Nsvsp

Generic Clearance for Cognitive, Pilot and Field Studies for Bureau of Justice Statistics Data Collection Activities

NSVSP Questionnaire

National Survey of Victim Service Providers Field Test of Questionnaire

OMB: 1121-0339

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National Survey of Victim Service Providers
A study by the U.S. Bureau of Justice Statistics to better understand the range of
services available for and provided to different types of crime victims.

Federal agencies may not conduct or sponsor an information collection, and a person is not required to respond to a collection of
information, unless it displays a currently valid OMB Control Number. Public reporting burden for this collection of information is estimated
to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate, or any other
aspects of this collection of information, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810
Seventh Street NW, Washington, DC 20531. The Omnibus Crime Control and Safe Streets Act of 1968, as amended (42 U.S.C. 3732),
authorizes this information collection. This request for information is in accordance with the clearance requirement of the Paperwork
Reduction Act of 1980, as amended (44 U.S.C. 3507). Although this survey is voluntary, we urgently need and appreciate your cooperation
to make the results comprehensive, accurate, and timely.

OMB Number: 1121-0339
Approval expires 01/31/2016

National Survey of Victim Service Providers
Survey Instructions
Please mark your response with an “X” using blue or black ink, as in the examples below.
Example:

Example:
Right Way		

Other, specify:

Wrong Way

Survey Purpose and Sponsors

General Instructions

The National Survey of Victim Service Providers (NSVSP) is designed
to fill existing gaps in knowledge and information on the variety of
organizations that provide services to victims of crime, the types of
victims served and services provided, and staffing and resources
available for the provision of services.

Your organization is receiving this survey because it has been
identified as providing at least some services or assistance to victims
of crime. The survey should be completed by the person(s) in your
organization with knowledge of and access to information on the
provision of these services. To help you prepare to take the survey, we
will be asking for information about the number and types of services
your organization provided to victims in the past year, the types
of crimes for which victims sought your services in the past year,
the number of staff providing victim services at your organization,
and your victim services budget. The survey should take about 30
minutes to complete. Please respond to all items.

The first goal of the NSVSP is to develop a clearer picture of the victim
services field. While there are many directories in place, and many lists
of organizations serving specific types of victims, they are not all inclusive
and many are not routinely updated. This survey will provide a picture of
the broad range of victim service providers across the country, including
how they are structured, the types of services they offer, and the types of
crime victims they serve. Your organization has been randomly selected
to participate in a small pilot test of the larger NSVSP data collection
effort.

Confidentiality Assurances
The information you provide will be used to generate aggregate
statistics on the provision of victim services. Your organization will
not be identified in any statistical reports produced by the Bureau of
Justice Statistics.

Information obtained from this initial pilot test will inform efforts to conduct
a census of the over 21,000 service providers in our current database.
Ultimately, through the census and additional survey efforts the NSVSP
aims to provide comprehensive, empirical data useful for funding and
planning purposes. An additional goal is to standardize measures of
victim services, enabling service providers to compare themselves with
other providers serving similar types of victims.

Burden Statement
Federal agencies may not conduct or sponsor an information
collection, and a person is not required to respond to a collection
of information, unless it displays a currently valid OMB Control
Number. Public reporting burden for this collection of information is
estimated to average 30 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing
the collection of information. Send comments regarding this burden
estimate, or any other aspects of this collection of information,
including suggestions for reducing this burden, to the Director,
Bureau of Justice Statistics, 810 Seventh Street NW, Washington, DC
20531. The Omnibus Crime Control and Safe Streets Act of 1968,
as amended (42 U.S.C. 3732), authorizes this information collection.
This request for information is in accordance with the clearance
requirement of the Paperwork Reduction Act of 1980, as amended
(44 U.S.C. 3507). Although this survey is voluntary, we urgently need
and appreciate your cooperation to make the results comprehensive,
accurate, and timely.

This survey is sponsored by the Bureau of Justice Statistics of the U.S.
Department of Justice and funded by the federal Office for Victims of
Crime.

Important Definitions
1)	 CRIME - An act which if done by a competent adult or juvenile would
be a criminal offense
2)	 VICTIM - Any person who contacts your organization for services
or assistance that are related to concerns over past, on-going, or
potential future crimes and other abuse. This includes those who are
directly harmed or threated by such crimes, but also their…
a)	 Family or household members,
b)	 Legal representatives, or
c)	 Survivors (if deceased)
3)	 SERVICE ­- Efforts that (1) respond to the needs of crime victims; (2)
assist victims of crime to stabilize their lives after a victimization; (3)
assist victims to understand and participate in the criminal justice
system; or (4) provide victims of crime with measures of safety and
security.

