2019 - 60-Month Survey Youth Interview – telephone (using electronic assisted capturing)

APPENDIX F

YOUTH SURVEY INSTRUMENT

OMB # 0960-0799

OMB Expiration Date: [DATE]

PROMISE 60-Month Follow-Up Survey:

Youth Questionnaire

DRAFT DATED: MAY 30, 2018

Administrative Notes:

• Field Period. The PROMISE 60-month parent and youth surveys will be administered beginning 60 months after random assignment. The parent and youth surveys will be deployed independently and fielded concurrently. They may be completed in any order (parent then youth or youth then parent). We anticipate that for the majority of cases, the parent interview will be completed first, followed by the youth.

• Consent for participation in all interviews (parent 18-month and 60-month and youth 18-month and 60-month) was collected from parents at enrollment. All youth provided assent at enrollment.

• Eligibility. Deceased youth are ineligible for the survey. Youth who withdrew from the PROMISE evaluation will be classified as eligible for weighting and response rate computations but will be removed from all survey outreach.

• The target respondent is the youth who enrolled in the PROMISE evaluation and provided assent to take part. If the youth is unable to complete the interview on his/her own or with the support of a trusted adult, we will allow a proxy to complete it on the youth’s behalf.

• Mode and length. This instrument is designed for an interviewer administration and will take approximately 20-35 minutes to complete. Interviews will be conducted in English or Spanish. Spanish language cases will be flagged in advance whenever possible.

• Programming logic is used to route respondents to the next applicable item or section based on the responses provided. The target universe for each item (based on skip logic or other criteria) is shown in the bar above the item number, along with fills denoted by text in brackets. Formatting is used to guide interviewing staff on question administration. Text shown in ALL CAPS is not read aloud. Underlined text is emphasized. Item sources are designated at the end of the question text in parentheses. Items repeated from the PROMISE 18-month survey are designated with (P18M-…). Items newly added to the 60-month instrument are highlighted in blue.

Sections of the youth survey questionnaire:

Section	Description	Asked of Self-Reporting Youth	Asked of Youth’s Proxy
I.	Introduction	YES	YES
II.	Youth education and training	YES	YES
III.	Youth employment and work-based experiences	YES	YES
IV.	Youth’s health and well-being	YES	YES
V.	Youth’s self-determination and expectations for the future	YES	NO
VI.	Youth’s knowledge of SSA benefits and work incentives	YES	NO
VII.	Youth contact information	YES	YES

TEXT FILLS FOR SPECIFIC SITES AND STATES

PRGM State	Health Insurance Marketplace Name	State-Specific Name for Medicaid	State-Specific Name for TANF	State-Specific Name for American Job Center	State-Specific Name for S-Chip	SNAP program name (2/2018)	ABLE program name
AR	Federal Marketplace	Arkansas Medicaid	TANF	Workforce Center	ARKids	SNAP	-
CA	Covered California	Medi-Cal	CalWORKs	America’s Job Center of California	Healthy Families	CalFresh	CalABLE
MD	Maryland Health Connection	Maryland Medicaid Program	Temporary Cash Assistance (TCA)	One Stop Career Centers	Maryland Children’s Health Program (MCHP)	Food Supplement Program (FSP)	Maryland ABLE Program
NY	NY State of Health	New York Medicaid	Family Assistance (FA)	Career Center	Child Health Plus	SNAP	NY ABLE Program
WI	Federal Marketplace	ForwardHealth Medicaid	TANF	Job Center	BadgerCare Plus	FoodShare Wisconsin	-
ASPIRE AZ	Federal Marketplace	AHCCCS (pronounced ‘access’)	Cash Assistance (CA)	Arizona @ Work	KidsCare	Arizona Nutrition Assistance NA)	-
ASPIRE CO	Connect for Health Colorado	Health First Colorado	Colorado Works	Colorado Workforce Center	Child Health Plan Plus (CHP+)	Colorado Food Assistance Program	Colorado ABLE
ASPIRE MT	federal marketplace	Montana Medicaid and HMK Plus: Passport to Health (Passport)	TANF	Job Service	Healthy Montana Kids	SNAP	Montana ABLE
ASPIRE ND	federal marketplace	North Dakota Medicaid	TANF	Job Service	Healthy Steps	SNAP	ABLE Plan for North Dakota
ASPIRE SD	federal marketplace	South Dakota Medicaid	TANF	South Dakota Department of Labor and Regulation	Children’s Health Insurance Program (CHIP)	SNAP	-
UT	federal marketplace	Utah Medicaid	TANF	Utah Department of Workforce Services Employment Center	Children’s Health Insurance Program (CHIP)	Food Stamp Program	-

PROGRAMMER: ACROSS THE SPECIFICATIONS, THE “ENROLLING PARENT,” THE TARGET RESPONDENT FOR THE PARENT SURVEY, IS ABBREVIATED AS “EP.” FILL THE FIRST NAME OF THE EP UNLESS OTHERWISE SPECIFIED.

Program	AR PROMISE	CaPROMISE	MD PROMISE	NY PROMISE	WI PROMISE	ASPIRE-ARIZONA	ASPIRE-COLORADO	ASPIRE-MONTANA	ASPIRE- NORTH DAKOTA	ASPIRE-SOUTH DAKOTA	ASPIRE-UTAH
Program State Fill:	Arkansas	California	Maryland	New York	Wisconsin	Arizona	Colorado	Montana	North Dakota	South Dakota	Utah

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
I.	Youth: Introduction	YES	YES

all

I.MODE. PLEASE RECORD BELOW THE MODE IN WHICH YOU ARE COMPLETING THIS INTERVIEW. THIS HELPS US FILL IN TEXT IN LATER ITEMS AND STATUS THE CASE. (P18M-fieldLoc)

TELEPHONE INTERVIEW 1

FIELD INTERVIEW: in-person 2

FIELD INTERVIEW: BY phone 3

PROGRAMMER: MISSING NOT ALLOWED.

ALL

[INTERVIEWER FULL NAME] [IF 1.MODE=1 OR 3 FILL:CATI TEXT; IF I.MODE=2: FILL CAWI TEXT; [YOUTH FIRST AND LAST NAME]

I.HELLO. IF CATI: Hi! My name is [INTERVIEWER FULL NAME]. I’m calling from Mathematica Policy Research on behalf of the Social Security Administration, about an important national study. May I please speak to [YOUTH FIRST AND LAST NAME]?

IF CAWI: Hi! My name is [INTERVIEWER FULL NAME]. I’m here from Mathematica Policy Research on behalf of the Social Security Administration, as part of an important national study. May I please speak to [YOUTH FIRST AND LAST NAME]?

IF with PROXY (from parent i-vw) SELECT “SPEAKING TO YOUTH’S PROXY.” IF LANGUAGE BARRIER (NOT ENGLISH OR SPANISH), SEEK ANOTHER ADULT HOUSEHOLD MEMBER TO HELP YOUTH COMPLETE. IF NONE AVAILABLE, SELECT LANGUAGE BARRIER. IF YOUTH IN INSTITUTION AND CANNOT ENGAGE BY PHONE, SELECT INSTITUTION. IF YOUTH CAN RECEIVE CALLS, COLLECT CONTACT INFO.

SPEAKING TO youth 1 GO TO I.SUPT

YOUTH COMES TO THE PHONE 2 GO TO I.SUPT

proxy NEEDED FOR YOUTH 3 GO TO I.PROXY

SPEAKING TO YOUTH’S proxy 4 GO TO I.SUPT

YOUTH BUSY, UNAVAILABLE, NOT HOME 6 BARRIER

YOUTH MOVED/LIVES ELSEWHERE 7 BARRIER

YOUTH SPEAKS SPANISH [Spanish-speaking interviewer] 8 GO TO I.SUPT

YOUTH DOES NOT SPEAK ENGLISH OR SPANISH 9 BARRIER

YOUTH HAS HEALTH PROBLEM 10 BARRIER

YOUTH IN INSTITUTION 11 GO TO I.PROXY

YOUTH DECEASED 12 INELIGIBLE

WRONG NUMBER 13 BARRIER

HUNG UP DURING INTRODUCTION 14 BARRIER

YOUTH PROXY NEEDED (i.HELLO= 3 OR 11)

[EP] [YOUTH]

I. PROXY. INTERVIEWER: IF ALREADY SPEAKING TO PROXY FROM PARENT INTERVIEW, DO NOT READ QUESTION AND SELECT “PROXY WILL COMPLETE” BELOW.

ELSE, READ: May I speak with [EP], or with another parent/guardian who is knowledgeable about [YOUTH’s] education, work experiences, and overall well-being? (P18M- NeedProxy_2, rev)

PROXY WILL COMPLETE 1 GO TO I.SUPT

NO PROXY AVAILABLE 0 TERMINATE

DON’T KNOW d TERMINATE

REFUSED r TERMINATE

ALL

I.SUPT. IF SPEAKING WITH YOUTH, READ: Before we begin, will you be completing the interview on your own or would you prefer to have a trusted adult there to help if needed? And will you need any kind of special technology? (P18M-VII.A3, rev)

IF NEEDED: Special technologies can help people with disabilities complete an interview by telephone. These could include: voice amplification for people with hearing impairments or relay services for those who use sign language. Others may benefit from help from a person, where a trusted adult joins you for the interview, providing support, as needed.

IF with PROXY (per parent interview), SELECT “SUPPORT NEEDED - PERSON” BELOW AND DO NOT READ ITEM BELOW.

SUPPORT NEEDED – PERSON 1 GO TO I.SUPTS_SPEC

SUPPORT NEEDED - TECHNOLOGY 2 GO TO I.SUPTS_SPEC

NO SUPPORT NEEDED 0 GO TO I.INTRO

DON’T KNOW d TERMINATE

REFUSED r TERMINATE

PROGRAMMER: DO NOT ALLOW BLANK

HARD CHECK: IF I.PROXY = 1 AND I.SUPTS NE 1: INTERVIEWER – IN THE PRIOR ITEM, THE CASE WAS MARKED AS NEEDING A PROXY. IN THIS ITEM, NO PROXY IS RECORDED. PLEASE CORRECT THIS OR PRIOR ITEM FOR CONSISTENCY.

SUPPORT NEEDED FOR YOUTH INTERVIEW (I.SUPT = 1 OR 2)

I.SUPTS_SPEC. What technologies or supports should we have available? (P18M-VII.A3, rev)

PROBE: Anything else?

