Domestic Violence and Sexual Violence Organization Needs Assessment Questions Final with Revision Incorporated

DV/SA Provider Questions (FINAL post stakeholder feedback) (Introduction Q3 answers
B,C,D,E)
1. Does your organization consider itself a culturally specific service provider?
(A Culturally Specific Service Provider is a community-based program that provides culturally
and linguistically specific services to victims of domestic violence, dating violence, sexual
assault, or stalking.)
a.
b.
c.
d.

Yes
No
Not sure
Yes, but it’s not our primary focus

2. How knowledgeable is your organization about the scope of the Homeless/Housing system
(excluding domestic violence/sexual assault housing programs) in your community (i.e.
knowledgeable of emergency, transitional, rapid rehousing, and permanent housing options and
services offered/clearly understands process of accessing such services)?
a. Very knowledgeable
b. Somewhat knowledgeable
c. A little knowledgeable
d. Not at all knowledgeable
e. I don’t know
(if answered b (no) or c (some but not all) to Q2
2a. What are the barriers to knowing the scope of the Homeless/Housing system in your
community? (Select all that apply)
Not enough staff capacity
System too confusing
Not enough communication with homeless/housing providers
Lack of trust
Other (Please explain)
3. Is your organization involved in any of the Homeless/Housing system’s meetings (e.g.
Consolidated Plan Committee meetings, Continuum of Care Committee meetings)?
a.
b.
c.
d.

Yes (Please list)
Rarely attend
Not invited
Not sure

If answered b (Rarely attend) to Q3
3a. Why does your organization rarely attend the Homeless/Housing System’s meetings? (Select
all that apply)
Due to not enough staff capacity

Because it’s unproductive (Please explain)
Because it feels like domestic and/or sexual violence is not a priority
Other (Please explain)
If answered c (Not invited) to Q3
3b. Why is your organization not invited? Please explain
If answered a (yes) to Q3
4. What is your organization's general level of involvement in the Homeless/Housing system’s
meetings?
a. Very Involved
b. Somewhat Involved
c. A little Involved
d. Not at all Involved
e. I don’t know
If answered anything but d (not at all involved) in Q4
5. Your organization’s participation and feedback is valued in the Homeless/Housing system’s
meetings.
a. Yes
b. No
c. Sometimes
d. Not sure because another representative from my organization attends the
meetings
If answered a (yes) to Q3
6. Issues impacting domestic and/or sexual violence survivors are frequently discussed in the
Homeless/Housing system’s meetings.
a. Yes
b. No
c. Sometimes
6a. Issues impacting domestic and/or sexual violence survivors are adequately addressed in the
Homeless/Housing system’s meetings.
a. Yes
b. No
c. Sometimes
6b. Issues are resolved in a positive way for domestic and/or sexual violence survivors in the
Homeless/Housing system’s meetings (i.e. survivor safety is addressed, privacy and
confidentiality are respected needs of domestic and/or sexual violence survivors matter).
a. Yes

b. No (Please explain)
c. Sometimes
7. Is there a Taskforce/Working Group in your community that focuses on domestic and/or
sexual violence and homeless/housing issues?
a. Yes
b. One is in development
c. No, but we are interested in participating in a collaboration like this
d. No
e. Not Sure
If answered yes to Q7:
7a. How is the Taskforce/Working Group that focuses on domestic and/or sexual violence and
homeless/housing issues structured? (Select all that apply)
a. It is coordinated through our Continuum of Care
b. It is coordinated by a domestic and/or sexual violence organizations
c. It is coordinated by a housing/homeless organization
d. It is coordinated through a state domestic and/or sexual violence coalition
e. Other (Please explain)
(if answered a (yes) to Q7
7b. Does staff at your organization regularly participate in the Taskforce/Working Group?
a. Yes
b. No
c. No, but staff at other domestic and/or sexual violence organizations participate
If answered a (yes) Q7b
8. How helpful is the Taskforce/Working Group in addressing issues impacting survivors’ access
to safe and supportive housing options in your community?
a. Very helpful
b. Somewhat helpful
c. A little helpful
d. Not at all helpful
e. I don’t know
If answered (very helpful) or (somewhat helpful) in Q8
8a. What are the desired outcomes for this Taskforce/Working Group? (Select all that apply)
a. Build partnerships between domestic and/or sexual violence organizations and
homeless/housing agencies
b. Develop more permanent housing options for survivors
c. Coordinate advocacy efforts such that survivors’ concerns (e.g. safety and
confidentiality) are included in housing/homeless policy and programs
d. Advocate for local housing protections for survivors

e. Increase housing providers’ (including the PHA) awareness of housing protections for
survivors
f. Increase safety for survivors in the homeless system
g. Help facilitate or further implement a coordinated entry system that incorporates the
domestic and/or sexual violence housing system
h. Other (Please explain)
If answered (not helpful) in Q8
8b. If the Taskforce/Working group is not helpful in addressing issues impacting domestic and/or
sexual violence and homelessness/housing, please explain why.
9. Does your organization have ongoing relationships with staff from Homeless/Housing
programs?
a. Yes
b. No
c. Not sure
If answered “yes” to Q9
9a. How did your organization build these relationships with staff from Homeless/Housing
programs?
10. Does your organization advocate for survivors in the Housing/Homeless system (e.g. help
individual survivors you work with access housing protection such as lock changes,
eviction/termination, safety within programs)?
a. Yes (Please explain)
b. No (Please explain)
c. Not sure
11. Does your organization work with policy makers to address survivor’s rights within the
Housing/Homeless system?
a. Yes (Please explain)
b. No
c. Not sure
**If answered (no) to Q11
11a. Why does your organization not work with policy makers to address survivor’s rights within
the Housing/Homeless system? (Select all that apply)
a.
b.
c.
d.
e.

