names of the adults in
your family who live with you right now.
How many children in your family are living
with you right now. By children I mean
people 17 years old or younger
Please tell me the first names of the children
in your family who live with you right now.
Do you have a spouse, partner, or significant
other who is part of your family but is not
living with you right now?
Now, can you please tell me the first name of
your spouse/partner/significant other who is
part of your family but is not living with you
right now?
Do you have any of your own children who
are part of your family but are not living with
you right now. By children I mean people 17
years old or younger. Please do not include
children 18 years old or older. Do not include
yourself.
How many of your own children are not living
with you now? By children I mean people 17
years old or younger
Now, can you please tell the first name(s) of
any of your children who are part of your
family but are not living with you right
now. By children I mean people 17 years old
or younger.
Has your household remained the same
during the past year, that is, are all the
people who lived with you were getting help
from the RRHP [PROGRAM NAME] last
year, living with you now?
Please describe the change in your
household composition since last year.

A6
A7

What is [A1a/A2a1]’s relationship to you?
Is [A1a/A2a1] male or female?

A8

What is [A1a/A2a1]’s age right now?

Justification
To establish the universe of adults in the
Respondent’s household.
To allow the interviewer to prompt individually
about each member of the household in future
questions.
To establish the universe of children in the
Respondent’s household.
To allow the interviewer to prompt individually
about each member of the household in future
questions.
To establish the universe of adults in the
Respondent’s household.
To allow the interviewer to prompt individually
about each member of the household in future
questions.
To establish the universe of children in the
Respondent’s household.

To establish the universe of children in the
Respondent’s household.
To allow the interviewer to prompt individually
about each member of the household in future
questions.

To measure the extent of household change,
as a way to understand program impact on
family stability.

To measure reasons for household change, as
a way to understand program impact on family
stability.
To understand household composition.
To measure gender of clients served as a
factor in understanding the client population
served.
To measure age of clients served as a factor in
understanding the client population served,
and to target future questions in the survey
based on age of respondent.

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Q#
A9

A13
A14

Question
Does [A1a/A2a1] have any disabilities that
require any special housing features such as
wheelchair access?
ASK IF [A2a1] is 15 OR UNDER: Was there
any time in the past year when [CHILD] did
not live with you?
ASK IF [A2a1] IS 15 OR UNDER:
Please tell me all of the different places that
[A2a1] has lived when s/he did not live with
you. Did [A2a1] live …
[MARK ALL THAT APPLY.]
ASK IF [A2a1] IS 5 YEARS OLD OR OLDER.
Did [A2a1] attend school during the school
year? Is [A2a1] currently attending school?
What is [A3a/A4b1’s] relationship to you?
Is [A3a/A4b1] male or female?

A15

What is [A3a/A4b1]’s age right now?

A16

Does [A3a/A4b1] have any disabilities that
require any special housing features
such as wheelchair access?
ASK IF [A4b1] IS 15 OR UNDER: How long
has it been since [A5b1] lived with
you?
ASK IF [A3a/A4b1] IS 15 OR UNDER:
Please tell where the [A3a/A4b1] is currently
living, while not with you.
ASK IF [A3a/A4b1] IS 15 OR UNDER. Have
you done anything to try to get [A3a/A4b1] to
move back in with you?
ASK IF [A3a/A4b1] IS 15 OR UNDER:
What would you say has been the total
amount of time [A3a/A4b1] has spent living
apart from you?

A10

A11

A12

A17

A18

A19

A20

Justification
To measure disability of clients served as a
factor in understanding barriers to housing.
To measure the extent of family separation, as
a way to understand program impact on family
stability.
To measure the extent of family separation, as
a way to understand program impact on family
stability.

To measure the extent of school participation
for children served by the program.
To understand household composition.
To measure gender of clients served as a
factor in understanding the client population
served.
To measure age of clients served as a factor in
understanding the client population served,
and to target future questions in the survey
based on age of respondent.
To measure disability of clients served as a
factor in understanding barriers to housing.
To measure the extent of family separation, as
a way to understand program impact on family
stability.
To measure the extent of family separation, as
a way to understand program impact on family
stability.
To measure the extent of family separation, as
a way to understand program impact on family
stability.
To measure the extent of school participation
for children served by the program.

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B. Current Housing
Q#
B1

Question
Which one of the following best describes
your current living situation

B1aB1q

Identifies the type of housing the respondent
resides in: rental unit, owned unit, on lease,
not on lease, etc.

B2

Is this the same unit you lived in while you
were receiving rental assistance from [name
of program]?

B2a

How long have you lived in this unit?