2

S1

	Before you begin, please complete the following pieces of
information for your program.

SECTION A
A1

Agency Name:

 he primary function of the organization is to provide
T
services or programming for victims of crime.
Skip to A2
Victim services or programming are one component of the
larger organization (e.g., a hospital, university, community
center, law enforcement agency or prosecutors’ office)
Proceed to A1a

Address:
Address:
City, State, ZIP:
Main business
phone number:
Director, Victim
Services:

	  A1a. D
 oes your organization have a specific
program(s) or staff that are dedicated to
working with crime victims?
Yes
No

Email address:


S2

	Did you provide services to victims of crime or abuse in
the past month?
Yes
No

	Which of the following best describes how your
organization is structured to provide services to victims
of crime or abuse?

A2

Go to A1
 hank you! You do not need to complete the rest
T
of this survey. We will correct your listing. 
Please see mailing instructions after page 8.

	Which of the following best describes your
organization? Select one response.
a. Tribal government or
other tribal organization or
entity 	

 o to Section B
G
[Tribal], page 4

b. Campus organization or other
educational institution (public
or private)

 o to Section C
G
[Campus], page 4

c. Hospital, medical, or
emergency facility (public or
private)

 o to Section G
G
[Services for
Victims],
page 5

d. Government agency 	

 o to Section D
G
[Government],
page 4

e. Nonprofit or faith-based entity
(501c3 status)

 o to Section E
G
[Nonprofit or faith
based], page 4

f. For profit entity

 o to Section F
G
[For profit],
page 5

g. Informal entity (e.g., some other

 o to Section G
G
[Services for
Victims],
page 5

type of program or group, not formally
a part of an agency, registered
nonprofit, or business; Independent
survivor advocacy and support
groups; volunteer, grassroots, or
survivor network)

3

SECTION B
Tribal Agencies and Organizations Only
B1

D2

	Nationwide
	Statewide
	Regional/Multi-county/Multi-city
	County wide only
	City wide only
	Specific neighborhood only
	Other (please specify)

	Which designation best describes your tribal agency or
organization? Select one response.
	Law enforcement
	Prosecutor
	Court
	Juvenile justice
	Offender custody and supervision
	Advocacy program
	Other justice-based agency (please specify)

Go to section G [SERVICES FOR
All responses
VICTIMS], page 5

	Other agency that is NOT justice-based (e.g., human
services, health, education, etc.) (please specify)

SECTION E
Non-Profit or Faith-Based
Organizations Only

	Coalition
All responses
page 5

Go to section G [SERVICES FOR VICTIMS],
E1

	Which designation best describes your campus
organization? Select one response.
	Law enforcement/campus security
	Campus disciplinary body or student conduct body
	Physical or mental health service program
	Victim services or advocacy group
	Other campus-based program (please specify)

E2

Go to section G [SERVICES FOR VICTIMS],

SECTION D
Government Agencies Only
D1

	In what service area/jurisdiction does your non-profit
organization operate? Select one response.
	Nationwide
	Statewide
	Regional/Multi-county/Multi-city
	County wide only
	City wide only
	Specific neighborhood only
	Other (please specify)

	
All responses
page 5

	Which designation best describes your non-profit
organization? Select one response.
	Coalition (e.g., State Domestic Violence or Sexual Assault
Coalition)
	A single entity (may or may not have multiple physical
locations)
	Other (please specify)

SECTION C
Campus Organizations Only
C1

	In what service area/jurisdiction does your agency
operate in terms of victims served or services delivered?
Select one response.

All responses
Go to section G [SERVICES FOR
VICTIMS], page 5

	Which designation best describes your government
agency? Select one response.
	Law enforcement
	Prosecutor
	Courts
	Juvenile justice
	Offender custody and supervision
	Multi-agency (e.g., task forces, response teams, etc.)
	Other government agency (please specify)

4

SECTION F
For-Profit Organizations Only
F1

The following questions concern services you provided to
victims of crime or abuse during past calendar/fiscal year.
Did you provide any of the following services to
victims within the past calendar/fiscal year?

	What designation best describes your for-profit
organization? Select one response.

We recognize that victim service organizations provide a
wide array of services to victims. For the purposes of this
survey, we are asking about general categories of services
you provided to victims, which may not capture your victim
service offerings in detail. Do your best to place the
services you provided within the general categories below.

	Private legal office/law firm
	Private counseling service or other mental health care
provider
	Funeral home
	Other commercial or professional entity (please specify)
	

Does your organization provide (…)

G2

All responses
Go to section G [SERVICES FOR
VICTIMS], page 5

	Does your organization operate/report data on a calendar
year or fiscal year?