The domestic and/or sexual assault coalition handles advocacy efforts
Another local domestic and/or sexual violence program handles advocacy efforts
Survivors are treated well within the system so not necessary
Advocacy not received well by housing/homeless system
Limited time

f. Limited staff capacity
g. Other (Please explain)
12. Does your organization have any formal agreements (e.g., MOUs or interagency agreements)
with Homeless/Housing programs to coordinate domestic and/or sexual violence and housing
services?
a. Yes
b. No
c. Not sure
13. Does your organization have staff co-located at a Homeless/Housing program (regardless of
whether your community has a Coordinated Entry System (CES)?
(A Coordinated Entry System (CES) is a process developed to ensure that all people
experiencing a housing crisis have fair and equal access and are quickly identified, assessed,
referred, and connected to housing and assistance based on their strengths and needs. A CES
handles assessment/screening of consumer need, data entry, referrals, and, potentially, program
admissions, and prevention and diversion services as well.)
a. Yes
b. No
c. Not sure
if answered “yes” to Q13
13a. To what extent has having a staff member co-located at a Homeless/Housing program
assisted domestic and/ or sexual violence survivors with housing needs?
a. A lot
b. Somewhat
c. A little
d. Not at all
e. I don’t know
If answered a (a lot) or b (somewhat) to Q13a
13b. In what specific ways has having a staff member co-located at a Homeless/Housing
program helped domestic and/or sexual violence survivors with housing needs?
14. Does a Homeless/Housing program caseworker regularly work with survivors at your
program’s location or in another safe designated location?
a. Yes
b. No
c. Not sure
if answered “yes” to Q14

14a. To what extent has having a Homeless/Housing program caseworker that works regularly
with survivors at your program’s location or in another safe designated spot, helped assist
survivors with housing needs?
a.
A lot
b.
Somewhat
c.
A little
d.
Not at all
e.
I don’t know
If answered a (a lot) or b (somewhat) to Q14a
14b. In what specific ways has having a Homeless/Housing program caseworker that works
regularly with survivors at your program’s location or in another safe designated spot, helped
assist survivors with housing needs? Please explain
15. Does your organization have an open communication channel for questions and concerns
with Homeless/Housing programs?
a.
Yes
b.
No
c.
Depends on the Homeless/Housing program
d.
Not sure
If answered “yes” or “depends on the homeless/housing program) to Q15
15a. How effective are these open communication channels at meeting survivor’s housing needs?
a. Very Effective
b. Somewhat Effective
c. A little Effective
d. Not at all Effective
e. I don’t know
If answered “no” to Q15
15b. What are the barriers to creating open communication channels for questions and concerns
with Homeless/Housing programs? (Select all that apply)
a. Lack of relationships
b. Concerns not taken seriously
c. Concerns not remedied
d. Other (Please explain)

Topic Area: Training
1. Does your organization receive training from the Homeless/Housing community?

a. Yes
b. No
c. Not sure
(if answered a (yes) to Q1
2. How frequently does your organization receive training from the homeless/housing
community?
a.
Monthly
b.
Quarterly
c.
Yearly
d.
As needed/with new staff
e.
I don’t know

(if answered “Monthly” “Quarterly” “Yearly” or “As needed/with new staff” to Q1)
2a. What topic areas have been covered in the trainings provided by the Homeless/Housing
community? (Select all that apply)
a. Understanding the homeless/housing system
b. Understanding the scope and work of specific homeless/housing agencies
c. Coordinated Entry & Assessment
d. Housing First
e. Rapid Rehousing
f. Building relationships with landlords
g. Services for marginalized communities (e.g. culturally and linguistically appropriate
services)
h. Other (Please explain)
if answered b (No)” to Q1
1a. Why doesn’t your organization receive training from the Homeless/Housing community?
(Select all that apply)
a.
Not a priority
b.
Not enough time
c.
Too much staff turn over to make an impact
d.
Training more appropriate for member programs
e.
Other (Please explain)
1b. In what topic areas would you want to receive training provided by the Homeless/Housing
community? (Select all that apply)
a. Understanding the homeless/housing system
b. Understanding the scope and work of specific homeless/housing agencies
c. Coordinated Entry & Assessment
d. Housing First
e. Rapid Rehousing
f. Building relationships with landlords

g. Services for marginalized communities (e.g. culturally and linguistically appropriate
services)
h. Other (Please explain)
3. Does your organization provide training to Homeless/Housing programs in your community?
a.
Yes
b.
No
c.
Not sure
If answers a (yes) to Q3
3a. How often does your organization provide training to Homeless/Housing programs in your
community?
a.
Monthly
b.
Quarterly
c.
Yearly
d.
As requested/needed with new staff
e.
I don’t know
a.
b.
3b. What are the topic areas for trainings provided by your organization to Homeless/Housing
programs in your community? (Select all that may apply)
a. Domestic violence 101
b. Sexual violence 101
c. Safety planning
d. Confidentiality
e. Domestic and/or Sexual Violence Screening Assessments
f. Understanding legal housing protections for survivors (federal, state, local)
g. Services for marginalized communities (e.g. older victims, culturally and linguistically
appropriate services)
h. Survivor-Centered Voluntary Service Models
i. Trauma Informed Care
j. Unique barriers to housing faced by survivors (e.g. lack of affordable housing, lack of
available safe housing, inclusiveness and access for LGBTQ survivors)
k. Other (Please explain)
if answered b (no) to Q3
3c. Why doesn’t your organization provide trainings on a regular basis to the Homeless/Housing
community? (Select all that apply)
a.
Not a priority for your organization
b.
Not enough time
c.
Too much staff turnover to make an impact
d.
Not enough resources
e.
Another domestic and/or sexual violence organization provides training to the

f.