B2b

How many different places have you lived in
during the past year? ______

B2c

Why did you move out of the place you lived
in at the end of the [program name]?
SELECT ALL THAT APPLY – AND RANK AS
MAJOR/MINOR REASON.
IF B2 =YES: Was there ever a time during
the past year (that is, since MONTH/YEAR)
when you did not have your own place to
stay?

B3

B4

B5

B6

IF B2 = NO: was there ever a time during the
past year that you temporarily left your own
place (other than for vacation).
During the past year, when you did not have
your own place to stay, we would like to know
about any places where you stayed.
During the time when you did not have your
own place to stay in the past year, how much
of the time did LIST EACH CHILD’S NAME
FROM A2a AND A4b live with you
IF B2 = YES; Did you ever receive help from
an agency to pay your rent so you could stay
in your own place?

Justification
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the stability of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the stability of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the stability of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure barriers to retaining housing, as a
factor in understanding housing stability
outcome associated with the program.
To measure the extent of homelessness for the
respondent, as a factor in understanding
housing stability outcome associated with the
program.

To measure the extent of homelessness for the
respondent, as a factor in understanding
housing stability outcome associated with the
program.
To measure the extent of homelessness for the
respondent’s children, as a factor in
understanding housing stability outcome
associated with the program.
To measure the extent that assistance was
needed to help the respondent retain housing,
as a factor in understanding housing stability
outcome associated with the program.

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Q#
B7

Question
IF B6 =YES: How much and how many times
did you receive help?

B8

I have some questions about the
house/apartment/living space you live in now.
Overall, how would you describe the
condition of your current
house/apartment/living space? Would you
say it was in excellent, good, fair, or poor
condition?
Excluding kitchens, bathrooms and hallways,
how many rooms does the unit have?

B9

B10

IF B1a = YES i.e. FOR RENTERS: How
satisfied are you with building maintenance?

B11

Now I am going to ask you some questions
about problems that people have in some
homes/apartments/ living spaces. Since you
moved in to your current unit, have you had
any of the following housing quality issues:
B11a- Questions regarding specific housing
B11m qualities and problems.

B12

Which of the following statements best
describes how satisfied you are with your
neighborhood?

B13

Now I would like to ask you about problems
that occur in some neighborhoods. In your
neighborhood, how big of a problem is…

Justification
To measure the extent that assistance was
needed to help the respondent retain housing,
as a factor in understanding housing stability
outcome associated with the program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.

To measure the extent of overcrowding in the
respondent’s current housing, as a factor in
understanding housing stability outcome
associated with the program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the quality of the respondent’s
current housing, as a factor in understanding
housing stability outcome associated with the
program.
To measure the quality of the respondent’s
current neighborhood, as a factor in
understanding housing stability outcome
associated with the program.

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C. Income and Employment
Q#
C1

Question
Have you received any income from any
source in past 30 days?

C2

In the past 30 days, have you received any
income from … (IF YES:) How much did you
receive in the past 30 days

C3

IF OTHER PERSONS 15 or OLDER IN THE
HOUSEHOLD, ASK: Did any other persons
who live with you in your unit receive any
income in the past 30 days?
If YES, How many other persons who live
with you in your unit received any income?
What is the total income received by other
persons in your household in the past 30
days? _______
Did any of these persons contribute any
money toward rent?
What is the total amount these other persons
paid toward your rent in the past 30 days?
_______
Did any other adults who do not live with you
contribute any money toward your rent in the
past 30 days?

C3aC3d

C4

C4a

What is the total amount these other adults
paid toward your rent in the past 30 days?
_______

C5

In the past 30 days, did you or anyone in your
household receive (or are you on) any of the
following benefits: … (IF YES:) How much
did you receive in the past 30 days? JUST
ASK AMOUNT FOR THE MARKED ONES.
Last week, did you do any work for pay?

C6

C7

What is the main reason that you did not
work for pay last week?

C8

Have you been doing anything to find work
during the past four weeks?

C9

When did you first start working at your job?

Justification
To measure the income of the respondent, as
a factor in understanding housing affordability
and potential increases in income associated
with program participation.
To measure the income of the respondent, as
a factor in understanding housing affordability
and potential increases in income associated
with program participation.
To measure the income of the respondent’s
household, as a factor in understanding
housing affordability and potential increases in
income associated with program participation.
To measure the income of the respondent’s
household, as a factor in understanding
housing affordability and potential increases in
income associated with program participation.

