96010-I Logic Model

Tenant Resource Network Program

HUD 96010-I.xls

Tenant Resource Network Program

OMB: 2502-0601

Document [xlsx]

Download: xlsx | pdf

Overview

Instructions
Coversheet
Year1
Year2
Year3
Total
GoalsPriorities
Needs
Services
Outcomes
Tools
Reporting

Sheet 1: Instructions

Sheet 2: Coversheet

2010 eLogic Model® Information Coversheet
		Instructions
	When completing this section there are "mandatory" fields that must be completed. These fields are highlighted in yellow. The required data must be entered correctly to complete an eLogic Model®. After completing all mandatory fields on the coversheet click on the “Check Errors” button at the top of this page. Applicant Legal Name must match box 8a in the SF-424 in your application. Enter the legal name by which you are incorporated and pay taxes. CCR Doing Business is new for 2010 eLogic Model®. Only complete this field if your registration at CCR includes an entry in Doing Business as: (dba). Enter the DUNS # as entered into box 8c of the SF-424 Application for Federal Assistance form. Enter the City where your organization is located, this information must match the SF-424 data in your application. Use the dropdown to enter the State where your organization is located, this information must match the SF-424 data in your application. This information must match the SF-424 data in your application. Enter the Grantee Contact Name and email address in the field provided. Enter the name of the person that completed the eLogic Model® and their email address in the field provided. When completing the Project Information Section, applicants except Indian Tribes must enter their Project Name, Project Location City/County/Parish, State, Project Type, and Construction Type. If there are multiple locations, enter the location where the majority of the work will be done. Indian tribes, including multi-state tribes, should enter the City or County associated with their business address location. For Indian Tribes, enter the state applicable to the business address of the Tribal entity.






		Program Information
		HUD Program	Service Coordinators in Multifamily Housing
		Program CFDA #	14.191
			Program Component
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
			Program Component: If the program under which you are applying has components, e.g., EOI or PEI under the Fair Housing Initiatives Program, or CHDO or HOME TA under the CDTA NOFA, enter the name of the program component for which you are applying. If there are no components in the funding opportunity for which you are seeking funding, leave this field blank.
		Grantee Information
		Applicant Legal Name	Applicant Legal Name: Applicant Legal name must Match Box 8a in the SF-424 in your application. Enter the legal name by which you are incorporated and pay taxes.
		CCR Doing Business As Name	CCR Doing Business As Name: CCR Doing Business as is new for 2010. Only complete this field if your registration at CCR includes an entry in Doing Business as: (dba).
		DUNS Number	DUNS Number: Enter the DUNS # as entered into box 8c of the SF-424 Application for Federal Assistance form.	DUNS Number: Enter the DUNS # as entered into box 8c of the SF-424 Application for Federal Assistance form.
		City	City: Enter the City where your organization is located, this information must match the SF-424 data in your application
		State	State: Use the dropdown to enter the State where your organization is located, this information must match the SF-424 data in your application.
		Zip Code	Zip Code Enter the first 5 digits of your 9 digit zip code here.	Zip Code: Enter the last 4 digits of your 9 digit zip code here.
		Grantee Contact Name
		Grantee Contact email
		Logic Model Contact Name
		Logic Model Contact email
		Project Information
		Project Name	Project Name: Use exactly the same name as you did on box 15 of the form SF-424. If you are submitting multiple applications under the same applicant name for the same HUD program, you must include a project name that can distinguish between the two applications and logic models submitted, e.g., HBCU_DillardAffordableHousing15, HBCU_DillardAffordableHousing16. If the project name is not known at time of application, then insert TBD1, TBD2, etc., e.g., HBCU_DillardTBD1, HBCU_DillardTBD2.
		Project Location City/County/Parish	Project Location City/County/Parish: Applicants, except Indian Tribes, will enter the city, township, County/Parish, where the project will be located. If there are multiple locations, enter the location where the majority of the work will be done. Indian Tribes, including multi-state tribes, should enter the city or county associated with their business address location.
		Project Location State	Project Location State: Use the dropdown menu to select the location of your project. The data field label, “Project Location State” includes all fifty states and American Samoa, District of Columbia, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, and, Virgin Islands. In the case of multi-state, or regional entities, enter the State location where the majority of activities are to occur. For Indian Tribes, enter the state applicable to the business address of the Tribal entity.
		Zip Code	Zip Code Enter the first 5 digits of your 9 digit zip code here.	Zip Code: Enter the last 4 digits of your 9 digit zip code here.
		Project Type	Project Type: Project Type describes the type of project you are doing, e.g., technical assistance, counseling, housing group home, independent living, homeownership, transitional housing, supportive housing, or economic development. See the program NOFA for specific instructions or if no instructions are provided, use your judgment to identify the project type.
		Construction Type	Construction Type: Construction Type describes the type of Construction you are doing, e.g., new construction, rehabilitation, acquisition, mixed use development, etc. A program NOFA may provide specific instructions for this field. If the NOFA does not address this field, leave it blank.