Homeless/Housing community
Other (Please explain)

4. What training topics/issues do you believe Homeless/Housing programs should be trained on?
(Select all that apply)
a.
Domestic violence 101
b.
Sexual violence 101
c.
Safety planning
d.
Confidentiality
e.
Domestic and/or Sexual Violence Screening Assessments
f.
Understanding legal housing protections for survivors (federal, state, local)
g.
Services for marginalized communities (e.g. older victims, culturally and linguistically
appropriate services)
h.
Survivor Centered Voluntary Service Models
i.
Trauma Informed Care
j.
Unique barriers to housing faced by survivors (e.g. lack of affordable housing, lack of
available safe housing, inclusiveness and accessibility for LGBTQ survivors)
k.
Other (Please explain)
TOPIC AREA: Coordinated Entry and Assessment
Q1. Does your community have a Coordinated Entry System (CES)?
(A Coordinated Entry System (CES) is a process developed to ensure that all people
experiencing a housing crisis have fair and equal access and are quickly identified, assessed,
referred, and connected to housing and assistance based on their strengths and needs. A CES
handles assessment/screening of consumer need, data entry, referrals, and, potentially, program
admissions, and prevention and diversion services as well.)
a.
Yes
b.
No
c.
Not sure
If answers a (Yes) to Q1
Q2: Does your community have a Coordinated Entry System (CES) that addresses the needs of
survivors of domestic and/or sexual violence (includes a community in the process of
developing a CES process)?
a.
Yes
b.
No
c.
Not sure
if answered “no” to Q2
Q2a: Why doesn’t your community have a CES that addresses the needs of survivors of
domestic and/or sexual violence? (Select all that apply)
a.
Lack of coordination within domestic and/or sexual violence provider community

b.
c.
d.
e.
f.
g.
h.
i.
j.

Lack of trust within domestic and/or sexual violence provider community
Lack of coordination with homeless service system
Lack of trust with homeless service system
Lack of relationships with homeless service system
Lack of knowledge (e.g. how to set up a coordinated entry system with homeless service
system)
Data entry and confidentiality concerns with utilization of HMIS system
Lack of resources
Separate domestic violence and/or sexual violence and Homeless/ Housing funding
streams are not conducive to coordination
Other (please explain)

if answered “yes” to Q2
Q2b: What kind of CES does your community have for domestic and/or sexual violence
survivors?
a. Single point of entry for all (for homeless services, including survivors)
b. Multiple points of entry for all (for homeless services, including survivors)
c. Domestic and/or sexual violence providers have independent/parallel system
d. In development of domestic and/or sexual violence provider independent/parallel
system
e. In development of single point of entry for all (for homeless services, including
survivors)
f. In development of multiple points of entry for all (for homeless services,
including survivors
g. Other (Please explain)
(if answered C (“independent/parallel system”) Q2b
Q3a: What is the entry point to the independent/parallel domestic and/or sexual violence
system? (Select one of the following)
a.
Intake center (centralized physical location)
b.
Multiple entry points (i.e. various organizations have the ability to make referral to the
system)
c.
Hotline (can include 2-1-1)
d.
Other (Please explain)
(
Q3b: How is housing availability made known within the independent/parallel domestic
and/or sexual violence system? (Select all that apply)
a.
Shared availability list updated by shelter and/or housing programs
b.
Coordinated through hotline
c.
Shared database
d.
Managed through another coordinating body (e.g. coalition, local government agency)
(Please explain)
e.
Other (Please explain)
f.
Not sure

(
Q3c: Is there only one standardized assessment used to determine housing eligibility within
the independent/parallel domestic and/or sexual violence system?
a.
Yes (which assessment tool is used (i.e. VI-SPDAT) ________)
b.
No (please explain how housing eligibility is determined)
c.
Not sure
(if answered A “single point of entry” Q2b
Q4a: What is the entry point within the single point of entry system?
a.
Intake center (centralized physical location)
b.
Community-wide hotline (can include 2-1-1)
c.
Not sure
d.
Other (Please explain _____)
Q4b: The single point of entry system is coordinated by: (Select all that apply)
a.
A local government agency
b.
Homeless program or homeless coalition /Continuum of Care
c.
Not Sure
d.
Other (Please explain _____)
Q4c: How are survivors’ needs assessed (e.g., housing, safety, confidentiality and privacy) and
triaged within the single point of entry system? (Select all that apply)
a.
An intake assessment is used to screen for domestic and/or sexual violence, along with
other housing needs
b.
Housing placement is prioritized for domestic and/or sexual violence survivors
c.
There is a dedicated domestic and/or sexual violence specialist at the centralized intake
center or hotline to assess survivor needs
d.
There is no specialized domestic and/or sexual violence assessment/triage protocol
e.
There are various precautions and measure in place to protect survivor confidentiality and
safety
f.
Other (Please explain _______)
g.
Not sure
if answered E “in development of single point of entry” to Q2b
Q5a. What will the actual entry point be within the single point of entry system?
a.
Intake center (centralized physical location)
b.
Community-wide hotline (can include 2-1-1)
c.
Other (Please explain _____)
d.
Not sure
i
Q5b: What agency (or agencies) will coordinate the centralized intake within the single point of
entry system? (Select all that apply):

a.
b.

c.
d.