INTERVIEWER: PLEASE MAKE NOTE OF ANY ASSISTIVE TECHNOLOGIES REQUESTED IN THE youth CASE NOTES.

ADULT WILL ASSIST WITH YOUTH INTERVIEW 1 GO TO I.INTRO

ADULT WILL PROXY FOR YOUTH 2 GO TO I.PRXY-NME

VIDEO RELAY 4 GO TO I.INTRO

VOICE AMPLIFICATION 5 GO TO I.INTRO

IN-PERSON INTERVIEW 6 GO TO I.INTRO

OTHER TECHNOLOGY 99 GO TO I.INTRO

DON’T KNOW d GO TO I.INTRO

REFUSED r GO TO I.INTRO

SOFT CHECK: IF I.SUPTS_SPEC_2=1 May I confirm that [YOUTH] would not be able to answer any of the questions on [his/her] own, even with support from you or another trusted adult?

YOUTH PROXY IDENTIFIED (I.SUPTS_SPEC_2=1)

[youth]

I.PRXY-NME. Thanks for agreeing to complete the survey on [YOUTH]’s behalf. Would you please tell me your first and last name? (P18M-VII.A4)

IF NEEDED: This tells us who answered the questions on [YOUTH]’s behalf.

(STRING 30)

FIRST NAME

(STRING 1)

MIDDLE INITIAL

(STRING 60)

LAST NAME

DON’T KNOW d TERMINATE

REFUSED r TERMINATE

YOUTH PROXY IDENTIFIED (I.SUPTS_SPEC_2=1) AND (I. PRXY-NME. NE D OR R)

[I.PRXYPHNE]

I. PrxyPhne. May I please have [your/ (his/her)] telephone number? (P18M-ProxyPhone2)

| | | | - | | | | - | | | | |

200-999 0-999 0-9999

DON’T KNOW d

REFUSED r

SOFT CHECK: IF I.PRXYPHNE NE . : I have recorded [I.PRXYPHNE] is that correct?

YOUTH PROXY IDENTIFIED (I.SUPTS_SPEC_2=1) AND (I. PRXY-NME NE D OR R)

I. PrxyAdd. And (your/his/her) address? (P18M-Add2)

IF NEEDED: If you don’t know the exact address, the city and state are helpful too.

STREET STRING (25)

CITY STRING (25)

STATE STRING (2)

| | | | | | ZIP CODE (00501-99950)

DON’T KNOW d

REFUSED r

YOUTH PROXY IDENTIFIED (I.SUPTS_SPEC_2=1) AND (I. PRXY-NME. NE . OR D OR R)

[YOUTH] [I.PXY-NME]

I-PRXY-REL. How (are you/is [I.PXY-NME]) related to [YOUTH]? (P18M-VII.A5/NLTS2012, J1d)

INTERVIEWER: WHAT IS THE RELATIONSHIP OF THE PROXY TO THE YOUTH?

parent OF YOUTH 1

ADULT sibling OR other family member 2

sTAFF PERSON from [youth]’s school 3

someone from an agency/service provider 4

family member living in household 5

NON-family member living in household 6

OTHER RELATIONSHIP 99

DON’T KNOW d TERMINATE

REFUSED r TERMINATE

PROGRAMMER: MISSING VALUE NOT ALLOWED

SOFT CHECK: IF I-PRXY-REL= D OR R PRIOR TO TERMINATE READ: This helps us document who completed each interview. Your name will be kept private and will not be linked to your answers in any reports we create. Are there any questions or any concerns you have about this question that I could help address?

YOUTH PROXY IDENTIFIED (I-PRXY-REL=1-6 OR 99)

[you/PROXY NAME]

I.Prxy_Avail. READ IF NEEDED. IF SPEAKING TO PROXY, SELECT “ABLE TO BEGIN” AND CONTINUE.

Would [you/PROXY NAME] be available to speak now? (P18M-Proxy2_available)

YES – ABLE TO BEGIN INTERVIEW NOW 1 GO TO I.INTRO

NO – NOT ABLE TO BEGIN INTERVIEW NOW 0 SET CALLBACK

DON’T KNOW d SET CALLBACK

REFUSED r TERMINATE

PROGRAMMER BOX 1

IF PROXY IDENTIFIED (I.PRXY_AVAIL=1), PROCEED WITH INTERVIEW LOGIC TO POPULATE FILLS BASED ON PROXY REPORT. IF YOUTH SURVEY RESPONDENT SWITCHES TO PROXY MID-WAY THROUGH, APPLY PROXY LOGIC SHOWN AS THOUGH I.PRXY_AVAIL=1.

POTENTIAL YOUTH SURVEY RESPONDENT (I.SUPT= 1 OR 2 OR 0)

IF YOUTH (I.SUPT= 0 OR 2) IF PROXY, I.PROXY_AVAIL=1

[PROMISE PROGRAM] [$30/$40/$50] [YOUTH]

PROGRAMMER: IF >12 DAYS FROM RELEASE, FILL $30 FOR ALL.

IF <12 DAYS FROM RELEASE, FILL $40 FOR GROUP A, $50 FOR GROUP B

I.INTRO. IF YOUTH: About five years ago, you enrolled in a study called [PROMISE PROGRAM NAME]. You may remember completing a consent form explaining that the study includes two interviews. This is the final one. You’ll receive [$30/$40/$50] for completing this 20 to 35-minute interview. There are questions about your education, experiences with jobs, your hopes for the future, and your health and well-being.

IF PROXY: We are conducting a national study for the Social Security Administration. This study includes two interviews. This is the second and final one. You’ll receive [$30/$40/$50] for completing this 20 to 35-minute interview. There are questions about [YOUTH]’s education, experiences with jobs, and about [YOUTH]’s health and well-being. (P18M-I.ELIG, rev)

IF NEEDED: All your answers will be held in strict confidence. Nothing you say will affect any benefits or services you may receive, now or in the future. We can start now and take a break whenever you need one.

IF NEEDED: The length of the interview ranges based on your experiences. For most people, we expect the interview will take 24 minutes to complete, but it can range from 20 to 35 minutes.

CONTINUE 1

REFUSED r TERMINATE - refusal

PROGRAMMER: MISSING VALUE NOT ALLOWED.

POTENTIAL SURVEY RESPONDENT (I.INTRO=1)

IF YOUTH (I.SUPT= 0 OR 2) IF PROXY, I.PROXY_AVAIL=1

[you/YOUTH] [R IS YOUTH (I.HELLO=1 OR 2)/R IS PROXY (I.Prxy_Avail=1)]

I-CONSENT. Before we begin, may I confirm that you read the letter that we sent [you/YOUTH]? On the back, there was information about how SSA can use and share the information you provide. Would you like me to read that to you now? Or would you prefer to begin the interview . . . (P18M-VII.A2_1)

IF REQUESTED, READ:

IF R IS YOUTH FILL: Section 1110 of the Social Security Act, as amended, authorizes us to request this information. We will use this information to evaluate the impact of services provided to you (the minor participant or household member) during your participation in the Promoting Readiness of Minors in SSI (PROMISE) project. Providing us this information is voluntary. Failing to provide us with all or part of the information will not affect the SSI benefits that you, your child, or other household members receive now or in the future.

We may use the information for the administration of our programs, including sharing information: (1) To comply with Federal laws requiring the release of information from our records (e.g., to the Government Accountability Office and the Department of Veterans Affairs); and, (2) To facilitate audit, investigative, or statistical research activities necessary to assure the integrity and improvement of our programs (e.g., to the Bureau of Census and to private entities under contract with us). A complete list of when we may share your information with others, called routine uses, is available in our Privacy Act System of Records Notice entitled, Supplemental Security Income Studies, Surveys, Records and Extracts (Statistics), 60-0203. Additional information about this and other system of records notices and our programs are available from our website at www.socialsecurity.gov or at your local Social Security office.

IF R IS PROXY, FILL: Section 1110 of the Social Security Act, as amended, authorizes us to request this information. We will use it to evaluate the impact of any services provided to [EP] during (his/her) participation in a national study. Providing us this information is voluntary. Failing to provide us with all or part of the information will not affect the SSI benefits that [EP], (his/her) child, or other household members receive now or in the future.

We may use the information for the administration of our programs, including sharing information: (1) to comply with Federal laws requiring the release of information from our records (e.g., to the Government Accountability Office and the Department of Veterans Affairs); and (2) to facilitate audit, investigative, or statistical research activities necessary to assure the integrity and improvement of our programs (e.g., to the Bureau of Census and to private entities under contract with us). A complete list of when we may share this information with others, called routine uses, is available in our Privacy Act System of Records Notice entitled, Supplemental Security Income Studies, Surveys, Records and Extracts (Statistics), 60-0203. Additional information about this and other system of records notices and our programs are available from our website at www.socialsecurity.gov or at a Social Security office.

ok to begin interview NOW 1

NOT A GOOD TIME 2 Set CallBack

REFUSED r TERMINATE - REFUSAL

PROGRAMMER: DO NOT ALLOW MISSING VALUE

ALL CONSENTING (I.CONSENT = 1)

[your/YOUTH’s] [YOUTH FIRST AND LAST NAME] [with/for]

I.Q1. May I double check the spelling of [your/YOUTH’s] name? I have [YOUTH FIRST AND LAST NAME], is that correct? (P18M-VII.A4)

IF NEEDED: This helps us document who we completed this interview [with/for]. [Your/YOUTH’s] name will be kept in confidence and will not be linked to [your/YOUTH’s] answers in any reports we create. Are there any questions I can answer or any concerns you may have about answering this question that I could help address?

CORRECT AS SHOWN - CONTINUE 1 GO TO I.Q2

CORRECTIONS NEEDED 99

REFUSED r TERMINATE - REFUSAL

youth name to be corrected (I.Q1=99)

I.Q1A. RECORD RESPONDENT NAME BELOW: (P18M-VII.A4)

(STRING 30)

[FIRST NAME]

(STRING 1)

[MIDDLE INITIAL]

(STRING 30)

[LAST NAME]

REFUSED r TERMINATE - REFUSAL

PROGRAMMER: MISSING VALUE NOT ALLOWED.

SOFT CHECK: IF I.Q1A=r, PRIOR TO TERMINATE ASK; This helps us document who completed each interview. Your name will be kept in confidence and will not be linked to your answers in any reports. Are there any questions or any concerns you have about this question that I could help address?