		Additional Information for Reporting (Leave Blank At the Time of Application)
		Grants.gov Application Number	Grants.gov Application Number: When you submit your report enter your Grants.gov application number here.
		HUD Award Number	HUD Award Number: When you submit your report enter your HUD Award Number here.
		Logic Model Amendment Number	Logic Model Amendment Number: If you received an amendment HUD will record the number here.

Sheet 3: Year1

eLogic Model®

Year 1

OMB Approval 2535-0114 exp. 2/28/2011

Applicant Legal Name

CCR Doing Business As Name

HUD Program

Service Coordinators in Multifamily Housing

Reporting Period

Program Component

Reporting Start Date

DUNS No.

Project Name

Reporting End Date

2010

HUD Goals

Policy Priority

Needs

Services/Activities

Measures

Outcomes

Measures

Evaluation Tools

Policy

Planning

Programming

Pre

Post

YTD

Impact

Pre

Post

YTD

Accountability

#VALUE!

A. Tools for Measurement

#VALUE!

B. Where Data Maintained

#VALUE!

C. Source of Data

#VALUE!

D. Frequency of Collection

#VALUE!

E. Processing of Data

#VALUE!

Program Component

#VALUE!

Sheet 4: Year2

eLogic Model®

Year 2

OMB Approval 2535-0114 exp. 2/28/2011

Applicant Legal Name

CCR Doing Business As Name

HUD Program

Service Coordinators in Multifamily Housing

Reporting Period

Program Component

Reporting Start Date

DUNS No.

Project Name

Reporting End Date

2010

HUD Goals

Policy Priority

Needs

Services/Activities

Measures

Outcomes

Measures

Evaluation Tools

Policy

Planning

Programming

Pre

Post

YTD

Impact

Pre

Post

YTD

Accountability

#VALUE!

A. Tools for Measurement

#VALUE!

B. Where Data Maintained

#VALUE!

C. Source of Data

#VALUE!

D. Frequency of Collection

#VALUE!

E. Processing of Data

#VALUE!

Sheet 5: Year3

eLogic Model®

Year 3

OMB Approval 2535-0114 exp. 2/28/2011

Applicant Legal Name

CCR Doing Business As Name

HUD Program

Service Coordinators in Multifamily Housing

Reporting Period

Program Component

Reporting Start Date

DUNS No.

Project Name

Reporting End Date

2010

HUD Goals

Policy Priority

Needs

Services/Activities

Measures

Outcomes

Measures

Evaluation Tools

Policy

Planning

Programming

Pre

Post

YTD

Impact

Pre

Post

YTD

Accountability

#VALUE!

A. Tools for Measurement

#VALUE!

B. Where Data Maintained

#VALUE!

C. Source of Data

#VALUE!

D. Frequency of Collection

#VALUE!

E. Processing of Data

#VALUE!

Sheet 6: Total

eLogic Model®

Total

OMB Approval 2535-0114 exp. 2/28/2011

Applicant Legal Name

CCR Doing Business As Name

HUD Program

Service Coordinators in Multifamily Housing

Reporting Period

Program Component

Reporting Start Date

DUNS No.

Project Name

Reporting End Date

2010

HUD Goals

Policy Priority

Needs

Services/Activities

Measures

Outcomes

Measures

Evaluation Tools

Policy

Planning

Programming

Pre

Post

YTD

Impact

Pre

Post

YTD

Accountability

#VALUE!