Local government agency
Homeless/housing program or homeless coalition (A homeless coalition is typically a
network of stakeholders working together to coordinate advocacy, and may or may not
serve as the CoC. A homeless coalition often includes people who are currently
experiencing or who have experienced homelessness, activists and advocates, and
community-based service providers.)
Other (Please explain _____)
Not sure

Q5c: How will domestic violence and/or sexual violence survivors’ needs assessed (e.g.
housing, safety, confidentiality and privacy) and triaged within the single point of entry
system? (Select all that apply)
a.
An intake assessment is used to screen for domestic and/or sexual violence, along with
other housing needs
b.
Housing placement is prioritized for domestic and/or sexual violence survivors
c.
There is a dedicated domestic and/or sexual violence specialist at the centralized intake
center or hotline to assess survivor needs
d.
There is no specialized domestic and/or sexual violence assessment/triage protocol.
e.
There are various precautions and measure in place to protect survivor confidentiality and
safety
f.
Other (Please explain _______)
if answers B “multiple points of entry” to Q2b
Q6a: How is housing availability made known within the multiple points of entry system?
(Select all that apply)
a.
Shared availability list updated by shelter and/or housing programs
b.
Coordinated through hotline (can include 2-1-1)
c.
Managed through another coordinating body (e.g. domestic and/or sexual violence
coalition, local government agency) (Please explain)
d.
Other (Please explain)
e.
Not sure
i
Q6b. Is there only one standardized assessment used to determine housing eligibility within the
multiple points of entry system?
a. Yes (which assessment tool is used (i.e. VI-SPDAT) ________)
b. No (Please explain how housing eligibility is determined throughout the system)
c. Not sure

Q6c: How are survivors’ needs assessed (e.g. housing, safety, confidentiality and privacy)
and triaged? (Select all that apply)
a.
One (shared) intake assessment tool is used to screen for domestic and/or sexual violence,

b.
c.
d.
e.
f.
g.

along with other housing needs
Each entry point uses its own intake assessment to screen for domestic and/or sexual
violence, along with other housing needs
Housing placement is prioritized for domestic and/or sexual violence survivors
There is a dedicated victim specialist (staff with expertise in domestic and/or sexual
violence) at one or more of the non-victim specific entry points
There are no specialized domestic and/or sexual violence assessment/triage protocols at
the multiple entry points
There are various precautions and measures in place to protect survivor confidentiality
and safety
Not included at this point

if answered A (single point of entry), B (multiple points of entry) or C (domestic and/or sexual
violence providers have an independent/parallel system) to Q2b
Q7a. Coordinated entry works well in my community.
a.
Strongly Agree
b.
Agree
c.
Disagree
d.
Strongly Disagree
e.
Neither agree nor disagree
f.
I don’t know
Q7b. My community struggles with coordinated entry, particularly as it relates to safety and
confidentiality considerations for domestic and/or sexual violence survivors.
a.
Strongly Agree
b.
Agree
c.
Disagree
d.
Strongly Disagree
e.
Neither agree nor disagree
f.
I don’t know
i
Q7c: Domestic and/or sexual violence survivors who access my community’s coordinated
entry system have the option to withhold consent to share data via any electronic database.
a.
Yes
b.
No
c.
Not sure
If answers a (yes) to Q7c
Q7c1: Survivors offered the option of withholding consent, ultimately give consent to share
personal information because they feel that their housing options would be compromised.
a.
Strongly Agree

b.
c.
d.
e.
f.

Agree
Disagree
Strongly Disagree
Neither agree nor disagree
I don’t know

if answered A (single point of entry), B (multiple points of entry) or C (domestic and/or sexual
violence providers have an independent/parallel system) to Q2b
Q7d. Coordinated entry staff members in my community are adequately equipped to assess
when an individual or a family would benefit from housing in a domestic violence/sexual
assault program rather than a general homeless assistance provider.
a.
Strongly Agree
b.
Agree
c.
Disagree
d.
Strongly Disagree
e.
Neither agree nor disagree
f.
I don’t know
Q7e: During Coordinated Entry assessment, survivors are able to make their own decisions (i.e.
survivor choice is respected) regarding which programs or resources they want to access so they
have a range of options (i.e. whether to access domestic and/or sexual violence shelter/housing
or programs available through the homeless system).
a.
b.
c.
d.
e.
f.

Strongly Agree
Agree
Disagree
Strongly Disagree
Neither agree nor disagree
I don’t know

i
Q7f. Coordinated entry staff members have access to the necessary information (i.e. knowledge
of programs, scope of work, etc) to make referrals to domestic and/or sexual violence agencies
when needed (including when requested by domestic and/or sexual violence survivors)?
a.
Strongly Agree
b.
Agree
c.
Disagree
d.
Strongly Disagree
f.
Neither agree nor disagree
e.
I don’t know
i
Q7g. Does the coordinated entry process help the community prioritize services based on
vulnerability and severity need to ensure that domestic and/or sexual violence survivors who
need immediate access to safe housing options receive assistance in a timely manner?

a.
b.
c.

Yes
No
Not sure

Q7h. How are domestic and/or sexual violence survivors triaged through the coordinated
entry process when they have multiple needs (e.g. older victims, Limited English Proficiency)?
TOPIC AREA: HMIS/confidentiality
1.

Does your organization receive Emergency Solutions Grant (ESG) funds?

(HUD’s Emergency Solutions Grant (ESG) program provides funding to: (1) engage
homeless individuals and families living on the street; (2) improve the number and quality of
emergency shelters for homeless individuals and families; (3) help operate these shelters; (4)
provide essential services to shelter residents, (5) rapidly re-house homeless individuals and
families, and (6) prevent families/individuals from becoming homeless.)
A. Yes
B. No
C. Not Sure
If answered “yes” to Q1
1a. What ESG activities are you funded for? (Select all that apply)
a.
b.
c.
d.

Rapid Re-Housing
Emergency Shelter
Prevention
Other (please list)

2. Does your organization receive Continuum of Care funds?
(HUD’s Continuum of Care (CoC) program is designed to promote community wide
commitment to the goal of ending homelessness through the provision of funds for
coordinated efforts by nonprofit providers, and State and local governments to quickly
rehouse homeless individuals and families while minimizing the trauma and dislocation
caused to homeless individuals, families.)
a.
b.
c.