G1.1. What is the date of the beginning of the fiscal year at
your organization?
/
MM	

	

Yes

No

Yes

No

Financial and material assistance services
Does your organization provide (…)

G3

a. Monetary assistance? (e.g., providing
funds or offering assistance in seeking
victim compensation; public benefits
assistance; other emergency funds
assistance; etc.)

/
DD	

No

b. Service or victimization information
and referrals? (e.g., information about
crime and victimization; medical referrals;
legal referrals; financial counseling
referrals; other referrals; etc.)

	Calendar year
skip to G2
	Fiscal year
proceed to G1.1
	Both
proceed to G1.1
	

Yes

a. Justice related information and
referrals? (e.g., information about the
justice system and the victim’s role;
notification of events and proceedings;
justice referrals; etc.)

SECTION G
Services for Victims
G1

Information and referral services

YY

b. Material assistance? (e.g., emergency
or transitional shelter; food; clothing;
utility assistance; employment
assistance; etc.)

For the remainder of the questionnaire, unless indicated
otherwise, provide your answers based on the past fiscal
year or the past calendar year depending on how your
organization operates as answered in Question G1.
	
G4

Emotional support and safety
Does your organization provide (…)
a. Mental health services? (e.g.,
individual; group counseling support
groups; other therapy; social
programming for children; etc.)
b. Crisis Counseling
c. Safety services? (Safety planning;
witness protection; address
confidentiality; self-defense; etc.)
(Does NOT include protective orders)

5

	

Medical and health assistance
Does your organization provide (…)

G5

G10

Yes

No

a. Emergency medical care or
accompaniment?
b. Medical forensic exam or
accompaniment?

	Excluding hotline/helpline or crisis line calls, how
many unique victims received direct services from
your organization/program during the past calendar/
fiscal year? Estimates are acceptable. (Exclude services
provided through a hotline/helpline or crisis line and victims
who only received information through the mail)
Check box if estimate

c. STD/HIV testing?
G11

	

Legal and victims’ rights assistance
Does your organization provide (…)

G6

Yes

No

Crime type for which victims sought services

a. Criminal/juvenile/military/tribal
justice related assistance?
(e.g., representation; advocacy;
accompaniment; assistance in exercising
victims’ rights; etc.)

Yes
a. Adults molested as children
b. Child sexual abuse/sexual assault
c. Rape/sexual assault (other than sexual
victimizations against children)

b. Civil justice related assistance? (e.g.,
protective or restraining order; assistance
with family law matters; assistance with
landlord/tenant matters; etc.)

d. Stalking
e. Child witness of violence

c. Immigration assistance? (e.g.,
assistance seeking special visas;
continued presence applications; other
immigration relief; etc.)
	
G7

f. Child physical abuse or neglect
g. Elder physical abuse
h. Domestic violence/dating violence
i. Assault (Other than domestic/dating
violence or child/elder abuse)

Other services
Does your organization provide (…)

Yes

No

j. Robbery

a. Case management?

k. Human trafficking (Labor)

b. Supervised child visitation?

l. Human trafficking: (Sex)

c. On-scene coordinated response?

m. Survivors of homicide victims

d. Education classes for survivors
regarding victimization dynamics?

n. Victim witness intimidation
o. DUI/DWI crashes

e. Culturally and ethnically specific
services?

p. Identity theft

f. Specialized services for specific
settings? (e.g., military; school; college/
university; etc.)
G8

q. Financial fraud and exploitation (Other
than identity theft)
r. Motor vehicle theft
s. Burglary

	Did your organization operate a hotline/helpline or crisis
line at any time during the past calendar/fiscal year?
	Yes
	No

G9

During the past calendar/fiscal year did victims of
the following crime types seek services from your
organization?

t. Other property crimes
u. Other violent crimes

proceed to G9
skip to G10

v. Other (specify)

	How many calls did you receive from victims/survivors in
the past calendar/fiscal year? Estimates are acceptable.
Check box if estimate

6

No

SECTION H
Staffing

New staff since the beginning of the most recent
calendar/fiscal year
H6

The following questions concern staff dedicated to working
with victims of crime during past calendar/fiscal year.
Provide your answer based on the past fiscal year or the
past calendar year depending on how your organization
operates as answered in Question G1.
	
H1

Current Staff

	How many paid full-time staff dedicated to working with
victims did you hire in the past calendar/fiscal year,
whether to fill new positions or to fill vacancies? Count
each person only once. Enter ‘0’ if there are no paid staff
of that type. Include contractual workers in your counts.
Estimates are acceptable.
Check box if estimate

	How many paid staff dedicated to working with victims
currently work at your organization full-time (35 hours or
more/week)? Count each person only once. Enter ‘0’ if there
are no paid staff of that type. Include contractual workers in your
counts. Estimates are acceptable.