A. Tools for Measurement

#VALUE!

B. Where Data Maintained

#VALUE!

C. Source of Data

#VALUE!

D. Frequency of Collection

#VALUE!

E. Processing of Data

#VALUE!

Sheet 7: GoalsPriorities

	HUD Goals		HUD Priorities
1A	Strengthen the Nation’s Housing Market to Bolster the Economy and Protect Consumers (1A) Stem the foreclosure crisis.	1a	Job Creation/Employment (1a) Improving access to job opportunities through information sharing, coordination with federal, state, and local entities, and other means.
1B	Strengthen the Nation’s Housing Market to Bolster the Economy and Protect Consumer (1B) Protect and educate consumers when they buy, refinance or rent a home.	1b	Job Creation/Employment (1b) Increasing access to job training, career services, and work, supports through coordination with federal, state, and local entities.
1C	Strengthen the Nation’s Housing Market to Bolster the Economy and Protect Consumers (1C) Create financially sustainable homeownership opportunities.	1c	Job Creation/Employment (1c) Expanding economic and job creation opportunities for low-income residents and creating better transportation access to those jobs and other economic opportunities by partnering with federal and nonprofit agencies, private industry, and planning and economic development organizations and by leveraging federal and private resources.
1D	Strengthen the Nation’s Housing Market to Bolster the Economy and Protect Consumers (1D) Establish an accountable and sustainable housing finance system.	2a	Sustainability (2a) Promote and preserve community assets including small businesses, fresh food markets, parks, hospitals, and quality schools by incentivizing comprehensive and inclusive local economic development planning.
2A	Meet the Need for Quality Affordable Rental Homes (2A) End homelessness and substantially reduce the number of families and individuals with severe housing needs.	2b	Sustainability (2b) Give consumers more information about the true cost of living by incorporating both housing and transportation costs into measures of affordability.
2B	Meet the Need for Quality Affordable Rental Homes (2B) Expand the supply of affordable rental homes where most needed.	2c	Sustainability (2c) Improve residents’ health and safety, particularly that of children and other vulnerable populations, by promoting green and healthy design, construction, rehabilitation, and maintenance of housing and communities.
2C	Meet the Need for Quality Affordable Rental Homes (2C) Preserve the affordability and improve the quality of federally assisted and private unassisted affordable rental homes.	2d	Sustainability (2d) Support and promote an energy-efficient, green, and healthy housing market by retrofitting existing housing, supporting energy-efficient new construction, improving home energy labeling, and promoting financing products that reduce the carbon footprint of non-HUD-supported residential buildings.
2D	Meet the Need for Quality Affordable Rental Homes (2D) Expand families' choices of affordable rental homes located in a broad range of communities.	2e	Sustainability (2e) Reduce energy consumption and incorporate green building practices in the design and operation of HUD-supported affordable housing.
3A	Utilize Housing as a Platform for Improving Quality of Life (3A) Utilize HUD assistance to improve educational outcomes and early learning and development.	2f	Sustainability (2f) Promote coordinated planning, integrating federal resources, and targeting technical assistance at the local, state, and regional levels for sustainable housing and communities.
3B	Utilize Housing as a Platform for Improving Quality of Life (3B) Utilize HUD assistance to improve health outcomes.	2g	Sustainability (2g) Promote the design and construction of buildings and communities that are accessible and visitable by people with disabilities.
3C	Utilize Housing as a Platform for Improving Quality of Life (3C) Utilize HUD assistance to increase economic security and self-sufficiency.	2h	Sustainability (2h) Promote the use of climate-resilient and disaster-resistant building design, construction and siting.
3D	Utilize Housing as a Platform for Improving Quality of Life (3D) Utilize HUD assistance to improve housing stability through supportive services for vulnerable populations including the elderly, people with disabilities, homeless people, and those individuals and families at risk of becoming homeless.	2i	Sustainability (2i) Encourage metropolitan and regional focus in planning and community development.