Yes
No
Not sure

If answered “yes” to Q2
2a. What, if any, Continuum of Care activities is your organization funded for? (Select all that
apply)

a.
b.
c.
d.
e.
f.

Transitional housing
Permanent Supportive Housing
Rapid Re-Housing
HMIS
Coordinated Assessment
Not sure

3. How does your organization capture data regarding survivors seeking shelter and/or
housing?
A. Comparable database (insert comparable database vendor _______)
B. Excel Spreadsheet
C. Other (Please explain)

If answered A in Q3
3a. Does your organization utilize a comparable database system that has been approved by
your COC?
a.
b.
c.
d.
e.
f.

Yes
No
Yes, but still have challenges
Previously approved but being challenged now
Not sure
Other ___________

3b. How is your comparable database funded?
a.
ESG
b.
CoC
c.
Other (Please explain)
d.
Not sure
3c. Can the comparable database system generate HUD-required ESG reports?
a.
Yes
b.
No
c.
Yes, until recent changes with CAPER
d.
Not Sure
3d. Can the comparable database system generate the HUD-required CoC reports?
a.
Yes
b.
No
c.
Not Sure

3e. Does the comparable database have all of the data fields required by CoC or ESG funding?
a.
Yes
b.
No
c.
Not sure
3f. Does your organization enter information for all of the data fields per client?
a.
Yes
b.
No
c.
Not sure
3g. Does your organization have staff to operate the comparable database?
a.
Yes (how many ____)
b.
No
c.
Not sure
I
3h. Does a state domestic and/or sexual violence coalition manage the database for multiple
domestic and/or sexual violence organizations?
a.
Yes
b.
No
c.
Not sure
4. Does your Coordinated Entry System (CES) utilize HMIS?
f.
Yes
g.
No
h.
Not sure
5. Does your CES utilize a comparable database to HMIS?
a. Yes (If known, please indicate which database your CES uses _____)
b. No
c. Not sure
If answers A (yes) to Q4 or Q5
5a. Your community’s CES and related data-system (i.e. HMIS or comparable database) ensure
survivor safety and confidentiality while allowing survivors access to needed housing
resources.
a.
Strongly Agree
b.
Agree
c.
Disagree
d.
Strongly Disagree
e.
Neither agree nor disagree
f.
I don’t know
If answered “strongly agree” or “agree” to Q5a

6. How does your community ensure survivor safety and confidentiality while allowing
survivors access to needed housing resources? (Select all that apply)
a.
Your organization shares non-identifiable information into the shared database with
contact details of the program
b.
Survivors go to another agency to enter their personal information
c.
Survivors’ personally identifying information does not have to be entered into HMIS
because a verbal/in-person prioritization system exists
d.
Other (Please explain)
6a. What are the elements that have helped develop your comparable database system to ensure
survivor safety and confidentiality? (Select all that apply)
a.
Technical assistance
b.
Developed “work-around” with funder to address needs of victims
c.
Strong local understanding of the comparable database requirements
d.
Other (Please explain)
6b. The homeless/housing system’s HMIS addresses survivor confidentiality by: (Select all that
apply)
a.
b.
c.
d.
e.
f.
g.

Providing clients informed options to opt out of answering questions with “refused to
answer”
Providing clients the ability to give limited information
Providing clients the option to not be entered in HMIS at all
Providing data safety protocols
Other (Please explain)
Not sure
I don’t believe our system offers any of these options for survivors

I
if answered “disagree” or “strongly disagree” to Q5a
7. How do you think the challenges to ensuring survivor safety and confidentiality, while
allowing survivors access to needed housing resources, can be resolved? (Select all that
apply)
a.
b.
c.
d.
e.

Clearer guidance from HUD and training for local staff on the laws governing victim
service provider’s obligations around data
Clearer guidance from DOJ and training for local staff on the laws governing victim
service provider’s obligations around data
Best practice models and training on practical solutions to address database issues
Don’t know
Other (Please explain)

7a. If your program and community have experienced challenges with reaching consensus
about how to best obtain data from domestic violence agencies, what concerns arise? (Select all
that apply)
a.
Survivor safety and confidentiality
b.
Not meeting the requirements of VAWA and FVPSA
c.
Not being competitive for HUD grant funds
d.
Community will lose competitiveness for grant funds
e.
Pressure from funder to change practices/violate VAWA
f.
Not meeting the requirements of ESG or CoC programs
g.
No solution/continuous stalemate with funder
h.
Other (Please explain)
7b. Has your organization faced pressure during program monitoring/audits to reveal client files
or databases with personally-identifying information?
a.
b.
c.

Yes
No
Not sure

If answered “yes” to Q7b
8. When faced with this pressure, has your organization felt confident utilizing VAWA
confidentiality provisions to protect personally-identifying information?
a.
Yes
b.
No
c.
Not sure