H7

	How many paid part-time staff dedicated to working
with victims did you hire in the past calendar/fiscal
year, whether to fill new positions or to fill vacancies?
Count each person only once. Enter ‘0’ if there are no
paid staff of that type. Include contractual workers in your
counts. Estimates are acceptable.

Check box if estimate
H2

	How many paid staff dedicated to working with victims
currently work at your organization part-time (less than 35
hours/week)? Count each person only once. Enter ‘0’ if there
are no paid staff of that type. Include contractual workers in your
counts. Estimates are acceptable.

Check box if estimate

SECTION I
Funding
I1

Check box if estimate
H3

	Does your organization use volunteers to provide direct
services to victims?
 es
Y
No

Check box if estimate

Staff at the beginning of the most recent
fiscal year
H4

	How many paid full-time staff dedicated to working with
victims worked at your organization at the beginning
of the past calendar/fiscal year? Count each person only
once. Enter ‘0’ if there are no paid staff of that type. Include
contractual workers in your counts. Estimates are acceptable.
Check box if estimate

H5

	How much total funding did your organization receive
for victim-related programming and services (including
direct services, prevention, outreach, training, and
education efforts) during the past calendar/fiscal
year? Please include direct services, prevention, outreach,
training and education efforts. Estimates are acceptable.

	How many paid part-time staff dedicated to working with
victims worked at your organization at the beginning
of the past calendar/fiscal year? Count each person only
once. Enter ‘0’ if there are no paid staff of that type. Include
contractual workers in your counts. Estimates are acceptable.
Check box if estimate

7

I2

	How much funding did your organization receive from each
of the following sources during the past calendar/fiscal
year? Enter ‘0’ if you did not receive funding from the source.
The total amount across all sources should equal the amount
provided in Q.I1. Estimates are acceptable.
 heck box if information on amount of funding by source is
C
not available
a. Victims of Crime Act
$
Assistance Grant (VOCA)

	

b. Other Office on Victims of
Crime (OVC)
c. Services, Training, Officers,
and Prosecutors (STOP)
d. Sexual Assault Services
Program (SASP)
e. Other Office on Violence
against Women (OVW)
f. Family Violence Prevention
Services Act (FVPSA)
g. Other federal funding,
please specify

Check box if estimate

SECTION J
Record Keeping
J1

 es
Y
No
J2

$

$

$
K1

$
Check box if estimate

i. Local government funding

j. Tribal government funding

$
Check box if estimate
K2

k. Source of funds unknown

l. Other funding sources (e.g.,
foundations, corporate funding,
individual donations, insurance
reimbursements, etc.)
I3

Check box if estimate

$
K3

$

$
Check box if estimate
K4

Check box if estimate

	How concerned are you about the burden of grant
reporting?
	Very concerned
	Somewhat concerned
	A little concerned
	Not concerned at all

	Did your organization receive any federal funding for victim
programming or services within the past 5 years? This could
include funding from VOCA, OVC, OVW, a STOP or SASP grant,
or some other funding coming from a federal agency.
Yes
No

	How concerned are you about the predictability of future
funding for your program?
	Very concerned
	Somewhat concerned
	A little concerned
	Not concerned at all

Check box if estimate

$

	How concerned are you about the amount of victim
service funding that your organization received in the
past year?
	Very concerned
	Somewhat concerned
	A little concerned
	Not concerned at all

$

Check box if estimate

	How concerned are you about your organization’s ability
to retain staff?
	Very concerned
	Somewhat concerned
	A little concerned
	Not concerned at all

Check box if estimate

h. State government funding
(NOT state disbursement of
federal grant)

	Does your electronic records system track individual
cases?

SECTION K
Current Issues of Concern to
Victim Service Providers

Check box if estimate

$

Skip to Section K

 es
Y
No

Check box if estimate

Check box if estimate

	Does your organization use an electronic records system
to maintain case files?

K5

	How concerned are you about your organization’s ability
to access technology?
	Very concerned
	Somewhat concerned
	A little concerned
	Not concerned at all

8

Thank you for your participation.

Mailing Instructions
Please place the completed questionnaire into the postage-paid return envelope. If the
envelope has been misplaced, please mail the questionnaire to:
National Survey of Victim Service Providers
NORC at the University of Chicago
1 North State Street - 16th Floor
Chicago, IL 60602
If you have any questions, please call NORC toll free at 1-XXX-XXX-XXXX
or email [email protected].


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