3E	Utilize Housing as a Platform for Improving Quality of Life (3E) Utilize HUD assistance to improve public safety.	3a	Affirmatively Furthering Fair Housing (3a) Regional coordination of affirmatively furthering fair housing plans, including such activities as developing regional analyses of impediments.
4A	Build Inclusive and Sustainable Communities Free from Discrimination (4A) Catalyze economic development and job creation, while enhancing and preserving community assets.	3b	Affirmatively Furthering Fair Housing (3b) Regional strategies to reduce racially segregated living patterns and other effects of formely de jure segregated public or assisted housing in metropolitan areas with a year 2000 dissimilarity index of 70 or higher and where the minority population is at least 20,000 or 3 percent of the total population in the Core Based Statistical Area (CBSA), whichever is greater.
4B	Build Inclusive and Sustainable Communities Free from Discrimination (4B) Promote energy efficient buildings and location efficient communities that are healthy, affordable and diverse.	3c	Affirmatively Furthering Fair Housing (3c) Decreasing the concentration of poverty and racial segregation in neighborhoods and communities through strategic targeting of resources.
4C	Build Inclusive and Sustainable Communities Free from Discrimination (4C) Ensure open, diverse, and equitable communities.	3d	Affirmatively Furthering Fair Housing (3d) Promoting visitability for persons with disabilities in single-family housing.
4D	Build Inclusive and Sustainable Communities Free from Discrimination (4D) Facilitate disaster preparedness, recovery and resiliency.	4a	Capacity Building and Knowledge Sharing (4a) Develop, target and deliver technical assistance for increasing affordability in areas experiencing increased rental costs due to development.
4E	Build Inclusive and Sustainable Communities Free from Discrimination (4E) Build the capacity of local, state and regional public and private organizations.	4b	Capacity Building and Knowledge Sharing (4b) Strengthen the capacity of state and local partners, including governments and nonprofit organizations, to implement HUD programs, participate in decision making and planning processes, and coordinate on cross-programmatic, place-based approaches through grantmaking and technical assistance.
5A	Transform the Way HUD Does Business (5A) Build Capacity: Create a flexible and high performing learning organization with a motivated, skilled workforce.	4c	Capacity Building and Knowledge Sharing (4c) Support knowledge sharing and innovation by disseminating best practices, encouraging peer learning, publishing data analysis and research, and helping to incubate and test new ideas.
5B	Transform the Way HUD Does Business (5B) Focus on Results: Create an empowered organization that is customer-centered, place based, collaborative, and responsive to employee feedback and focused on results.	5a	Using Housing as a Platform for Improving Other Outcomes (5a) Increasing access to high quality early learning programs and services through coordination with local programs.
5C	Transform the Way HUD Does Business (5C) Bureaucracy Busting: Create flexible, modern rules and systems that promote responsiveness, openness and transparency.	5b	Using Housing as a Platform for Improving Other Outcomes (5b) Providing physical space to co-locate healthcare and wellness services with housing (e.g., on-site health clinics).
5D	Transform the Way HUD Does Business (5D) Culture Change: Create a healthy, open, flexible work environment that reflects the values of HUD’s mission.	5c	Using Housing as a Platform for Improving Other Outcomes (5c) Increasing access to public benefits (such as Temporary Assistance to Needy Families and Supplemental Security Income) through outreach and other means.
		5d	Using Housing as a Platform for Improving Other Outcomes (5d) Maintaining or improving the physical environment and design of HUD-assisted residences, giving attention to physical safety and crime prevention.
		5e	Using Housing as a Platform for Improving Other Outcomes (5e) Providing mobility counseling to increase access to neighborhoods of opportunity.
		6a	Expand Cross-Cutting Policy Knowledge (6a) Support knowledge sharing and innovation by disseminating best practices, encouraging peer learning, publishing data analysis and research, and helping to incubate and test new ideas.