To measure the income of the respondent’s
household, as a factor in understanding
housing affordability and potential increases in
income associated with program participation.
To measure the income of the respondent’s
household, as a factor in understanding
housing affordability and potential increases in
income associated with program participation.
To measure the non-cash income of the
respondent’s household, as a factor in
understanding potential increases in income
associated with program participation.
To measure the employment status of the
respondent, as a factor in understanding the
effect of program participation on employment
To measure the employment status of the
respondent, as a factor in understanding the
effect of program participation on employment
To measure the employment status of the
respondent, as a factor in understanding the
effect of program participation on employment
To measure the employment status of the
respondent, as a factor in understanding the
effect of program participation on employment

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Q#
C10

Question
Through your employer are you eligible for
any of the following benefits? By eligible we
mean the benefit is available for you now,
even if you have decided to not receive it or
have not needed it.

Justification
To measure the employment status of the
respondent, as a factor in understanding the
effect of program participation on employment

D. Housing Costs
Q#
D1

D1aD1c

D2

D3

D4

D4a

Question
IF RENTERS BASED ON B1a= yes, or
B1c=yes, or B1d=yes: ALL OTHERS SKIP
TO D4.
In the month just past, what did you and the
family you headed pay in rent? We are
interested only in knowing the amount of the
rent payment that you or the family you head
paid, not any amount that may have been
paid by other people or by a government
agency and not including any utilities that you
pay for directly to the utility company.
Can you give me a range? Is your monthly
rent payment:
What is the total contract rent that is paid to
the landlord? That is the rent including any
amount you and your household pay and
including any amounts paid by other people
or by a government agency.
Can you give me a range? Is the total
monthly rent payment:
Are you paying lower rent because you
receive assistance from the government, or
some other program to pay part of your rent?
Is this assistance: public housing, a Section 8
Voucher, Project-based Section 8 or some
other type of assistance?
IF OWNERS: (IF THE ANSWER TO B1B =
YES. ALL OTHERS SKIP TO E1) In the
month just past, what did you and the family
you headed pay for your mortgage? We are
interested only in knowing the amount of the
mortgage payment that you or the family you
head paid, not any amount that may have
been paid by other people or by a
government agency.
Can you give me a range? Is your monthly
mortgage payment:

Justification
To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.
To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.
To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

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Q#
D5

D6

D6a

Question
Did you pay for any utilities that are not
included as part of the RENT/MORTGAGE
that you pay? By utilities, I mean electricity,
heat, gas, and water, but NOT telephone and
cable services.
What is the total amount of all utility
payments that you and the family you head
pay in a typical month—that is not a month
with unusually high or low heat or air
conditioning bills?
Can you tell me the range for your monthly
utility payment?

Justification
To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

To measure the respondent’s housing costs,
as a factor in understanding housing
affordability and stability.

E. Housing Barriers
Q#
E1

Question
Next, I’d like to ask about things that make it
difficult at times for some people to keep a
place of their own to live. There are many
things that can make keeping a place of their
own live difficult. I’m going to read a list of
reasons why some people might have trouble
keeping housing. Please tell me if you think
this is a big problem, a small problem, or not
a problem at all for you and your family.

Justification
To measure housing barriers, as a factor of
understanding the effect of the program on
housing stability.

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Q#
E1aE1p

Question
E1a. Not having enough income
to pay rent
E1b. Not being currently employed
E1c. Family violence
E1d. Your having problems with
police or a criminal record or
background
E1e. Another family member having
problems with police or a criminal
record or background
E1f. Your having a drug problem or
a felony drug record
E1g. Another family member with a
drug problem or a felony drug
record
E1h. Having three or more children
in the household
E1i. Having teenagers in the
household
E1j. Having an adult in the
household that is frequently sick.
E1k. Having an adult in the
household that has a physical
disability that requires specific
housing modifications.
E1l. Having an adult in the
household that has a mental
disability.
E1m. Having an adult in the
household with HIV/AIDS
E1n. Having a child in the
household that is frequently sick.
E1o. Having a child in the
household that has a physical
disability that requires specific
housing modifications..
E1p. Having a child in the
household that has a mental
disability.

Justification
To measure housing barriers, as a factor of
understanding the effect of the program on
housing stability.

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F. Education
Q#
F1

F2

F3

F4

F5

Question
When you entered ,
what is the highest grade or year of regular
school that you have completed and gotten
credit for?
Did you have (a high school diploma or) a
GED? [PROBE FOR GED VS. HIGH
SCHOOL DIPLOMA]
Now I would like to ask you about any regular
school or any training you may have had
since you entered/ the Rapid Rehousing
Program (this is since, DATE OF ENTRY).
Have you participated in any additional
regular schooling or in some other type of
schooling or training program that lasted at
least two weeks that was designed to help
you find a job, improve your job skills, or
learn a new job?
What kind of schooling or training was that?
[INTERVIEWER: CHECK ALL THAT APPLY)

Did you get the training while you were in the
program, after, or both?

