Project Specific Information Questionnaires & Project Staff Questionnaires

FY 2013 HUDQC Study’s PSI Questionnaire
Public Housing Program
The Project Specific Information (PSI) questionnaire is provided to administrators of Public
Housing, Housing Choice Voucher (HCV), Moderate Rehabilitation (Mod Rehab) units, and
Section 8, Section 202 PRAC, Section 202/162 PAC, and Section 811 PRAC assisted units selected
in the FY 2013 HUD Quality Control (HUDQC) Study. We use the data you provide to prepare for
our data collection process.
The PSI questionnaire is divided into 5 sections, with an average completion time of 30 minutes:
I. Project Specific Information
II. Reference Information
III. Rent Calculation Policies
IV. Questions to Facilitate Data Collection
V. Contact Information
Your answers are very important to us and we appreciate your time. If you have any questions
about the survey, please feel free to contact us toll-free at (877) 392-9776 or by email at
[email protected].
How We Designate “Projects” in Our Study
Before you begin, we would like to tell you how we designate “projects” in our study. For the
purpose of selecting programs of comparable size during our sampling process, we often divide up
larger projects into smaller entities (for Public Housing programs this is usually by AMP#). We call
each entity we select “projects” in our study. This means that the project we select may not be your
entire portfolio of public housing projects, but only a project(s) with a specifically designated
AMP#.
Note that if you are a large PHA we may have selected multiple projects (in Public Housing, HCV,
or Mod Rehab programs) for this study. If multiple projects at your site have been selected for this
study, you must complete a PSI survey for each project.
Please complete this survey for the specific project we have identified (provided to you in the email in
which this survey was attached or in the cover letter you received with a fax of this survey).

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I. Project Specific Information
1. We will be selecting a sample of tenants in the Public Housing project we have identified for the study.
Please check the information below for accuracy and make any corrections in the “Correction” fields below.
HUDQC’s Project Identifier

Correction

a. PHA Name: [PHA Name]

___________________________________________

b. PHA Code: [PHA Code]

___________________________________________

c. Project Name: [Project Name]*

___________________________________________

d. [# Units] total assisted units in AMP #[AMP #]

___________________________________________

e. [# Units] currently occupied in AMP #[AMP #]

___________________________________________

f.

___________________________________________

Project address: [Project Address]

* If the AMP# applies to more than one project name, please list all project names.
If no corrections were made above, please check this box to confirm that no corrections are needed.
2. If you want to provide any additional information about the project identified, please do so here:
_______________________________________________________________________________________
_______________________________________________________________________________________

HUDQC FY2013 Study Period
Unless otherwise stated, all questions in this survey refer to our
study period of November 1, 2012 to October 31, 2013.
Special Circumstances
HUD gives special permission to programs/sites to design and implement non-standard policies and
procedures for calculating rent. Note that for the purpose of this study, Moving to Work is not considered a
special demonstration project.
3. Is the project selected for this study considered a special demonstration project?
O Yes
O No
If you selected yes above, please answer Section A on the next page.
4. Is your project part of a Moving to Work (MTW) program?
O Yes
O No
O Not Applicable (not associated with a PHA)
If you selected yes above, please answer Section B on the next page.
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If your project is a special demonstration, please answer these questions.
Please explain how your project’s policies and procedures related to rent calculation differ
from standard HUD policy:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Section
A

We may need additional information about your special project policies. Please provide us
with the contact information of the staff we should contact for follow up questions
regarding your special demonstration project:
Name: _____________________________________________________
Phone Number: ______________________________________________
Email: _____________________________________________________
If your project is a special demonstration, you do not need to complete the rest of the survey.
Please fax this survey to toll-free (800) 823-0127 or email it to [email protected].

If your project is a Moving to Work program, please answer these questions.
Does your project have a special recertification schedule that differs from HUD-standard
annual recertification for all households?

Section
B

O Yes

O No

If yes, please explain your MTW recertification schedule:
____________________________________________________________________________
____________________________________________________________________________
Please proceed with completing the rest of the survey.