TOPIC AREA: Federal, state and local legal protections (think VAWA, Fair Housing Act,
state/local: anti-discrimination, eviction, lock changes, etc)
Q1: What challenges do you hear about in your community when it comes to survivors trying to
access/find safe and stable housing, within each of these different types of housing systems?
(Domestic and/or sexual violence survivor specific shelter and/or housing includes:
Domestic violence shelters and other survivor specific housing programs)
(Homeless specific shelter and/or housing includes: Homeless shelters and other non-survivor
specific homeless/housing programs)
(Private housing includes: Privately owned apartments/houses)
(Public housing includes: Section 8 and/or local or federally subsidized housing)
In my community, sometimes survivors face barriers or are denied access to housing systems

because: (Select all that apply)
Domestic
and/or Sexual
Violence
survivor
specific shelter
and/or housing
The survivor must meet
additional requirements
before being accepted into
their shelter and/or
housing (e.g. obtain
protection order,
counseling, police report)
The survivor discloses that
s/he is experiencing or has
experienced domestic
and/or sexual violence or
is perceived to be a
survivor (i.e. believed to
be a survivor by housing
provider even if the
survivor has not disclosed)
The survivor has limited
English proficiency
(LEP)(e.g. has another
language as their primary
language and may need an
interpreter/ translator)
The survivor is a Native
person
The survivor is Deaf or
hard of hearing
The survivor is a person of
color
The survivor has an active
addiction
The survivor has a
criminal history
S/he is a survivor of sex
trafficking
S/he is or perceived to be
lesbian, gay, bi-sexual or
transgender

Homeless
specific
shelter
and/or
housing

Private housing

Public
housing

The survivor has a male
child over the age of 12
S/he is a survivor of sexual
violence (non-intimate
partner violence)
S/he is a survivor over the
age of 50
S/he is a survivor of teen
dating violence
The survivor's family, age
of children or composition
of the family seeking
shelter
The survivor is an
immigrant (documented)
The survivor is an
immigrant
(undocumented)
The survivor has an animal
companion/pet (not for
reasonable
accommodation)
The survivor has a
disability
The survivor has a mental
health issue
The survivor has poor
credit and/or poor rental
history
The survivor opts out of
sharing confidential
information due to safety
and/or privacy issues
The survivor is a member
of a minority religious
group
The survivor is a male
Other

Q1a. Please use the space below to provide any examples of barriers or challenges (from
those listed in the previous question) faced by survivors in your community when it comes
to survivors being able to access/find safe and stable housing.

Q2: What challenges do you hear about in your community when it comes to survivors trying to
stay in/keep housing? (Select all that apply)
(Domestic and/or sexual violence survivor specific shelter and/or housing includes:
Domestic violence shelters and other survivor specific housing programs)
(Homeless specific shelter and/or housing includes: Homeless shelters and other non-survivor
specific homeless/housing programs)
(Private housing includes: Privately owned apartments/houses)
(Public housing includes: Section 8 and/or local or federally subsidized housing)

Domestic
and/or Sexual
Violence
survivor
specific
shelter and/or
housing
Housing provider refuses to
provide reasonable
accommodation in restoring
or improving security and
safety measures (e.g. repair
locks, windows, doors, and
other physical features of
residence)
Housing providers refuse to
change the locks
Not being able to move due to
cost associated with breaking
a lease
Eviction or threat of eviction
for calling police or other
emergency services
Threats of eviction because of

Homeless
specific
shelter
and/or
housing

Private housing

Public
housing

domestic and/or sexual
violence-related disruptions
Abusive and/or threatening
housing provider
Sexual harassment by housing
provider
Q1b. Please use the space below to provide any examples of barriers or challenges (from those
listed in the previous question) faced by survivors in your community when it comes to
survivors trying to stay in/keep housing.

Q3: Does your organization work with a local Public Housing Authority (PHA) to help
survivors seeking lease bifurcation and/or emergency transfer?
(A Public Housing Authority (PHA) is a local housing agency that receives HUD Federal
funds to manage federally subsidized housing for low-income residents at rents they can afford.)
(Bifurcation means the survivor is allowed to remain in place and the batterer will be taken off a
lease without their permission.)
(Emergency Transfer allows survivors to transfer to another available and safe dwelling unit.)
a.
b.
c.

Yes
No
Not Sure

(if answered “yes” Q3)
Q3a: Please rate how effective the PHA is in helping survivors seeking lease bifurcation and/or
emergency transfer?
a. Very effective
b. Somewhat effective
c. A little effective
d. Not at all effective
e. I don’t know
Q4: Does your organization work with a local PHA to create and expand housing options for
survivors?

a.
b.
c.

Yes
No
Not sure

If answered “yes” to Q4
4a. How does your organization collaborate with your local PHA to create more safe housing
options? (Select all that apply)
a.
The PHA prioritizes all survivor applications by placing them at the top of the waiting list
b.
The PHA has a local voucher program specifically for domestic and/or sexual violence
survivors who are exiting domestic and/or sexual violence survivor shelters/transitional
housing program or are homeless as a result of domestic and/or sexual violence.
c.
PHA provides vouchers or helps fund in some way housing that your organization
operates
d.
PHA provides permanent housing vouchers for survivors exiting your program
e.
Other (Please explain)

Q5: Does your organization work with private landlords to assist survivors seeking privately
owned housing?
a.
Yes
b.
No
c.
Not sure
If answered “yes” to Q5
Q5a: If your organization works with private landlords to assist survivors seeking privately
owned housing, please explain how your organization works with private landlords:

Q6: To the best of your knowledge, how familiar is your organization with federal housing laws
and protections for domestic and/or sexual violence survivors? Please rank your familiarity with
each law.

Q7: To the best of your knowledge, how has your organization utilized each of the following
federal laws and protections in advocacy efforts with survivors? (Select all that apply)

Q8: To the best of your knowledge, what are the most common ways your organization has
utilized the federal housing laws and protections in your advocacy efforts with shelter or other
housing organizations within the homeless system? (Select all that apply)
a.
b.
c.
d.

Summarized the protections that apply via e-mail, phone or in -person (informal
communication)
Provided the shelter or other housing organization with a written document outlining the
protections (e.g. fact sheet, toolkit, etc)
Provided training (e.g. webinar, in-person training) to shelter or other housing
organization staff
Provided legal counsel and/or represented the survivor in a legal proceeding against the
shelter or housing organization

e.
f.
g.