Sheet 8: Needs

CAMP eLogic Model®

Column 2

NEEDS

There is a lack of service coordinators in multi-family housing to link low-income elderly persons and people with disabilities to the supportive services they need in order to continue living independently.

Sheet 9: Services

CAMP eLogic Model®	*Click here to allow deletion of 'New' Activities*
Column 3
SERVICES/ACTIVITIES	UNITS
Case Management-Assist residents in applying for health benefits-Residents \|Residents	Residents
Case Management-Assist residents in applying for health benefits-Benefits \|Benefits	Benefits
Case Management-Coordinate assisted living services \|Residents	Residents
Case Management-Coordinate educational activities-Residents \|Residents	Residents
Case Management-Coordinate educational activities-Sessions \|Sessions	Sessions
Case Management-Coordinate preventive health activities-Residents \|Residents	Residents
Case Management-Coordinate preventive health activities-Sessions \|Sessions	Sessions
Case Management-Create supportive services-Residents \|Residents	Residents
Case Management-Create supportive services-Services \|Services	Services
Case Management-Help residents build informal support networks - residents \|Residents	Residents
Case Management-Monitor the activities and services of residents- residents \|Residents	Residents
Case Management-Set up volunteer programs-Programs \|Programs	Programs
Case Management-Set up volunteer programs-Volunteers \|Volunteers	Volunteers
Education-Educate property management staff on aging in place issues-Persons \|Persons	Persons
Education-Educate property management staff on aging in place issues-Sessions \|Sessions	Sessions
Education-Educate property management staff on service coordination issues- Persons \|Persons	Persons
Education-Educate property management staff on service coordination issues- Sessions \|Sessions	Sessions
Education-Educate residents in obligations of tenancy-Residents \|Residents	Residents
Education-Educate residents in obligations of tenancy-Sessions \|Sessions	Sessions
\|Residents	Residents
Management-Create a directory of community service providers-Number of providers \|Providers listed	Providers listed
Outreach-Work and consult with tenant organizations \|Organizations	Organizations
Policy Priority-Capacity Building and Information Sharing-Number of new strategies discussed and implemented to address service needs and increase local capacity. \|Strategies	Strategies
Policy Priority-Capacity Building and Information Sharing- Participation in, or creation of face-to-face networking meetings with other HUD-funded Service Coordinators and local government aging and/or disability agency staff to address the adequacy of supportive services in your jurisdiction \|Annual Meetings	Annual Meetings
Policy Priority- Housing as a Platform-Work with community volunteers to create at least one weekly new ongoing exercise activity open to HUD housing residents and the community \|Exercise Activities	Exercise Activities
Policy Priority- Housing as a Platform-Work with community volunteers to create at least one new ongoing exercise activity open to HUD housing residents and the community- volunteers \|Volunteers	Volunteers
Policy Priority- Housing as a Platform-Work with local or chapters of national community health organizations to arrange for periodic mobile health screening events open to residents and the neighboring community \|Screening Events	Screening Events
Policy Priority- Housing as a Platform-Number of partnerships developed with Community Health Clinics to establish medical homes for residents \|Partnerships	Partnerships
Policy Priority- Housing as a Platform-Number of public benefit programs for which residents apply for as a result of the work of the Service Coordinator - Residents \|Residents	Residents
Policy Priority-Number of public benefit programs for which residents apply for as a result of the work of the Service Coordinator \|Benefit programs	Benefit programs
Referral-Refer residents to available supportive services-Residents \|Residents	Residents
Referral-Refer residents to available supportive services-Services \|Services	Services
Other \|Other