IF PROXY (I.Prxy_Avail=1) AND YOUTH sex =. from sample load file

[YOUTH]

I.Q2. Is [YOUTH] male or female? (P18M-I.Q4)

IF NEEDED: This information helps the computer fill in “he” or “she” to describe [YOUTH], in the questions ahead.

YOUTH IS MALE 1

YOUTH IS FEMALE 2

DON’T KNOW d

REFUSED r

PROGRAMMER BOX 2

fill logic in references to youth: IF YOUTH MALE: load file = 1 or if 1.q2 = 1 then: USE MALE FILLS (HIM, HIS, HE). IF YOUTH FEMALE: load file= 2 or if I.Q2=2 then: USE FEMALE FILLS (HER, SHE). IF UNKNOWN: load file= . and I.Q2 – d or r then: PRESENT BOTH FILLS (HIM/HER), (HE/SHE), (HIS/HER).

all consenting (I. Consent=1)

[your/YOUTH’s] [you/YOUTH] [Are you/Is YOUTH]

I.Q3. The first few questions ask about [your/YOUTH’s] household and living situation. [Are you/Is YOUTH]… (NLTS-W4, Q20)

INTERVIEWER: PROBE, FOR CURRENT MARITAL STATUS. IF ONCE DIVORCED, BUT NOW REMARRIED, THE STATUS WOULD BE “MARRIED.”

Engaged, 1

Single, never married, 2

Married, 3

In a marriage-like relationship, 4

Divorced, 5

Separated, or 5

Widowed? 6

DON’T KNOW d

REFUSED r

SOFT CHECK: IF I.Q3=d or r; This information helps us know which types of questions to ask about [your/YOUTH’s] household. Are there any questions I can answer or any concerns you may have about answering this question that I could help address?

YOUTH ENGAGED, MARRIED OR IN MARRIAGE-LIKE RELATIONSHIP (I.Q3= 1 OR 3 OR 4)

[your/EP’s] [fiancé/spouse/partner] [you/YOUTH]

I.Q4. Does [your/YOUTH’s] [fiancé/spouse/partner] live in the same household with [you/YOUTH]? (P18M-I.Q3)

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL CONSENTING YOUTH AND PROXIES (I.CONSENT=1)

[Do you/Does YOUTH] [EP] [YOUTH] [you live/YOUTH lives] [you do/YOUTH does]

I.Q5. [Do you/Does YOUTH] live with [EP], with another parent or legal guardian, in a group home or institution, or somewhere else? (P18M-I.RTYPE)

INTERVIEWER: IF YOUTH RAN AWAY AND PROXY HAS NO CONTACT, CODE AS INDEPENDENT. PROBE ALL REFUSALS, THIS ITEM SUPPORTS IMPORTANT ROUTING.

youth lives with [EP] 1

youth lives with Other parent or Guardian [NOT EP] 2

Other setting (not with parent/guardian): group home, institution, or boarding school 3

Youth independent: does not live with parent/guardian 4

REFUSED r

PROGRAMMER: MISSING VALUE NOT ALLOWED.

SOFT CHECK: IF I.Q5=3: May I confirm I have recorded correctly that [you live/YOUTH lives] in a group home, institution, or boarding school?

SOFT CHECK: IF I.Q5 =4: May I confirm I have recorded correctly that [you/YOUTH] no longer lives with any parent, a foster parent, or any legal guardian? And [you do/YOUTH does] not live in a group home or institution?

YOUTH LIVING INDEPENDENTLY (I.Q5=4)

[you/YOUTH] [your/YOUTH’s] [RESPONSE TO I.Q6]

I.Q6. Including [you/YOUTH], how many people live or stay in [your/ YOUTH’s] household in total? (YTD36M-X.C2)

| | | people in household (1-25)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF I.Q6>10; May I confirm I’ve recorded [I.Q6] people live or stay in this household at this time?

all consenting (I. Consent=1)

[you were/YOUTH was] [I.Q7]

I.Q7. For verification purposes, can you please tell me the month and year [you were/YOUTH was] born? (P18M-I.Q5a, rev)

programmer:

| | |/| | | | |

(1-12) (1997- 2001)

DON’T KNOW d GO TO I.Q7A

REFUSED r GO TO I.Q7A

PROGRAMMER: MISSING NOT ALLOWED.

SOFT CHECK: IF I.Q7 NE BLANK; May I confirm, I have recorded [I.Q7]?

I.Q7 response IS VALID DATE and ≠ youth dob on file OR D, R

[you were/YOUTH was]

I.Q7A. And one more time, just so I can confirm that I am speaking to the right person, what was the month and year [you were/YOUTH was] born? (P18M-I.Q5b)

programmer:

| | |/| | | | |

(1-12) (1997- 2001)

DON’T KNOW d

REFUSED r

PROGRAMMER: MISSING NOT ALLOWED.

SOFT CHECK: IF I.Q7A DOES NOT MATCH YOUTH MONTH AND YEAR OF BIRTH IN SAMPLE FILE; Thanks for this information. I have recorded [I.Q7A], is that correct?

ALL CONSENTING (I.CONSENT=1)

I.Q8. INTERVIEWER CHECK POINT: IF R IS CONTINUING, SELECT ‘ABLE TO CONTINUE’ BELOW. IF NOT ABLE TO CONTINUE AND PARENT CASE NOT COMPLETE – SELECT CONTINUE WITH EP AND SET CALLBACK FOR YOUTH. IF EP INTERVIEW IS COMPLETE OR EP IS UNAVAILABLE, SET CALLBACK OR STATUS YOUTH AS REFUSAL, AS APPLICABLE.

YOUTH SURVEY R ABLE TO CONTINUE 1 GO TO II.A1

YOUTH SURVEY R BREAK OFF – CONTINUE WITH PARENT I-VIEW 2 SET CALLBACK

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
II.	Youth education and training	YES	YES

SECTION II. PART A. YOUTH’S EDUCATIONAL STATUS AND CREDENTIALS

ALL CONSENTING (I.CONSENT=1)

[Are you/Is (YOUTH)], [Do you/does (YOUTH)], [you/(him/her)], [YOU/(he/she)] [If you attend/If (YOUTH) attends]

II.A1. The first question is about school.

[Are you/Is (YOUTH)] currently attending or enrolled in school? Please include high school, adult basic education or GED courses, vocational or trade school, or college or university courses. (P18M-VIII.A1, rev/YTD-12 I.A1)

IF NEEDED: [If you attend/If (YOUTH) attends] a transition program or (take/takes) special courses for youth ages 18-22 through the school district, this counts as currently being in school.

IF SUMMER: [If you are/If (YOUTH) is] off school for the summer, will [you/ (he/she)] be going back to school in the fall?

INTERVIEWER: CODE “YES” IF ON SUMMER BREAK.

PROBE: [(Do you/ Does YOUTH] go to school?

YES 1

NO 0 GO TO II.A4

DON’T KNOW d GO TO II.A5

REFUSED r GO TO II.A5

SOFT CHECK: IF II.A1=D OR R: Are there any questions I can answer to help address any concerns you have about this question? All the information you provide will be kept private. Your name will not be linked to your answers in any reports about this study.

YOUTH IN SCHOOL NOW (ii.a1=1)

II.A2. What type of school is this? (P18M-VIII.A2/YTD-12 I.B2, rev)

INTERVIEWER:

IF ‘HIGH SCHOOL’ PROBE: Does that school serve a variety of students? Or does it serve only students with disabilities or other special needs?

IF ‘COLLEGE’ PROBE: Is that a trade school, a 2-year college, or a 4-year college/university?

IF ‘ALTERNATIVE SCHOOL’ PROBE: Is that in a regular high school serving a variety of students? Or is it a stand-alone program for youth with disabilities or other special needs?

IF ‘ONLINE SCHOOL’ PROBE: Is that online school for high school or a program after high school? Is it a high school program serving a variety of students or is it an online program that serves only students with disabilities or other special needs?

IF ‘PRIVATE SCHOOL’ PROBE: Is that a regular private school serving a variety of students? Or is it a special private school that serves only students with disabilities or other special needs?

VOCATIONAL OR TRADE PROGRAMS CAN BE OFFERED AT THE HIGH SCHOOL AND POST-SECONDARY LEVEL. PROBE TO CLARIFY WHICH CATEGORY BEST APPLIES.

IF YOUTH ATTENDS MORE THAN ONE TYPE OF SCHOOL, ASK FOR THE ONE WHERE HE/SHE SPENDS THE MOST TIME.

regular HIGH SCHOOL serving a variety of students (INCLUDes vocATIONAL OR TRADE, MAGNET, CHARTER, private, or online SCHOOLS) 1 go to viii.a3

special HIGH SCHOOL THAT SERVES ONLY STUDENTS WITH DISABILITIES 2 go to viii.a3

HOME SCHOOL (BY PROFESSIONAL OR PARENT) 3 go to viii.a3

POSTSECONDARY: VOCATIONAL, technical, OR TRADE SCHOOL 4 go to viii.a3

POSTSECONDARY: 2-year or community COLLEGE 5 go to viii.a3

POSTSECONDARY: 4-YEAR COLLEGE OR UNIVERSITY 6 go to viii.a3

POSTSECONDARY: masters, phd, or other advanced degree program 7 go to viii.a3

GED OR OTHER ADULT EDUCATION PROGRAM 8 go to viii.a3

ANOTHER TYPE OF SCHOOL (SPECIFY) 99 go to viii.a2_spec

DON’T KNOW d go to viii.a3

REFUSED r go to viii.a3

II.A2=99

II.A2_SPEC. What type of school is this? (P18M-VIII.A1/YTD-12 I.B2, rev)

(STRING 150)

youth in school now (II.A1=1)

[Do you/Does YOUTH] [you/(him/her)] [you take/YOUTH takes]

II.A3. [Do you/Does YOUTH] receive any services, supports, or accommodations to help [you/ (him/her)] in school?

This can include: accommodations in how [you take/YOUTH takes] tests or complete assignments – such as more time for tests or taking tests in different settings, having an aid or staff person assigned to help [you/(him/her)] in class, adaptations to a classroom space, or technology or special equipment. (P18M-VIII.B1, rev)

PROBE: [Do you/Does YOUTH] have any special help or supports in school because of a disability or health condition?