Other (Please explain)
We do not use any of these
Not sure

Q9. Do your domestic and/or sexual violence local and/or state laws provide housing protections
to survivors (e.g. fair housing protection, eviction protection)?
a.
Yes
b.
No
c.
Not Sure
if answered “yes” to Q9
Q9a. To what extent does your organization understand the domestic and/or sexual violence local
and/or state laws that provide housing protections to survivors (e.g. fair housing protection,
eviction protection)?
a. A lot
b. Somewhat
c. A little
d. Not at all
e. I don’t know
TOPIC AREA: Rapid Re-Housing, Housing First, Flexible Spending
1. Does your organization provide Rapid Re-Housing (RRH)?
(Rapid Re-Housing (RRH) is a housing first approach that aims to help survivors secure stable
housing immediately - often forgoing the traditional crisis shelter-to-transitional shelter model.
By drawing on an established network of partner landlords and property managers who are
educated about the impact of domestic violence, survivors are able to lease housing units in their
own names, often despite poor credit or employment histories. Programs typically provide a
monthly rental subsidy and home-based advocacy to support the family to create economic
stability so that they can maintain their unit housing for the long–term.)
a.
b.
c.
d.

Yes
No
Not sure
Does not apply

If answered “no” to Q1
1a1. Why doesn’t your organization provide Rapid Re-housing? (Select all that apply)
a.
Not part of our program model
b.
Need support in developing a RRH model
c.
Do not have relationships with landlords and property managers
d.
Unable to access rapid re-housing funds
e.
Do not have funding

f.
g.

Other local domestic and/or sexual violence organization(s) provide RRH
Other (Please explain)

1a2. Would your organization do RRH if more domestic and/or sexual violence designated
funding existed specifically for this model?
a.
Yes
b.
No
c.
Not sure
if answered “yes” to Q1
1b1. What is your source of funding for your RRH program (this can include elements of the
RRH program, such as services, assistance with housing costs)? (Select all that apply)
a.
HUD (ESG, Continuum of Care, Public Housing Authority)
b.
TANF
c.
State or local designated funds
d.
Foundation or private funding
e.
Other (Please explain)
1b2. What is the average length of time that assistance is provided to survivors enrolled in your
RRH program?
a.
Less than 3 months
b.
3-6 months
c.
6-12 months
d.
12-24 months
e.
Other (Please explain)
f.
Not sure
1b3. If you collect data on the survivors who retained housing (e.g. survivors able to maintain
rent payments, may include having a lease) once RRH financial assistance/services end, what is
your average retention rate?
a.
Above 75% retained housing
b.
More than 50% retained housing
c.
Less than 50% retained housing
d.
Less than 25% retained housing
e.
Do not collect data
if answered “Above 75%” or “More than 50%" to Q1b3
1b4. What elements of your program contribute to the relatively high retention rate? (Select all
that apply)
a.
Advocates conduct mobile/home based advocacy
b.
Case load supported by adequate staffing
c.
Strong relationships with landlords

d.
e.
f.
g.

Strong community partnerships to enhance/provide support services
Pets allowed in RRH housing or separate pet housing is offered
Sufficient resources have been provided for RRH services
Other (please expand)

2. Are survivors able to access RRH through Housing/Homeless service providers?
a.
Yes
b.
No (Please explain)
c.
Not sure
(if answered “yes” to Q2)
2a. Does your domestic and/or sexual violence organization continue to provide advocacy and
supportive services to survivors who access RRH through housing/homeless service providers?
a.
Yes
b.
No
c.
Not sure
3. How often has your organization encountered the following barriers when attempting to
implement RRH?
Always
HUD defined length of
stay is too short
HUD eligibility criteria
is too narrow
HUD documentation
requirements are too
onerous
Longer-term subsidy
needed
Program includes
disincentives to help
survivors who need
more help in the future
HUD requires program
provide HMIS data
Local Preference (i.e.
CoC) defined length of
stay is too short
Local Preference (i.e.
CoC) eligibility criteria
is too narrow
Local Preference (i.e.
CoC) documentation
requirements are too
onerous

Often

Sometimes Rarely

Never

Not sure

Local Preference (i.e.
CoC) requires program
provide HMIS data
Other (Please explain)
4. Does your organization utilize a housing first approach?
(Housing first is an approach to ending homelessness that centers on providing people
experiencing homelessness with permanent housing as quickly as possible without any preconditions – and then providing additional services as needed. [supportive services are
voluntary])
a.
Yes
b.
No
c.
Not sure
d.
Does not apply
if answered “yes” to Q4
4a. How effective would you say the housing first approach is for survivors of domestic and/or
sexual violence?
a.
Very Effective
b.
Somewhat Effective
c.
A little Effective
d.
Not At all Effective
e.
I don’t know
If answered “Very effective” or “Somewhat effective” to Q4a
4b. Why is the housing first approach your organization uses effective? (Select all that apply)
a.
Facilitates permanent housing for survivors
b.
Survivors you serve tend to prefer living in their own housing as opposed to a shelter
facility
c.
Most cost effective approach
d.
Staff prefer this approach
e.
Survivor choice is respected
f.
Other (Please explain)
If answer (not at all effective) to Q4a
4c. What are the barriers facing your organization to making the housing first approach effective
for survivors? (Select all that apply)
a.
Push back from the board of directors/organizational leadership
b.
Resistance from staff
c.
Survivors you serve tend to prefer the way housing is currently provided by your
organization
d.
Concern for survivor safety & confidentiality
e.
Lack of affordable housing options

f.
g.