Sheet 10: Outcomes

CAMP eLogic Model®	*Click here to allow deletion of 'New' Outcomes*
Column 5
OUTCOMES	UNITS
Case Management-Assist residents in applying for social service benefits \|Residents	Residents
Case Management-Assist residents in identifying employment opportunities \|Residents	Residents
Case Management-Assist residents in obtaining education benefits \|Residents	Residents
Case Management-Decrease in monthly living expenses-Dollars \|Dollars	Dollars
Case Management-Decrease in monthly living expenses-Residents \|Residents	Residents
Case Management-Percentage reduction in eviction actions from previous year-Evictions \|Percent Change	Percent Change
Case Management-Percentage reduction in eviction actions from previous year-Higher Level Care \|Percent Change	Percent Change
Case Management-Receipt of healthcare services enabling independent living \|Residents	Residents
Case Management-Receipt of home management services enabling independent living \|Residents	Residents
Case Management-Reduction in eviction actions initiated due to lease violations \|Evictions	Evictions
Case Management-Reduction in move-outs to higher level care \|Residents	Residents
Case Management-Referrals from directory of community service providers \|Referrals	Referrals
Case Management-Residents linked with health services \|Residents	Residents
Case Management-Residents linked with legal services \|Residents	Residents
Case Management-Residents linked with mental health services \|Residents	Residents
Case Management-Residents linked with substance abuse services \|Residents	Residents
Case Management-Residents linked with tax assistance services \|Residents	Residents
Case Management-Residents linked with transportation services \|Residents	Residents
Case Management-Residents participating in informal support networks that address issues of morale and social isolation \|Residents	Residents
Case Management-Residents participating in informal support networks that address recreation issues \|Residents	Residents
Case Management-Residents participating in informal support networks that address financial issues \|Residents	Residents
Case Management-Residents participating in informal support networks that address transportation issues \|Residents	Residents
Case Management-Residents participating in informal support networks that address home management issues \|Residents	Residents
Case Management-Units receiving services \|Units	Units
Policy Priority-Capacity Building and Knowledge Sharing-Number of new strategies implemented to address service needs and increase local capacity \|Strategies	Strategies
Policy Priority- Capacity Building and Knowledge Sharing-Number of new service contacts established to address gaps in services needed by residents \|Contacts	Contacts
Policy Priority- Capacity Building and Knowledge Sharing-Number of new services provided to residents to address service gaps \|Services	Services
Policy Priority-Housing as a Platform-Number of exercise activities instituted per week \|Activities	Activities
Policy Priority-Housing as a Platform-Number of residents attending weekly exercise activities on the property or in the community \|Residents	Residents
Policy Priority- Housing as a Platform-Number of additional benefits residents receive as a result of the work of the Service Coordinator. \|Additional Benefits	Additional Benefits
Policy Priority-Housing as a Platform-Number of HUD housing and community residents participating in periodic mobile health screening events \|Participants	Participants
Policy Priority- Housing as a Platform- Number of mobile health screening events held annually \|Events	Events
Policy Priority- Housing as a Platform-Number of residents with a medical home \|Residents	Residents
Other \|Other

Sheet 11: Tools

CAMP eLogic Model®

A. Tools For Measurement

Bank accounts

Construction log

Database

Enforcement log

Financial aid log

Intake log

Interviews

Mgt. Info. System-automated

Mgt. Info. System-manual

Outcome scale(s)

Phone log

Plans

Pre-post tests

Post tests

Program specific form(s)

Questionnaire

Recruitment log

Survey

Technical assistance log

Time sheets

B. Where Data Maintained

Agency database

Centralized database

Individual case records

Local precinct

Public database

School

Specialized database

Tax Assessor database

Training center

C. Source of Data

Audit report

Business licenses

Certificate of Occupancy

Code violation reports

Counseling reports

Employment records

Engineering reports

Environmental reports

Escrow accounts

Financial reports

GED certification/diploma

Health records

HMIS

Inspection results

Lease agreements

Legal documents

Loan monitoring reports

Mortgage documents

Payment vouchers

Permits issued

Placements

Progress reports

Referrals

Sale documents

Site reports

Statistics

Tax assessments

Testing results

Waiting lists

Work plan reports

D. Frequency of Collection

Daily

Weekly

Monthly

Quarterly

Biannually

Annually

Upon incident

E. Processing of Data

Computer spreadsheets

Flat file database

Manual tallies

Relational database

Statistical database

Sheet 12: Reporting

	Carter-Richmond Methodology
	The Management Questions developed for your program are based on the Carter-Richmond Methodology.* A description of the Carter-Richmond Methodology appears in the General Section of the NOFA.
	* © The Accountable Agency – How to Evaluate the Effectiveness of Public and Private Programs,” Reginald Carter, ISBN Number 9780978724924