YES 1 go to viii.a5

NO 0 go to viii.a5

DON’T KNOW d go to viii.a5

REFUSED r go to viii.a5

NOT CURRENTLY ATTENDING SCHOOL (II.A1=0)

[you/YOUTH]

II.A4 Why did (you/YOUTH) stop going to school? (P18M- VIII.A3/YTD-12 I.C5)

PROBE: Why [are you/is YOUTH] no longer taking classes at school? / Did [you/YOUTH] graduate or complete [your/ (his/her)] classes, or did [you/ (he/she)] leave for some other reason? What was the reason?

PROBE: Any other reasons?

INTERVIEWER: IF R SAYS ‘JUST STOPPED GOING’ OR ‘DIDN’T WANT TO GO’ PROBE AS TO WHY/WHAT WAS THE REASON THEY STOPPED GOING OR DIDN’T WANT TO GO.

IF ‘BORED’ CODE – DIDN’T LIKE SCHOOL.

IF ‘TOO HARD’ CODE – POOR GRADES/NOT DOING WELL IN SCHOOL.

GRADUATED 1

POOR GRADES/NOT DOING WELL IN SCHOOL 2

DIDN’T LIKE SCHOOL 3

ILLNESS or DISABILITY 4

EXPELLED 5

GENERAL DISCIPLINARY PROBLEMS 6

older than student age limit/aged out 7

personal or family problem(s) 8

OTHER (SPECIFY) 99

DON’T KNOW d

REFUSED r

II.A4_99=1

II.A4_SPEC. SPECIFY Why stopPED going to school: (P18M- VIII.A3/YTD-12 I.C5)

(STRING 150)

all consenting (i.consent=1)

[you have/YOUTH has]

II.A5. What is the highest grade or year of school that [you have/YOUTH has] finished? (P18m-viii.a9/YTD12, I.D1)

8TH GRADE OR LESS 1

9TH GRADE/FRESHMAN IN HS 2

10TH GRADE/SOPHOMORE IN HS 3

11TH GRADE/JUNIOR IN HS 4

12TH GRADE/SENIOR IN HS 5

SOME COLLEGE OR TECHNICAL SCHOOL 6

POSTSECONDARY: VOCATIONAL, technical, OR TRADE SCHOOL 7

POSTSECONDARY: 2-year or community COLLEGE 8

POSTSECONDARY: 4-YEAR COLLEGE OR UNIVERSITY 9

POSTSECONDARY: masters, phd, or other advanced degree program 10

UNGRADED SCHOOL/PROGRAM 11

HOME SCHOOLED 12

OTHER 99

DON’T KNOW d

REFUSED r

all consenting (i.consent=1)

[MONTH, YEAR ONE YEAR PRIOR TO INTERVIEW] [have you/has YOUTH]

II.A6. In the past year, that is since [MONTH AND YEAR PRIOR TO INTERVIEW] [have you/has YOUTH] been suspended or expelled from school? (P18M-VIII.A7 rev/NEW)

INTERVIEWER: IF INTERVIEW IS BEING CONDUCTED IN SUMMER, ASK YOUTH/PROXY TO REFER TO THE MOST RECENT ACADEMIC YEAR.

IF YOUTH WAS NOT IN SCHOOL IN THE PAST YEAR, SELECT “NO” BELOW.

YES 1

NO 0

DON’T KNOW d

REFUSED r

if youth is in school (ii.a1=1) and highest grade = 5-12 or 99

or if youth not in school (ii.a1=0)

[Do you/Does YOUTH]

II.A7. Some young people finish high school with a diploma, others get a certificate of completion. Others do not finish high school but then go on to complete a GED, also known as a general equivalency degree or general education degree.

[Do you/Does YOUTH] have a… (P18M-VIII.A8Aa-c, rev/ YTD-12 I.D2)

IF NEEDED: The GED is a battery of tests, based on courses and/or guided self-study, that when passed result in the award of a certificate that is recognized in the United States as the legal equivalent of a high school diploma. A high school diploma documents that a student completed the number and type of class credits required for graduation in their state. A certificate of completion does not have course or grade requirements. Those who exit high school with this certificate are eligible to participate in their school’s graduation ceremonies.

Select one per row

	YES	NO	DON’T KNOW	REFUSED
a. GED? IF NEEDED: This is also known as a general equivalency degree or general education degree.	1	0	D	R
b. High school diploma or a certificate of completion from high school?	1	0	D	R

SOFT CHECK: IF A7a=1 and A7b = 1; INTERVIEWER: YOU HAVE RECORDED “YES” FOR BOTH OF THESE ITEMS. PROBE AS TO WHETHER THE YOUTH GRADUATED FROM HIGH SCHOOL OR NOT AND HAVE THE R PICK THE APPROPRIATE CATEGORY. USE THE DEFINITIONS ABOVE AS NEEDED.

if youth is in school (ii.a1=1) and highest grade = 5-12 or 99

or if youth not in school (ii.a1=0)

[you/YOUTH] [were you/was YOUTH] [you/(he/she)]

II.A8_MO. When did [you/YOUTH] leave high school? (NLTS-2007, Q12)

PROBE: What was the month and year [you/YOUTH] left high school? Your best guess is fine.

PROBE: How old [were you/was YOUTH] when [you/ (he/she)] left high school?

Did [you/YOUTH] finish in the winter, summer, or some other time of the year?

| | | month

(1-12)

DON’T KNOW d

REFUSED r

II.A8_YR.

| | | | | year

(1997 TO CURRENT YEAR)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF II.A8_YR> CURRENT YEAR; YOU HAVE RECORDED A DATE IN THE FUTURE. PLEASE CORRECT THE RESPONSE.

all consenting (i.consent=1)

[you are/YOUTH is] [I do/YOUTH does] [I need/YOUTH needs] [I do/YOUTH does] [I’m/YOUTH is] [I have/YOUTH has] [my/YOUTH’s]

II.A9. I’m going to read a list of challenges people sometimes face in furthering their education or training after high school.

For each, please tell me whether it will be a challenge for [you /YOUTH] or not. (NLTS2012-Par-FU E4, rev)

PROBE: There are no right or wrong answers, this is about your opinions and experiences.

INTERVIEWER: IF YOUTH SAYS SOMETHING DOES NOT APPLY, CODE AS “NO.”

PROGRAMMER: RANDOMIZE THE SEQUENCE OF THE ROWS

	WILL BE A CHALLENGE	WILL NOT BE A CHALLENGE	DK	REF
a. [You do/YOUTH does] not have enough information about education or training options for after high school.	1	0	d	r
b. [You need/YOUTH needs] to work and cannot attend school while working.	1	0	d	r
c. [You do/YOUTH does] not know how to get financial aid or help paying for school.	1	0	d	r
d. [You don’t/YOUTH doesn’t] do well in school.	1	0	d	r
e. [You have/YOUTH has] physical or mental health issues that would make it difficult.	1	0	d	r
f. Schools could not accommodate [your/ YOUTH’s] disability.	1	0	d	r
g. Transportation is a challenge.	1	0	d	r

SECTION II. PART B. YOUTH’S TRAINING

ALL CONSENTING (I.CONSENT=1)

[MONTH OF PRIOR YEAR] [you/YOUTH]

II.B1. In the last year, since [MONTH OF PRIOR YEAR], did [you/ (YOUTH)] receive a training diploma, certificate, or license? (NEW)

PROBE: This training program could be for a number of purposes – to explore career interests, to help you find a job, or to build skills needed for living independently.

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL CONSENTING (I.CONSENT=1)

[ARE YOU/IS YOUTH] [YOU/YOUTH]

II.B2. [Are you/ Is YOUTH] currently in a training program or taking classes outside of school to help [you/ YOUTH] learn job skills or get a job? (P18M-VIII.C2/YTD-12 I.A1a)

YES 1

NO 0 GO TO II.B5

DON’T KNOW d GO TO II.B5

REFUSED r GO TO II.B5

YOUTH IN TRAINING PROGRAM (II.B2=1)

II.B3. What type of training is this? (P18M-VIII.C3, rev/YTD-12 I.B2, rev)

PROBES:
Is the training focused on learning a trade or building skills needed for a specific job?

Is the training helping you learn life skills – like how to prepare food, manage money, or other skills you need to live on your own?

Is the training focused on helping you become a leader, to stand up for yourself, and get what you need from others?

Any other training in the past year?

INTERVIEWER: IF R PROVIDES THE NAME OF THE PLACE WHERE TRAINING WAS PROVIDED, PROBE TO AK WHAT KINDS OF THINGS HE/SHE LEARNED FROM THAT PLACE.

IF ‘DVR (DEPARTMENT OF VOCATIONAL REHAB) CODE: VOC, TECH, BIZ OR TRADE SCHOOL (1).

IF ‘RESUME WRITING’, ‘JOB INTERVIEWING’, OR ‘JOB SHADOWING’ CODE: JOB SKILLS TRAINING (3).

VOCATIONAL, TECHNICAL, BUSINESS, OR TRADE SCHOOL 1

LIFE SKILLS TRAINING 2

JOB SKILLS TRAINING 3

LEADERSHIP SKILLS/SELF-DETERMINATION SKILLS TRAINING 4

OTHER TRAINING PROGRAM (SPECIFY) 99

DON’T KNOW d

REFUSED r

YOUTH IN TRAINING PROGRAM (II.B3_99=1)

[you/YOUTH] [you/YOUTH] [you need/YOUTH needs] [your/(his/her)] [your/(him/her)]

II.B3_SPEC. SPECIFY TYPE OF TRAINING YOUTH RECEIVED: (P18M-VIII.C3/YTD-12 I.B2, rev)

PROBES:
Is the training focused on learning a trade or building skills needed for a specific job?

Or helping [you/YOUTH] learn life skills – like how to prepare food, manage money, or other skills [you need/YOUTH needs] to live on [your/ (his/her)] own?

Or was it helping [you/YOUTH] become a leader, to stand up for [your/him/her)] self, and get what [you need/ (he/she) needs] from others?

Any other training in the past year?

(STRING 150)

YOUTH IN TRAINING PROGRAM NOW (II.B2=1)

[Do you/Does YOUTH] [you/(him/her)] [you take tests or complete assignments/YOUTH takes tests or completes assignments]

II.B4. [Do you/Does YOUTH] receive any services, supports, or accommodations to help [you/ (him/her)] in this training program? (P18M-VIII.B1, rev)

IF NEEDED: This can include accommodations in how [you take tests or complete assignments/YOUTH takes tests or completes assignments] – such as more time for tests or taking tests in different settings, having an aid or staff person assigned to help [you/(him/her)] in class, adaptations to a classroom space, or special technology or equipment.