Lack of community support
Other (Please explain)

If answered “no” to Q4
4d. Has your agency considered a housing first approach?
a. Yes
b. No
c. Not sure
If answered “yes” Q4d
4e. If your organization has considered a housing first approach, where is your organization in
the process of adopting one?
a.
Preliminary internal discussions
b.
In the process of implementing
c.
Looking for funding
d.
Nearly completed implementation
e.
Considered housing first, but decided against it at this time
If answered “no” or “yes” Q4d
5. What are the barriers to adopting a housing first approach? (Select all that apply)
a.
Inadequate affordable housing stock
b.
Inadequate landlord relationships
c.
Inadequate subsidized housing/permanent supportive housing options for survivors with
high needs
d.
No advocacy capacity to implement
e.
Don’t think it could be applicable to survivors (Please explain)
f.
Push back from Administration/Board
g.
Lack of staff buy-in (Please explain)
h.
Inadequate training
i.
Other (Please explain)
6. Has your agency ever had flexible funds available for survivors?
(Flexible funds are cash assistance grants made to survivors, often at the moment of crisis, to
help maintain housing or quickly stabilize housing, thus avoiding homelessness. Flexible funds
can be used to address rent, as well as emergency medical expenses, debt owed, child care, auto
repair, or any immediate financial need to offset housing expenses.)
a.
Yes
b.
No
c.
Not sure
If answered “yes” to Q6
6a. What was the funding source for your organization’s flexible funding? (Select all that apply)

a.
b.
c.
d.
e.
f.

Agency donations (e.g. private donations – discretionary funds)
Private foundations
Eligible activities through HUD funds
Eligible activities through OVW-Transitional Housing funds
Local/state government funds
Other (Please explain)

6b. Does your agency utilize discretionary funds to support flexible funding grants for survivordirected needs, including housing stability related costs?
a.
Yes
b.
No
c.
Not sure
6c. What is the total amount of funding that your agency has provided to survivors through
flexible funds in the previous fiscal year?
a.
Less than 10K
b.
10k – 20k
c.
20k-40k
d.
40k-60k
e.
60k – 100k
f.
Other (Please explain)
6d. Does your organization have policies for flexible fund distribution?
a.
Yes
b.
No
c.
Not sure
If answered “yes” to Q6d
6e. What do the policies for fund distribution include? (Select all that apply)
a.
Determination of survivor eligibility
b.
Cap on amount per survivor
c.
Length of time survivor may receive flexible funds
d.
Whether a survivor may return for another request for funds or support
e.
Types of requests that can be funded
f.
Other (Please explain)
If answered “yes” to Q6
6f. Are survivors who receive flexible funds also receiving (or provided with the option to
receive) further advocacy and supportive services through your agency?
a.
Yes
b.
No
c.
Not sure

6g. Do advocates follow up with survivors after the survivor has received flexible funds to
determine if the support was effective?
a.
Yes
b. No
c.
Not sure
6h. Compared to the other services that you provide, how effective would you rate flexible
funding as a homeless prevention strategy?
a.
Very effective
b.
Somewhat effective
c.
A little effective
d.
Not at all effective
e.
I don’t know
If answered “no” to Q6
7. Why doesn’t your organization utilize flexible funds for survivor-directed needs, including
housing stability related costs? (Select all that apply)
a.
Not familiar with this model/intervention
b.
Do not have access to funding streams that would allow us to do this
c.
Need assistance in determining how
d.
Not part of our agency’s mission/programs
e.
Other (Please explain)
Topic Area: Funding
1. Does or has your organization received HUD funding (through the Continuum of Care or
another program)?
a. Yes
b. No
c. Not sure

If answered “yes” to Q1
1a. Has your organization been concerned with losing HUD funding?
a.
Yes
b.
No
c.
Not sure

1b. Has your organizations HUD funding allocation been reduced or eliminated?
a. Yes
b. No

c. Not sure
1c. Has your organizations HUD funding for Transitional Housing been reduced or eliminated?
a.
Yes, the funding has been reduced
b.
Yes, the funding has been eliminated
c.
No
d.
Not sure
If answered “yes” to Q1c:
2. If your organization has experienced a reduction or elimination in HUD funding for
transitional housing, what has been the impact of that reduction or elimination? (Select all that
apply)
a.
Fewer survivors served
b.
Fewer units available
c.
Staff reduction
d.
Fewer service availability
e.
The program has had to fold
f.
Other (Please explain)
If answered “yes” to Q1
3. Does or has your organization received HUD funding for emergency shelter?
a. Yes
b. No
c. Not sure
If answered “yes” to Q3
3a. Has your HUD funding for emergency shelter been reduced or eliminated?
a.
Yes, it has been reduced
b.
Yes, it has been eliminated
c.
No
d.
Not sure
If answered “yes” to Q3a
4. What has the impact of the reduction or elimination in HUD funding for emergency shelter
been for your organization? (Select all that apply)
a.
Fewer survivors served
b.
Fewer units available
c.
Staff reduction
d.
Fewer services available
e.
The program had to fold
f.
Other (Please explain)

5. What makes your organization potentially less competitive for funding? (Select all that apply)
a.
Services model – transitional housing when HUD programs are prioritizing RRH/PSH
b.
Issues around data sharing, reports and data quality
c.
Outcome measurements
d.
Other (Please explain)
6. Does your organization struggle with competing OVW and HUD funding
requirements/restrictions that make it challenging to provide services?
a.
Yes (Please explain)
b.
No
c.
Not sure
d.
Only receive OVW funding
e.
Only receive HUD funding
f.
Do not receive funding from OVW or HUD
if answered “yes” to Q6
6a. If you receive funding from both OVW and HUD, are there conflicting requirements that
impact your services?
a.
Yes (please describe conflicting requirements)
b.
No
c.
Not sure
7. Do you have anything to add regarding funding concerns your organization has related to your
programs?
a.
Yes (Please explain)
b.
No