Please answer the questions below in regard to the Public Housing project(s) identified for the study.
5. How many units are currently unoccupied due to renovation? _________
If units are currently unoccupied due to renovation, we need more information about households that
previously occupied these units. Please enter the name and phone number of the staff person we should
contact for follow up questions about these households:
Name: ____________________________________

Title: ____________________________________

Phone Number: _________________________

Email Address: ____________________________

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II. Reference Information
Note: Please remember that we will select a sample of tenants from the Public Housing project(s) we
identified for the study. For the purpose of this survey, we will use the term “project” to refer to this Public
Housing project(s).
6. What passbook rate was used to impute asset income for 50058 transactions effective November 1, 2012
through October 31, 2013? For each rate entered please indicate the period it was used:
Please enter rates as percentages. For example, enter two percent as “2” (do not enter as “0.02”). If your
project is using the rate currently, please enter today’s date as the “End Date.”
Start Date

End Date

Rate: ____________ %

Period used:_____________ to _____________

Rate: ____________%

Period used:_____________ to _____________

7. What is the project’s minimum rent? $ _______ If there is no minimum rent, please enter 0.
8. We need information about your project’s Flat Rent Schedule for transactions effective November 1, 2012
to October 31, 2013. You can list your schedule here or you can send us a copy. More information about
sending project documentation can be found at the end of Section II.
_______________________________________________________________________________________
9. Does your project have Welfare Rent?
O Yes

O No

If yes, we will need information about the Welfare Rent Schedule(s) used for transactions effective
November 1, 2012 to October 31, 2013. You can list your schedule here or you can send us a copy. More
information about sending project documentation can be found at the end of Section II.
_______________________________________________________________________________________
_______________________________________________________________________________________

Request for Policy and Rent Calculation Documents
At this time we would like to request that you send us documents related to rent and income calculation
for your project. Note that we need documents that were used for transactions effective during our study
timeframe of Nov. 1, 2012 to Oct. 31, 2013, unless otherwise indicated.
We require the following documents:
 Approved Admissions and Continued Occupancy Policy (ACOP)
 Flat Rent Schedule
 Welfare Rent Schedule, if applicable
 Policy and procedural guidance related to rent and income calculation
We will reference the documents you provide us to calculate rent and measure improper payments during
our review of your files. It is important that documentation accurately reflects your policies.

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Mail Documents to:
ICF International
Attn: HUDQC Study
11785 Beltsville Dr., Ste.300
Calverton, MD 20705

Fax Documents to:
Toll-free (800) 823-0127
Email Documents to:
[email protected]
III. Rent Calculation Policies

Reference to Rent and Income Calculation Policies
10. Please provide the page number(s) and/or chapter and section where we can reference the specified
policies in the document(s) you have sent or will send us. Please indicate the name of the specific document
you are referring to.
Policy Topic

Reference Document & Page/Section

a. Seasonal Income

______________________________________________

b. Child Support Income

______________________________________________

c. Asset Income

______________________________________________

d. Medical Expenses

______________________________________________

e. Disability Assistance Expenses

______________________________________________

f. Childcare Expenses

______________________________________________

g. Zero-Income Households

______________________________________________

h. Specific Income-Based Rent Policies

______________________________________________

i. Permissible Deductions

______________________________________________

11. We will reference the document(s) you provide us to calculate rent and measure improper payments
during our review of your files. If you would like to provide any additional explanation regarding policies or
procedures related to rent or income calculation at your project, please do so here:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
12. Moving to Work Projects - If you are an MTW project and have any additional instructions or
explanations that you would like to add, please do so here:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Note: If your policy changed at some point within our study period of November 1, 2012 to October 31,
2013, please indicate the date of the change and explain the policy in place before the change.
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PIH Notice 2013-03 (HA), Issued on January 22, 2013
Questions #13-15 refer to policy changes established by PIH Notice 2013-03.
13. In reference to PIH Notice 2013-03, PHAs may choose to use either actual past income or projected
future income to determine a household’s annual income. Please indicate the method your project used to
determine a household’s annual income for transactions effective November 2012 to October 2013:
O We use actual past income to determine annual income
O We did not change our policy and continue to use projected future income
O Other – Please explain:
_____________________________________________________________
If your project chose to use actual past income or some other income determination method, what
date was the policy implemented? _____________________
14. Has your project adopted a policy for households with assets less than $5,000 that allows these
households to self-certify their asset amount and asset income?
O Yes

O No

If yes, what was the date this policy was effective at your project? _________________________
If yes, please describe the application of this policy at your project:
_________________________________________________________________________________
_________________________________________________________________________________
15. Has your project adopted a policy to streamline recertification for elderly and disabled households with
100% fixed income?
O Yes

O No

If yes, what was the date this policy was effective at your project? ___________
If yes, please describe the application of this policy at your project:
_________________________________________________________________________________
_________________________________________________________________________________

\

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IV. Questions to Facilitate Data Collection
16. When did your project conduct Criminal Background Checks? Please check all that apply.
During screening at initial certification
During recertification
When a household member turned 18 years old
When screening new household members
If there was reason to believe someone was involved in a criminal activity
Other – Please describe other times you would conduct a criminal background check:
__________________________________________________________________________________