PROBE: [Do you/Does YOUTH] have any special help or supports in school because of a disability or health condition?

YES 1

NO 0

DON’T KNOW d

REFUSED r

all consenting (I.CONSENT=1)

[you have/YOUTH has] [have you/has YOUTH] [your/(his/her)]

II.B5. I’m going to read a list of services some people receive to help prepare them for the future. For each, please tell me whether [you have/YOUTH has] received this service from someone who is not part of your family. (NEW)

PROBE: These may come from more than one place or any kind of service provider.

PROGRAMMER: RANDOMIZE SEQUENCE OF ROWS PRESENTED.

	YES	NO	DON’T KNOW	REFUSED
a. In the past year, [have you/has YOUTH] received any supports or services in getting or keeping a job?	1	0	d	r
b. In the past year, [have you/has YOUTH] received any supports or services in continuing [your/ (his/her)] education beyond high school?	1	0	d	r
c. IF NEEDED: In the past year, [have you/has YOUTH] received any supports or services in: Getting accommodations for school, work, or living independently?	1	0	d	r

ALL CONSENTING (I.CONSENT=1)

II.B6. INTERVIEWER CHECK POINT: IF R IS CONTINUING, SELECT ‘ABLE TO CONTINUE’ BELOW. if not able to continue and parent case not complete – select continue with EP and set callback for youth. if ep interview is complete or ep is unavailable, set callback OR STATUS youth AS REFUSAL, AS APPLICABLE.

YOUTH SURVEY R ABLE TO CONTINUE 1 GO TO III.A-INTRO

YOUTH SURVEY R BREAK OFF – CONTINUE WITH PARENT I-VIEW 2 SET CALLBACK

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
III.	Youth employment and work-based experiences	YES	YES

SECTION III. PART A. YOUTH EMPLOYMENT

all consenting (i.consent = 1)

[you have/YOUTH has], [you/YOUTH]

III.A-Intro. Next I’ll ask questions about jobs that [you have/YOUTH has] had in the past 12 months. This includes any job or jobs [you/YOUTH] may have now, as well as jobs that ended in that timeframe. (P18M-IX-INTRO, rev)

CONTINUE 1

all consenting (i.consent = 1)

[HAVE YOU/HAS YOUTH], [CALCULATE AND FILL MONTH AND YEAR ONE YEAR PRIOR]. [RA MONTH] [RA YEAR], [YOU DO/YOUTH DOES], [YOU ARE/YOUTH IS] [MONTH AND YEAR ONE YEAR AGO], [YOUR/(HIS/HER)], [YOU GET/YOUTH GETS]

III.A1. [Have you/ Has YOUTH] worked at a job or a business at any time in the past year, since [MONTH AND YEAR PRIOR]?

This includes any job or jobs [you/YOUTH] may currently have as well as jobs that have ended in the past year. Please include all jobs in the past year, even if [you/YOUTH] only worked for a short time. Include paid or unpaid jobs, but not chores around the house, even if [you are/YOUTH is] paid to do them.

A job could be a school-sponsored job or a work study job. Jobs include internships, apprenticeships and volunteer work even if (you/YOUTH) didn’t get paid. A job could be working for a business or organization or work (you do/YOUTH does) on [your/ (his/her)] own, such as babysitting or dog walking, that (you get/YOUTH gets) paid to do. (P18M- IX.A3/YTD36M-II.A1)

YES 1

NO 0 GO TO III.A25

DON’T KNOW d GO TO III.A25

REFUSED r GO TO III.A25

PROGRAMMER: DO NOT ALLOW BLANKS

SOFT CHECK, IF III.A1=0: May I confirm I have recorded this correctly, that (you have/YOUTH has) not worked in the past year, paid or unpaid, even volunteer or community service work?

SOFT CHECK, IF III.A1=D OR R: Are there any questions or concerns you have about this question that I can help address?

youth WORKED IN PAST YEAR (iii.a1=1)

[HAVE YOU/HAS youth], (YOU/YOUTH), (HAVE/HAS), [YOU (are or were)/YOUTH (is or was)], [MONTH AND YEAR ONE YEAR AGO]

III.A2. How many jobs [have you/has YOUTH] had within the past year?

Please include jobs that [you/YOUTH] currently [have/has] as well as jobs that ended within the past year. Please include jobs at which [you (are or were)/YOUTH (is or was)] self-employed. Do not include chores around the house, even if (you are/YOUTH is) paid to do them. (P18M-IX.A4/YTD36M-II.A1_num)

INTERVIEWER: JOBS SUCH AS BABYSITTING COUNT AS ONE ‘JOB’ EACH (SELF EMPLOYED AS A . . . ). PROBE TO CONFIRM THESE ARE NOT COUNTED IN TERMS OF THE NUMBER OF TIMES SUCH A JOB WAS PERFORMED IN THE PAST YEAR.

IF YOUTH DOES NOT KNOW HOW MANY JOBS, (1) ASK HIM/HER TO LIST THEM OUT AND YOU HELP COUNT THE JOBS. OR (2) TO START WITH THE NUMBER HE/SHE KNOWS AND ADD MORE AS NEEDED UPON PROMPT AT END OF SERIES.

| | | JOBS GO TO BOX 3

(01-99)

DON’T KNOW d GO TO BOX 3

REFUSED r GO TO BOX 3

SOFT CHECK: May I confirm I have recorded that (You have/YOUTH has) had [FILL III.A2] jobs in the past year?

III.A1=1

[WERE YOU/ WAS YOUTH], [YOU/(HE/SHE)]

IIII.A2A. [Were you / Was YOUTH] paid or did [you / (he/she)] receive income through self-employment in any of these jobs? (P18M-IX.A2)

PROBE: Self-employed means that you work for yourself or own your own business.

YES 1

NO 0

DON’T KNOW d

REFUSED r

BOX 3

IF WORKED IN PAST YEAR (IXA3=1) and NUMBER OF JOBS (III.A2) = DK or R, TREAT AS 1 JOB.

(III.A4 ONWARD IN LOOP, AS APPLICABLE, ASKED FOR EACH JOB AT III.A2 – UP TO 8 JOBS.

youth WORKED IN PAST YEAR (III.A1=1) AND had AT LEAST 1 job NUM or number of JOBS was UNKNOWN: (III.A2>0 OR D OR R)

[YOU HAVE/YOUTH HAS], [YOUR/HIS/HER], [YOU/YOUTH], [WORK/WORKS], [YOU ARE/HE IS/SHE IS] [MONTH AND YEAR ONE YEAR AGO]

III.A3. IF III.A2 = D OR R, FILL: Now, I would like to get more information about the job where you worked in the past year. What is the name of the place [you/YOUTH] currently [work/works] at or worked at most recently?

IF III.A2 = 1, (ONE JOB), FILL: Now, I would like to get more information about this job. What is the name of the place [you/YOUTH] currently [work/works] at or worked at most recently?

IF III.A2 > 1, FIRST JOB, FILL: Now, I would like to get more information about each job [you have/YOUTH has] had in the past year. I'd like to start with [your/ (his/her)] most recent job and work backwards. What is the name of the place [you/YOUTH] currently [work/works] at or worked at most recently? Please include jobs at which [you are/ (he/she) is] self-employed.

IF III.A2 > 1, AND LOOPING TO NEXT JOB FILL: Now, I’d like to get more information about each of the other jobs [you have/YOUTH has] had in the past year. What is the name of the next place [you have/ (he/she) has] worked at since [MONTH AND YEAR ONE YEAR AGO]? (P18M-IX.A5/YTD36M-II.A2)

PROBE: Please include jobs at which [you were/YOUTH was] self-employed.

IF R CANNOT REMEMBER THE NAME OF THE JOB, PROVIDE SOME KIND OF DESCRIPTION OF JOB BELOW. FOR EXAMPLE: PIZZA PLACE; THE OFFICE BUILDING; THE BOOK STORE. THIS KEEPS EACH SET OF EMPLOYMENT EXPERIENCES SEPARATE IN FOLLOW UP QUESTIONS.

	NAME OF PLACE WORKED OR TYPE OF SELF-EMPLOYMENT (1-8)	DK	REF
a.	________________Name of place worked – 1 (STRING 150)	d	r
b.	________________Name of place worked – 2 (STRING 150)	d	r
c.	________________Name of place worked – 3 (STRING 150)	d	r
d.	________________Name of place worked – 4 (STRING 150)	d	r
e.	________________Name of place worked – 5 (STRING 150)	d	r
f.	________________Name of place worked – 6 (STRING 150)	d	r
g.	________________Name of place worked – 7 (STRING 150)	d	r
h.	________________Name of place worked – 8 (STRING 150)	d	r

SOFT CHECK IF III.A3a-h= D OR R: I’m collecting the name of each place worked (or type of self-employment) to help us in the questions that come up next, so we can keep them separate for people who report more than one job. All the information you provide will be kept private.

BOX 4

USE “NAME OR PLACE” PROVIDED IN IX.A3a-j, AS FILL FOR [NAME OR PLACE] IN LOOPS FOR III.A4-III.A23.

IF JOB IS POPULATED (LOOP 1-8, PER VALUE IN iii.a3a-h)

[(Are or were) you/(Is or was) YOUTH] [NAME OR PLACE] [you work for yourself/YOUTH works for him/her self] [own your own/owns his/her own]

III.A4. IF YOUTH LISTED AN EMPLOYER CODE “1” BELOW AND MOVE ON.

IF EMPLOYER WAS NOT SPECIFIED OR UNCLEAR, ASK: [(Are or were) you/ (Is or was) YOUTH] self-employed at [NAME OR PLACE]? By self-employed we mean [you work for yourself/YOUTH works for (him/her) self] or [own your own/owns (his/her) own] business. (P18M-IX.A5)

IF NEEDED: If [you were/ YOUTH was] working for an employer or company at [NAME OR PLACE], it is not self-employment.

WORK(ED) FOR AN EMPLOYER 1

SELF EMPLOYED 2

DON’T KNOW d

REFUSED r

SEQUENCE BEGINS WITH START, END DATES – SO AS TO EXCLUDE OUT OF RANGE JOBS FROM FURTHERING IN THE LOOP.