	Response to Management Questions	Measure	Answer
1	How many persons are you serving (unduplicated count)?	Persons
2	What is the total cost to operate case management services?	Dollars
3	What does it cost per person to offer case management services?	Dollars
4	How many persons were able to live independently and/or age in place as a result of being connected to services through this program?	Persons
5	How many persons stabilized or improved their living conditions as a result of being connected to services through this program?	Persons
6	What is the average estimated dollar value of benefits received by persons assisted by the Service Coordinator?	Dollars
7	How many persons obtained FTE employment as a result of services?	FTEs
8	How many persons retained FTE employment as a result of services?	FTEs
9	How many persons receiving services moved to a higher level of care?	Persons
10	How many persons receiving services moved to alternative housing?	Persons
11	How many residents received community-based services through the assistance of a Service Coordinator?	Persons
12	What was the average number of services referrals provided to residents?	Services Referrals
13	What was the average value in dollars of referred services provided by other community based organizations?	Dollars
14	What was the reduction (#) in move-outs to higher level care?	Move-outs
15	What was the reduction (#) in eviction actions initiated due to lease violations?	Evictions
16	Identify the top three aging in place issues. Please enter in order of priority.
16a	Aging in Place Issue #1	Aging in Place Issue
16b	Aging in Place Issue #2	Aging in Place Issue
16c	Aging in Place Issue #3	Aging in Place Issue
17	Policy Priority- Identify the three top service gaps identified and addressed as a result of the award
17a	Service gap #1	Service gap
17b	Service gap #2	Service gap
17c	Service gap #3	Service gap
18	Policy Priority- Identify the three top medical screenings provided to residents:
18a	Medical screenings #1	Medical screenings
18b	Medical screenings #2	Medical screenings
18c	Medical screenings #3	Medical screenings
19	Identify up to three issues facing service coordinators, Please enter in order of priority.
19a	Issues facing service coordinators #1	Issues facing service coordinators
19b	Issues facing service coordinators #2	Issues facing service coordinators
19c	Issues facing service coordinators #3	Issues facing service coordinators

20	Policy Priority-Identify up to three new strategies that were implemented to address service needs and increase local capacity?
20a	New strategy implemented #1	Strategy
20b	New strategy implemented #2	Strategy
20c	New strategy implemented #3	Strategy
21	Policy Priority- Identify up to three additional benefits residents receive as a result of the work of the Service Coordinator?
21a	Benefit residents receive as a result of the work of the Service Coordinator? #1	Benefit
21b	Benefit residents receive as a result of the work of the Service Coordinator? #2	Benefit
21c	Benefit residents receive as a result of the work of the Service Coordinator? #3	Benefit
	If you are collecting client level data, identify the number of persons receiving services:
	How many persons receiving services are under the age of 6?	Persons
	How many persons receiving services are ages 6-17?	Persons
	How many persons receiving services are ages 18-30?	Persons
	How many persons receiving services are ages 31-50?	Persons
	How many persons receiving services are ages 51-61?	Persons
	How many persons receiving services are age 62 and older?	Persons
















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	ALABAMA
	ALASKA
	AMERICAN SAMOA
	ARIZONA
	ARKANSAS
	CALIFORNIA
	COLORADO
	CONNECTICUT
	DELAWARE
	DISTRICT OF COLUMBIA
	FEDERATED STATES OF MICRONESIA
	FLORIDA
	GEORGIA
	GUAM
	HAWAII
	IDAHO
	ILLINOIS
	INDIANA
	IOWA
	KANSAS
	KENTUCKY
	LOUISIANA
	MAINE
	MARSHALL ISLANDS
	MARYLAND
	MASSACHUSETTS
	MICHIGAN
	MINNESOTA
	MISSISSIPPI
	MISSOURI
	MONTANA
	NEBRASKA
	NEVADA
	NEW HAMPSHIRE
	NEW JERSEY
	NEW MEXICO
	NEW YORK
	NORTH CAROLINA
	NORTH DAKOTA
	NORTHERN MARIANA ISLANDS
	OHIO
	OKLAHOMA
	OREGON
	PALAU
	PENNSYLVANIA
	PUERTO RICO
	RHODE ISLAND
	SOUTH CAROLINA
	SOUTH DAKOTA
	TENNESSEE
	TEXAS
	UTAH
	VERMONT
	VIRGIN ISLANDS
	VIRGINIA
	WASHINGTON
	WEST VIRGINIA
	WISCONSIN
	WYOMING

File Type	application/vnd.ms-excel
Author	owner
Last Modified By	h18889
File Modified	2011-05-19
File Created	2005-11-22