Justification
To measure respondent education levels, as a
factor of understanding the client population
served and the effect of the program on selfsufficiency.
To measure respondent education levels, as a
factor of understanding the client population
served and the effect of the program on selfsufficiency.
To measure respondent education levels, as a
factor of understanding the client population
served and the effect of the program on selfsufficiency.

To measure respondent education levels, as a
factor of understanding the client population
served and the effect of the program on selfsufficiency.
To measure respondent education levels, as a
factor of understanding the client population
served and the effect of the program on selfsufficiency.

G. Food Security and Hunger
Q#
G1

G2

G3

Question
Now I am going to read you three statements
that people have made about their food
situation. Please tell me whether the
statement was often, sometimes, or never
true for you and the other members of your
household in the last 12 months.
In the last 12 months did you or other adults
in your household ever cut the size of your
meals or skip meals because there wasn’t
enough money for food?
How often did this happen—almost every
month, some months but not every month, or
in only 1 or 2 months?

Justification
To measure the extent of food security and
hunger, as a factor of understanding the effect
of the program on basic needs and selfsufficiency.

To measure the extent of food security and
hunger, as a factor of understanding the effect
of the program on basic needs and selfsufficiency.
To measure the extent of food security and
hunger, as a factor of understanding the effect
of the program on basic needs and selfsufficiency.

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Q#
G4

Question
In the last 12 months, did you ever eat less
than you thought you should because there
wasn’t enough money to buy food?

G5

In the last 12 months, were you ever hungry
but didn’t eat because you couldn’t afford
enough food?

Justification
To measure the extent of food security and
hunger, as a factor of understanding the effect
of the program on basic needs and selfsufficiency.
To measure the extent of food security and
hunger, as a factor of understanding the effect
of the program on basic needs and selfsufficiency.

H. Family Well-being
Q#
H1

Question
About how many days per week do you and
your (child/children) all eat dinner together?

Justification
To measure the extent of family involvement,
as a factor in understanding family well-being.

H2

Now I’d like to ask you about your
involvement in your children’s schooling. In
the past 12 months, have you or another
adult who lives with you gone to any events
at your (child/ren)’s school such as general
meeting school, like a back-to-school night,
parent/teacher organization meeting, a
school play or sports event?
Did [Child 1] miss more than 15 school days
during the past school year?

To measure the extent of family involvement in
school, as a factor in understanding family
well-being.

H3

H4

Have any of your children [CHILD] ever been
suspended or expelled from school?

H5

Has this happened in the past year, that is
since you left the RRHP in [PROGRAM EXIT
DATE)?
Have you ever been asked by any of your
children’s schools [CHILD’S] to come in and
talk about problems your child was having
with behavior?
Has this happened in the past year, that is
since you left the RRHP in [PROGRAM EXIT
DATE]?
Have any of your children ever gone to a
special class for gifted students or done
advanced work in any subjects?

H6

H7

H8

H9

H10

Has this happened in the past year, that is
since you left the RRHP in [PROGRAM EXIT
DATE]?
Has any of your children gone to a special
class or school or gotten special help in
school for…

To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s
educational success, as a factor in
understanding child well-being and educational
attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.

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Q#
H11

Question
Has this happened in the past year, that is
since you left the RRHP IN [PROGRAM EXIT
DATE]?

Justification
To measure the extent of children’s behavioral
health issues, as a factor in understanding
child well-being and educational attainment.

I. HEALTH
Q#
I1

I2

I3

I4

I5

I6

Question
Overall, how would you rate your health
during the past month (that is the past 30
days)?
In general, has your health been better,
worse or about the same in the last year,
since you left the rapid rehousing program
[INSERT THE PROGRAM NAME]
During the past 30 days, about how often did
you feel ..

The last set of questions asked about
feelings that might have occurred during the
past 30 days. Taking them altogether, do you
feel better, worse or about the same in the
last year, since you left the rapid rehousing
program [INSERT THE PROGRAM NAME?
Overall, how would you rate the health of
your children during the past month (that is
the past 30 days)?
In general, has the health of your children
been better, worse or about the same in the
last year, this is, since you left the rapid
rehousing program [INSERT THE
PROGRAM NAME]?

Justification
To measure respondent health, as a factor of
understanding the client population served and
the effect of the program on health.
To measure respondent health, as a factor of
understanding the client population served and
the effect of the program on health.
To measure respondent’s psychological
health, as a factor of understanding the client
population served and the effect of the
program on health.
To measure respondent’s psychological
health, as a factor of understanding the client
population served and the effect of the
program on health.

To measure children’s health, as a factor of
understanding the client population served and
the effect of the program on health.
To measure children’s health, as a factor of
understanding the client population served and
the effect of the program on health.

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