IF JOB IS POPULATED (LOOP 1-8, PER VALUE IN iii.a3a-h)

[you/(he/she)] (NAME OR PLACE) FILLED FROM RESPONSE TO III.A3a-h for (NAME OR PLACE)

Self-employed logic driven if III.A4=2

III.A5. When did [you/ (he/she)] start working at [NAME OR PLACE]? (P18M- IX.A8/YTD36M-II.B4)

IF SELF-EMPLOYED: When did [you/ (he/she)] start [NAME OR PLACE]?

INTERVIEWER: IF JOB BEGAN > 1 YR AGO AND R CANNOT RECALL START DATE, SELECT “MORE THAN ONE YR AGO”

programmer:

| | |/|| | | | |

MONTH YEAR

(1-12) (1997-CURRENT YEAR)

MORE THAN ONE YEAR AGO 9999

DON’T KNOW d

REFUSED r

HARD CHECK: IF YEAR IS GT CURRENT YEAR; YOU HAVE RECORDED A YEAR IN THE FUTURE. PLEASE GO BACK AND CORRECT.

IF JOB IS POPULATED (LOOP 1-8, PER VALUE IN iii.a3a-h)

[Do you/Does YOUTH] NAME OR PLACE FILLED FROM RESPONSE TO III.A3a-j

EMPLOYER FILLS: IF III.A4=1; SELF-EMPLOYED FILLS IF III.A4=2

III.A6. IF WORKED FOR EMPLOYER: [Do you/Does YOUTH] still work at [NAME OR PLACE]? (P18M- IX.A6/YTD36M-II.B1).

IF SELF-EMPLOYED: [Do you/Does YOUTH] still [NAME OR PLACE]?

YES 1 GO TO BOX 5

NO 0 GO TO III.A7

DON’T KNOW d GO TO BOX 5

REFUSED r GO TO BOX 5

not current job (III.A6=0)

[you/(he/she)], [your/(his/her)], (Is/Was) [NAME OR PLACE]

III.A7. When did [you/ (he/she)] stop working at [NAME OR PLACE] . . . (P18M- IX.A16/YTD36M-II.D4)

PROBES: In which month did [you/ (he/she)] stop? /What was the weather like?

Was it around a holiday or [your/ (his/her)] birthday? /Was it during the school year or during the summer? / (Is/Was) this a summer job?

INTERVIEWER: If “still working” at this job, CORRECT RESPONSE TO PRIOR QUESTION.

programmer:

| | |/| | | | | GO TO BOX 5

MONTH YEAR

(1-12) (1997 TO CURRENT YEAR)

DON’T KNOW d GO TO III.A8

REFUSED r GO TO III.A8

SOFT CHECK: IF III.A7_YEAR > CURRENT YEAR; YOU HAVE RECORDED A DATE IN THE FUTURE, PLEASE GO BACK AND CORRECT THE RESPONSE.

DATE YOUTH STOPPED WORKING JOB NOT PROVIDED (III.A7= D OR R)

[you/(he/she)] [NAME OR PLACE]

III.A8. How long did [you/ (he/she)] work at [NAME OR PLACE]? (P18M-IX.A16A/YTD36M-II.D4)

PROBE: Your best estimate is fine.

| | |WEEKS OR MONTHS OF EMPLOYMENT (ALLOWABLE RANGE: 1-99)

WEEKS 1 GO TO BOX 5

MONTHS 2 GO TO BOX 5

DON’T KNOW d GO TO BOX 5

REFUSED r GO TO BOX 5

BOX 5

CONTINUE THROUGH LOOP IF: JOB IS CURRENT JOB (III.A6=1) OR IF NOT CLEAR THAT JOB OCCURRED IN PAST YEAR. (END DATE IN III.A7=D, R)

ONCE IN LOOP - IF A CURRENT JOB (III.A6 =1) APPLY PRESENT TENSE FILLS. IF NOT A CURRENT JOB (III.A6 = 0) APPLY PAST TENSE FILLS. IF UNKNOWN (III.A6= d or r), present both options in the parenthesis.

PROCEED TO BOX 6 IF JOB IS NOT A CURRENT JOB (III.A6=0) AND END DATE OUTSIDE OF RANGE (IS >1 YEAR FROM DATE OF INTERVIEW). (III.A7_MONTH-YEAR IS > 1 YEAR PRIOR TO INTERVIEW MONTH AND YEAR)

if A current job (III.A6= 1)

[(do you/does YOUTH] [NAME OR PLACE] [your/(his/her)] [have you/has (he/she)] [(you/(he/she)]

III.A9. What [do you/does YOUTH] do at [NAME OR PLACE]? (P18M- IX.A7/YTD36M-II.B3)

PROBE: What are [your/ (his/her)] responsibilities? What kinds of things [have you/has (he/she)] done there? Tell me what [(you/ (he/she)] (do/does) when [you/ (he/she)] (get/gets) to work? Then what?

IF SELF-EMPLOYED: What [(do you/does (he/she)] do as a self-employed [NAME]?

INTERVIEWER: RECORD VERBATIM AND CODE ONE BELOW.

________________________________________ (STRING 150)

III.A9_CODE. APPLY CODE BELOW. INTERVIEWER: IF ‘SORTING/FOLDING CLOTHES’ CoDE To ‘stock clerk- retail (19).

ASSEMBLY WORK (SORTING, STUFFING) 1

ANIMAL CARE (DOG WALKING, GROOMING, VETERINARY HELPER) 2

CAMP COUNSELOR 3

CASHIER—GROCERY STORE, FAST FOOD PLACE, RETAIL. 4

CHILD CARE—BABYSITTING/MOTHERS HELPER, TEACHER’S AIDE 5

CLEANING—JANITOR/MAID 6

CLERICAL—FILING, RECEPTIONIST, DATA ENTRY 7

COMPUTER WORK—DATA ENTRY/PROGRAMMING/WEB PAGE DEVELOPMENT 8

DELIVERY PERSON – FOOD, NEWSPAPERS, OR PRESCRIPTIONS 9

FOOD SERVICE—BUS BOY, WAITER/WAITRESS, HOST, COOK 10

GARDENING AND GROUNDS MAINTENANCE 11

HEALTH CARE AIDE—PERSONAL CARE ATTENDANT, NURSE’S AIDE 12

MILITARY 13

SALES - RETAIL 14

SKILLED LABOR APPRENTICE—PLUMBER, CARPENTER, ELECTRICIAN 15

STOCK CLERK— RETAIL (GROCERY OR DRUG STORE, ETC) 16

OTHER, NOT LISTED ABOVE 99

DON’T KNOW d

REFUSED r

if A current job (III.A6= 1)

[you/(he/she)]

III.A10. How did [you/ (he/she)] find this job? (P18M- IX.A9/YTD36M-II.B5)

PROBE: How did [you/ (he/she)] hear about this job?

INTERVIEWER: IF ‘JOB FAIR’ CODE: DIRECT APPLICATION TO EMPLOYER (6).

NEWSPAPER AD 1 GO TO III.A11

INTERNET/WEBSITE 2 GO TO III.A11

EMPLOYMENT AGENCY (PRIVATE) 3 GO TO III.A11

SPECIAL EDUCATOR, VOCATIONAL EDUCATOR, COUNSELOR, OR OTHER SCHOOL STAFF 4 GO TO III.A11

FRIENDS, RELATIVES, COMMUNITY MEMBERS (E.G. CHURCH) 5 GO TO III.A11

DIRECT APPLICATION TO EMPLOYER 6 GO TO III.A11

VOC REHAB OR OTHER SERVICE AGENCY 7 GO TO III.A11

AMERICAN JOB CENTERS (UNEMPLOYMENT OFFICE, FORMERLY KNOWN AS ONE STOPS OR WORKFORCE DEVELOPMENT CENTERS) 8 GO TO III.A11

[PROMISE PROGRAM] 9 GO TO III.A11

OTHER SOURCE - SPECIFY 99 GO TO III.A10-SPEC

DON’T KNOW d GO TO III.A11

REFUSED r GO TO III.A11

YOUTH FOUND JOB THROUGH OTHER SOURCE (III.A10_99=1)

III.A10-SPEC. SPECIFY HOW YOUTH FOUND JOB: (P18M- IX.A9/YTD36M-II.B6)

(STRING 150)

CURRENT JOB OR JOB WORKED IN PAST YEAR (III.A6=1 OR III.A7_MONTH-YEAR WITHIN PAST 12 MONTHS OR D OR R)

[(do/did you)/(does/did) YOUTH] [do you/does (he/she)] [Do you/Does YOUTH]

III.A11. How many hours per week [(do/did you)/ (does/did) YOUTH] usually work at this job? (P18M- IX.A10)

PROBE: Which days [do you/does (he/she)] work? /What time [do you/does (he/she)] start work? /What time [do you/does (he/she)] finish work?/[Do you/Does YOUTH] take a break for lunch?

INTERVIEWER: IF JOB DID NOT HAVE USUAL HOURS, (SPORADIC WORK OR ONE-TIME OPPORTUNITY) RECORD AS SUCH BELOW

| | | HOURS PER WEEK USUALLY WORKED (1-98) GO TO III.A13

NO USUAL HOURS 99 GO TO III.A12

DON’T KNOW d GO TO III.A12

REFUSED r GO TO III.A12

YOUTH USUAL HRS PER WEEK WORKED DK, REF, OR NO USUAL HRS (III.A11 = D, R, OR 99)

[Do you think you work/Do you think YOUTH works]

III.A12. [Do you think you work/Do you think YOUTH works] ... (P18M-X.A10, YTD36M-II.B6)

Less than 10 hours per week? 1

10-20 hours per week? 2

21-30 hours per week? 3

31- 35 hours per week? 4

More than 35 hours per week? 4

Or was this a one-day or short-term opportunity? 5

DON’T KNOW d

REFUSED r

CURRENT JOB OR JOB WORKED IN PAST YEAR (III.A6=1 OR III.A7_MONTH-YEAR WITHIN PAST 12 MONTHs OR D OR R)

[you are/(he/she) is]/[you were/(he/she) was] FILL [NAME or PLACE] FROM APPLICABLE JOB IN LOOP FOR III.A5a-j

III.A13. Next, I’d like to ask you some questions about how [you are/ (he/she) is]/ [you were/ (he/she) was] paid at [NAME or PLACE].