17. Where did your project keep documentation showing that criminal background checks for household
members were conducted?
O There is a form in the tenant file showing that we performed the check.
O There is a note in the tenant file showing that we performed the check.
O Criminal background checks were not printed or were destroyed and there is no evidence that we
conducted the review.
O In a location other than the tenant file or we have another procedure not listed above – Please
identify location or clarify procedure here:_______________________________________________
18. When did your project conduct sex offender screenings? Please check all that apply.
During screening at initial certification
During recertification
When a household member turned 18 years old
When screening new household members
If there was reason to believe someone was involved in a sexual offense
Other – Please describe other times you would conduct a sex offender check:_____________________
19. Where did your project keep documentation showing that sex offender screenings for household
members were conducted?
O There is a form in the tenant file showing that we performed the check
O There is a note in the tenant file showing that we performed the check
O Sex offender reports were not printed out or were destroyed and there is no evidence that we
conducted the review.
O In a location other than the tenant file or we have another procedure not listed above – Please
identify location or clarify procedure here: ______________________________________________
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20. For move-ins and recertification transactions effective November 1, 2012 to October 31, 2013, are
documents related to income calculation scanned and stored electronically?
O Yes

O No

O Some documents are electronically stored and some are only on paper. Please explain here:
_________________________________________________________________________________
21. Does your project use a questionnaire or checklist to gather information from the household during the
move-in and recertification interview?
O Yes

O No

22. How will our data collectors access tenant files (50058/50059 forms and supporting documentation)
when they are at your project site?
O Paper tenant files will be provided to data collectors for review
O Data collectors will be given systems access to print out tenant file documentation
O Other: ___________________________________
23. Where does your project store EIV reports for households in the project?
O They are printed and stored in paper files, by household
O They are printed and stored in paper files, by a category other than household
O They are scanned and saved electronically in our systems
O The project does not keep EIV reports. The project completes a form or writes a note in the file
stating that the EIV report was reviewed
O Other: _______________________________________

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V. Contact Information
Please remember that “project” refers to tenants participating in the HCV program and living in the Public
Housing project(s) we identified for the study.
Contact Information for Project Sites - When we start collecting data, we will need to know where tenant
files are stored. Please provide the name, address, and contact information for the project site where tenant
files for the above listed project can be located:
Primary Contact
Name of Site Contact: __________________________________________________________
Site Contact Phone Number:_____________________________________________________
Site Contact Email: ____________________________________________________________
Office’s Hours of Operation: _____________________________________________________
Office Name: _________________________________________________________________
Project Address: _______________________________________________________________
Secondary Contact
Name of Site Contact: __________________________________________________________
Site Contact Phone Number:_____________________________________________________
Site Contact Email: ____________________________________________________________
Office’s Hours of Operation: _____________________________________________________
Office Name: _________________________________________________________________
Project Address: _______________________________________________________________
Study Contact Information - We would like to contact you if we have questions about the answers you
provided in this survey or other questions about the project. Please provide your contact information below:
Name of Site Contact: __________________________________________________________
Site Contact Phone Number:_____________________________________________________
Site Contact Email: ____________________________________________________________
Office’s Hours of Operation: _____________________________________________________
Office Name: _________________________________________________________________
Project Address: _______________________________________________________________
We need an alternate study contact who can answer questions about the project in the event that you are not
available. Please provide information for an alternate study contact below:
Name of Site Contact: __________________________________________________________
Site Contact Phone Number:_____________________________________________________
Site Contact Email: ____________________________________________________________
Office’s Hours of Operation: _____________________________________________________
Office Name: _________________________________________________________________
Project Address: _______________________________________________________________

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Next Steps

Project Specific Questionnaire (PSQ)
In a few months we will be sending your project a longer survey called the Project Staff Questionnaire. The
PSQ asks questions related to project staff, training, quality control practices, and recertification procedures.
Field Interviewer/Data Collector
Additionally, we will be sending out a HUDQC Field Interviewer to your project site sometime between
December 2013 and April 2014. If you have any scheduling issues or conflicts that you know of at this time,
please let us know here or you can always email us at [email protected]:
_______________________________________________________________________________________
_______________________________________________________________________________________
General Feedback
You can provide general feedback to us about this survey here or, if you prefer, you can email us your
comments and feedback at [email protected]:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Thank You for Your Participation

Thank you for completing the HUDQC Study FY2013 Project Specific Information questionnaire. Your
answers are very important to us and we appreciate your time.
As stated at the beginning of the PSI, if you are a large PHA or manage multiple project-based rental
assistance sites, we may have selected multiple projects for this study. If this is the case for your PHA, you
must complete this survey for EACH project that has been selected.

Thanks Again!

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