[Do/Did) you/ (Does/did) YOUTH] get paid by the hour or by how many things [you/ (he/she)] [(make/do/sell)/ (makes/does/sells)]? (P18M-IXA11/YTD36M-II.C1)

PROBE: [Are you/Is YOUTH] paid a certain amount per day, per week, per month, or per year?

[Do you/Does YOUTH] get a salary?

INTERVIEWER: IF R WAS PAID AS A SINGLE DAY OR ONE TIME EVENT, SELECT HOUR/DAY/WEEK OPTION BELOW.

Hour, day, week, month, year 1 GO TO III.A15

Things 2 GO TO III.A14

unpaid job 3 GO TO III.A19

PAID Some other way (SPECIFY) 99 GO TO III.A13_SPEC

DON’T KNOW d GO TO III.A19

REFUSED r GO TO III.A19

YOUTH PAID IN OTHER WAY (III.A13=99)

III.A13_SPEC. SPECIFY HOW YOUTH WAS PAID AT THIS JOB: (P18M-IXA11/YTD36M-II.C1)

IF R SAYS JOB WAS ‘UNPAID’ GO BACK TO III.A13 AND CORRECT RESPONSE TO UNPAID.

(STRING 150) GO TO III.A16

YOUTH PAID BY THINGS (III.A13=2)

[(are/were) you)/(is/was) YOUTH] [(do or did you)/(does (he/she))] [you (make/do/sell)/(he/she) makes/does/sells] [(do or did you)/does (he/she) (make/do/sell)]

III.A14. About how much [(are or were) you)/ (is or was) YOUTH] paid on this job? (P18M- IX.A12/YTD36M-II.C2)

IF R SAYS JOB WAS ‘UNPAID’ GO BACK TO III.A13 AND SELECT “UNPAID.”

PROBE: How much [(do or did you)/ (does (he/she)] get paid for each thing [you (make/do/sell)/ (he/she) makes/does/sells]?

PROBE: How many things [(do or did you)/does (he/she) (make/do/sell)] in an hour?

III.A14_amtthing RECORD AMOUNT PER THING

$| | |__|.| | | Per/THING (1-999)

III.A14_hrsthing RECORD THINGS PER HOUR

| | | | | THINGS/HOUR (1-999) GO TO III.A16

IF PAID BY TIME PERIOD (HR DAY MONTH, YEAR) or some other way (III.A13 = 1)

[(are or were) you)/(is or was) YOUTH]

III.A15. About how much [(are or were) you)/ (is or was) YOUTH] paid on this job? (P18M- IX.A12/YTD36M-II.C2)

IF R SAYS JOB WAS ‘UNPAID’ GO BACK TO III.A13 AND CORRECT RESPONSE TO UNPAID.

| | | | | DESCRIPTION (0-9999)

III.A15_unit. RECORD UNIT:

PER HOUR 1 GO TO III.A16

PER DAY 2 GO TO III.A16

PER WEEK 3 GO TO III.A16

EVERY OTHER WEEK 4 GO TO III.A16

TWICE A MONTH 5 GO TO III.A16

ONCE A MONTH 6 GO TO III.A16

OTHER WAY 7 GO TO III.A16

DON’T KNOW d GO TO III.A16

REFUSED r GO TO III.A16

paid job (III.13=1, 2, OR 99)

III.A16. (Does/Did) this job offer health insurance? (P18M-IX.A13//YTD36M-II.C3)

PROBE: It doesn’t matter if you take this benefit or not. We just want to know whether or not it is offered to [you/YOUTH].

YES 1

NO 0

DON’T KNOW d

REFUSED r

paid job (III.13=1, 2, OR 99)

III.A17. (Does/Did) this job offer paid vacation or sick leave? (P18M-IX.A13//YTD36M-II.C3)

PROBE: It doesn’t matter if you take this benefit or not. We just want to know whether or not it is offered to [you/YOUTH].

YES 1

NO 0

DON’T KNOW d

REFUSED r

paid job (III.13=1, 2, OR 99)

III.A18. (Does/Did) this job offer any kind of pension or retirement plan? (P18M-IX.A13//YTD36M-II.C3)

PROBE: It doesn’t matter if you take this benefit or not. We just want to know whether or not it is offered to [you/YOUTH].

YES 1

NO 0

DON’T KNOW d

REFUSED r

CURRENT JOB OR JOB WORKED IN PAST YEAR (III.A6=1 OR III.A7_MONTH-YEAR WITHIN PAST 12 MONTHS OR D, R)

III.A19. At this job, (do/did) most of the other workers have disabilities? (P18M-IX.A14//YTD36M-II.D1)

YES 1

NO 0

DON’T KNOW d

REFUSED r

CURRENT JOB OR JOB WORKED IN PAST YEAR (III.A6=1 OR III.A7_MONTH-YEAR WITHIN PAST 12 MONTHS OR D, R)

[NAME OR PLACE]

III.A20. (Is/Was) this job at [NAME OR PLACE] part of any school-sponsored work activities like a work-study job, an internship, or part of a school-based business? (P18M-IX.A15//YTD36M-II.D2)

INTERVIEWER: IF JOB WAS PART OF A SCHOOL-SPONSORED JOB AT FIRST, BUT YOUTH IS NO LONGER IN SCHOOL, SELECT “NO.”

YES 1

NO 0

DON’T KNOW d

REFUSED r

CURRENT JOB OR JOB WORKED IN PAST YEAR (III.A6=1 OR III.A7_MONTH-YEAR WITHIN PAST 12 MONTHS OR D, R)

[your/(his/her)] [you/(him/her)]

III.A21. Was there someone, either from [your/ (his/her)] school or from an agency, who went with [you/ (him/her)] to this job and helped [you/ (him/her)] to learn the job? (NLTS-FU, P21)

PROBE: This person can sometimes be called a job coach. His or her job is to help people learn the skills needed for a job while doing their job, as opposed to learning these skills at other places.

YES 1

NO 0

DON’T KNOW d

REFUSED r

BOX 6

IF JOBS IN III.A2 >1, CONTINUE WITH OTHER JOB(S) IN LOOPS (a-h) FOR ITEMS III.A4 THROUGH III.A21 AS APPLICABLE FOR EACH JOB.

IF NO MORE JOBS, GO TO III.A22 – UNLESS III.A22 WAS ASKED (III.A22 = 1 0 D OR R) THEN, GO TO III.A31.

youth reported job in past year (III.A2>0)

[YOU/YOUTH], [YOUR/YOUTH], [YOU DO/YOUTH DOES], [YOU ARE/YOUTH IS] [YOUR/(HIS/HER)]

III.A22. Thank you for telling me about these jobs, I just want to be sure we haven’t missed any job [you/ (YOUTH)] had in the past year. We just spoke about [your/YOUTH’s] job at:

[FILL JOB(S) FROM A5a-h]

Did (you/YOUTH) have any other jobs during the past year, even ones that lasted for just a short time? Do not include chores that (you do/YOUTH does) around the house, even if [you are/YOUTH is] paid to do them. (P18M- IX.A19/YTD36M-II.F2)

PROBE: A job is work, either paid or unpaid, other than work around the house. A job could be a school sponsored job or a work study job. Jobs include internships, apprenticeships, and volunteer work, even if you don't get paid. A job could be working for a business or organization or work that [you do/ (he/she) does] on [your/ (his/her)] own such as babysitting or dog walking.

YES 1

NO 0 GO TO III.A31

DON’T KNOW d GO TO III.A31

REFUSED r GO TO III.A31

YOUTH WORKED OTHER JOBS IN PAST YEAR NOT SPECIFIED (III.A22=1)

[YOU/YOUTH], [MONTH AND YEAR 1 YEAR AGO], [YOU WERE/YOUTH WAS]

III.A23. How many other jobs did [you/YOUTH] have during the past year?

Please do not include jobs you already told me about. Please include all jobs, even if [you/YOUTH] only worked for a short period of time. Please include jobs at which [you were/YOUTH was] self-employed or volunteered. (P18M- IX.A20/YTD36M-II.F2_num)

PROBE: That is since [month and year 1 year ago]?

| | | JOBS

(01-99)

DON’T KNOW d GO TO III.A31

REFUSED r GO TO III.A31

SOFT CHECK IF III.A23 >1: May I confirm that [you have/YOUTH has] had [FILL III.A23] jobs since this time last year, in addition to the jobs you have already told me about?

iii.a23 >0

[YOU/YOUTH], [NUMBER IN III.A24]

III.A24. Did any of these jobs last more than two weeks? (P18M- IX.A20a/YTD36M-II.F3)

YES 1 GO TO BOX 7

NO 0 GO TO III.A31

DON’T KNOW d GO TO III.A31

REFUSED r GO TO III.A31

SOFT CHECK: To confirm, (you/YOUTH) had [value from III.A23] job(s) that lasted more than two weeks?

BOX 7

IF YOUTH HAD MORE JOBS THAT LASTED MORE THAN 2 WEEKS (III.A24=1) AND HAS REPORTED FEWER THAN 8 JOBS TOTAL (IX.A2 <8), GO TO III.A2 AND ADD ADDITIONAL JOBS. RETURN THROUGH THE LOOP AS NEEDED FOR EACH NEW JOB.

YOUTH NOT WORKED IN PAST YEAR OR PAST YEAR WORK STATUS UNKNOWN (III.A1=0, D, OR R)

YOUTH NOT WORKING NOW OR WORK STATUS NOT KNOWN (III.A6 = 0 OR D OR R AT ALL LOOPS)

[Have you/Has YOUTH]

III.A25. [Have you/ Has YOUTH] been looking for work during the last four weeks? (NBS-B28/YTD36M-II.G4)

YES 1

NO 0 GO TO III.A27

DON’T KNOW d GO TO III.A28

REFUSED r GO TO III.A28

YOUTH NOT WORKING NOW, LOOKING FOR WORK (iii.a25=1)

[you/YOUTH] [FILL ONE STOP OFFICE NAME FOR PROGRAM STATE] [VR PROGRAM NAME IN PROGRAM STATE]

III.A26. I’m going to read you a list of things that some people do to look for work. Please tell me what [you/YOUTH] did during the last four weeks to look for work. In the last four weeks, did [you/YOUTH] . . . (NBS, B29 rev/YTD36M-II.G5 rev)

	YES	NO	DK	REF
a. Contact your state’s One Stop office, [FILL], Workforce Development office, or unemployment office?	1	0	d	r
b. Ask friends or relatives?	1	0	d	r
c. Look through job advertisements in a newspaper or on the internet?	1	0	d	r
d. Contact the State Vocational Rehabilitation Agency or [STATE VR NAME]?	1	0	d	r
e. Contact any employers in person, by mail, or by phone?	1	0	d	r
j. Do anything else that I didn’t mention?	99	0	d	r

YOUTH NOT LOOKING FOR WORK RIGHT NOW (III.A25=0)

[have you/ has YOUTH]

III.A27. Why [have you/has YOUTH] decided not to look for work right now? (NLTS2-W4, Q60)

PROBE: Any other reasons?

INTERVIEWER: code all that apply, read aloud only if needed.

DISABILITY IS TOO SEVERE 1

DON’T HAVE A WAY TO GET TO A JOB (TRANSPORTATION) 2

DON’T KNOW HOW TO FIND A JOB 3

DON’T WANT TO LOOK FOR WORK RIGHT NOW 4

DON’T NEED OR WANT A JOB RIGHT NOW 5

FAMILY DOES NOT WANT ME TO WORK 6

FEAR OF LOSING BENEFITS (LIKE SSI) IF I WORK 7

IN SCHOOL OR TRAINING PROGRAM 8

NO ONE WOULD HIRE ME - GAVE UP LOOKING 9

NOT INTERESTED IN THE KINDS OF JOBS I COULD GET 10

NO JOBS AVAILABLE 11

RAISING CHILDREN AND CHOSE NOT TO WORK NOW 12

WAITING TO HEAR ABOUT A JOB/START A JOB 13

OTHER REASON NOT LISTED ABOVE 14

DON’T KNOW d

REFUSED r

YOUTH NOT WORKED IN PAST YEAR OR PAST YEAR WORK STATUS UNKNOWN (III.A1=0, D, OR R)

YOUTH NOT WORKING NOW OR WORK STATUS NOT KNOWN (III.A6 = 0 OR D OR R AT ALL LOOPS)

[you are/YOUTH is] [Are you/is YOUTH] [You/YOUTH] [you want/(he/she wants] [You do/YOUTH does] [You are/YOUTH is] [You do/YOUTH does] [you need/(he/she) needs] [you/YOUTH] [You/YOUTH] [you are/(he/she) is]

III.A28. I’m going to read a list of reasons why some people do not work.

For each, please tell me if it is a reason why [you are/YOUTH is] not currently working.

[Are you/is YOUTH] not working because . . . (NBS-2017, B25/CPS)

PROBE: I need to read the entire list even though some of the reasons may not apply to you. If a reason does not apply, please just say so.

INTERVIEWER: IF RESPONDENTS SAYS 'DOES NOT APPLY' CODE AS 'NO'.

PROGRAMMER: RANDOMIZE THE SEQUENCE OF THESE ITEMS.

	YES	NO	DK	REF
a. [You/YOUTH] cannot find a job [you want/ (he/she) wants]?	1	0	d	r
b. [You do/YOUTH does] not have reliable transportation to and from work?	1	0	d	r
c. [You are/YOUTH is] caring for children or others?	1	0	d	r
d. [You do/YOUTH does] not want to lose benefits [you need/ (he/she) needs] like Social Security, disability insurance, workers’ compensation, or Medicaid?	1	0	d	r
e. A physical or mental condition prevents [you/YOUTH] from working?	1	0	d	r
f. [You/YOUTH] cannot find a job that [you are/ (he/she) is] qualified for?	1	0	d	r
g. [You/ YOUTH] is attending school and cannot work at the same time?	1	0	d	r

YOUTH NOT WORKED IN PAST YEAR OR PAST YEAR WORK STATUS UNKNOWN (III.A1=0, D, OR R)

YOUTH NOT WORKING NOW OR WORK STATUS NOT KNOWN (III.A6 = 0 OR D OR R AT ALL LOOPS)

[you are/YOUTH is]

III.A29. Are there any other reasons why [you are/ YOUTH is] not working at this time that I have not yet mentioned? (YTD36M-II.G7/NBS B26)

YES 1

NO 0 GO TO III.A31

DON’T KNOW d GO TO III.A31

REFUSED r GO TO III.A31

other reason why not working now (iii.a29=1)

[are you/is YOUTH]

III.A30-SPEC. Why [are you/is YOUTH] not working at this time? (NBS 2017, BP4a, rev, CPS)

INTERVIEWER: RECORD VERBATIM THEN CODE ALL THAT APPLY

(STRING 750)

DESCRIPTION

III.A30-CODE.

waiting to finish school or a training program 1

On layoff (temporary or indefinite) 2

Slack work/business conditions 3

Leave (maternity/paternity, personal) and vacation 4

previous attempts to work have been discouraging 5

cannot get help needed with personal care. [includes help dressing and bathing to get ready for work, or eating lunch, or using the restroom at work. 6

do not have special equipment or medical devices needed in order to work 7

Workplaces are not accessible to, or lack accommodations for people with a disability 8

other reason 9

DON’T KNOW d

REFUSED r

ALL CONSENTING (I.CONSENT=1)

III.A31. PROGRAMMER: INSERT DATE SECTION III.A (YOUTH EMPLOYMENT) WAS COMPLETED. POPULATE DATE AS [MM/DD/YYYY] THEN CONTINUE. (P18M- IX.A21)

CONTINUE 1

ALL CONSENTING (I.CONSENT=1)

III.A32. INTERVIEWER CHECK POINT:

IF R IS CONTINUING, SELECT ‘ABLE TO CONTINUE’ BELOW. if not able to continue and parent case not complete – select continue with EP and set callback for youth. if ep interview is complete or ep is unavailable, set callback OR STATUS youth AS REFUSAL, AS APPLICABLE.

YOUTH SURVEY R ABLE TO CONTINUE 1 GO TO IV.A1

YOUTH SURVEY R BREAK OFF – CONTINUE WITH PARENT I-VIEW 2 SET CALLBACK

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
IV.	Youth’s health and well-being	YES	YES

SECTION IV. PART A. Youth LIVING ARRANGEMENTS AND PARENTHOOD

ALL CONSENTING (I.CONSENT=1)

[your/youth’s]

IV.A-Intro. The next set of questions ask about [your/YOUTH’s] living situation, health, and well-being.

CONTINUE 1

ALL YOUTH NOT LIVING WITH PARENT OR GUARDIAN (I.Q5 = 3 OR 4, D OR R)

[your/YOUTH’s] [do you/does YOUTH] [you stay/YOUTH stays] [do you/does YOUTH]

IV.A1. Where [do you/does YOUTH] live now? If [you stay/YOUTH stays] in more than one place, where [do you/does YOUTH] stay most often? (YB2014, A0-A1/NLTS2-W4, 18)

In another person’s home (not a parent or foster parent), 1

In [your/youth’s] own place [you rent or own/ (he/she) rents or owns], 2

A group home or supervised living arrangement, 3

Dormitory (such as college, military or Job Corps housing), 4

A homeless shelter 5

A correctional facility (jail, prison, juvenile detention center), 6

Homeless and living on the street, or in a car, or 7

Some other place? 8

DON’T KNOW d

REFUSED r

ALL CONSENTING (I.CONSENT=1)

[you/(he/she)] [your/(his/her)] [Do you/Does YOUTH] [you are/(he/she) is]

IV.A2. Next I am going to ask about biological children, adopted, foster, and any other children for whom [you/(YOUTH)] may be responsible, even if they are not living in [your/(his/her)] household right now.

[Do you/Does YOUTH] have any children for whom [you are/ (he/she) is] responsible? (YTD-36M, X.D1, rev)

YES 1

NO 0 GO TO IV.B1

DON’T KNOW d GO TO IV.B1

REFUSED r GO TO IV.B1

YOUTH HAS CHILD(REN) RESPONSIBLE FOR (IV.A2= 1)

[your/YOUTH’s]

IV.A3. (Is this child/ Are any of these children) [your/ YOUTH’s] biological child (ren)? (YTD-36M, X.D4)

YES 1

NO 0 GO TO IV.B1

DON’T KNOW d GO TO IV.B1

REFUSED r GO TO IV.B1

youth has biological child(ren) (IV.A3 = 1)

[your/YOUTH’s] [IF NUM CHILDREN >1, FILL “FIRST”] [IV.A5]

IV.A4. INTERVIEWER, IF YOUTH HAS MORE THAN ONE CHILD, CHANGE TEXT AS NEEDED TO ASK ABOUT THE FIRST CHILD ONLY.

What month and year was [your/ YOUTH’s] (first) child born? (NEW)

PROBE: Your best guess is fine.

INTERVIEWER: help youth capture month with probes by season, as needed. probe for year with major life events.

programmer:

| | |//| | | | |

MONTH YEAR

(1-12) (1997-2021)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.A4_ year is < YOUTH’S YEAR OF BIRTH; I recorded that your first or oldest child was born in [FILL IV.A4]. What part should I correct?

SECTION IV. PART B. YOUTH HEALTH AND HEALTH INSURANCE

ALL CONSENTING (I.CONSENT = 1)

(your/ YOUTH’s) [your/ (his/her)]

IV.B1. In general, would [(you/YOUTH] say that [your/ (his/her)] health is . . . (P18M- XII.A1/YTD36M VI.B1/SF1)

Excellent, 1

Very good, 2

Good, 3

Fair, or 4

Poor? 5

DON’T KNOW d

REFUSED r

all SELF-REPORTING YOUTH (I.supt = 0 or 2) and all pry reports (i.prxy_avail = 1) where youth lives INDEPENDENTLY ( I.Q5=3 OR 4)

[ARE YOU/IS (YOUTH)] [you/YOUTH]

IV.B2. The next questions are about health insurance, including health insurance obtained through employment or purchased directly, as well as government programs like Medicaid and Medicare.

[Are you/Is (YOUTH)] covered by any kind of health insurance or some other kind of health care plan? (P18m- XII.C1/YTD36M-XI.A2, rev/NHIS, rev)

PROBE: This includes private insurance, as well as other types of health insurance [you/YOUTH] may receive or purchase through government programs.

Yes 1

No 0 GO TO IV.C1

DON’T KNOW d GO TO IV.C1

REFUSED r GO TO IV.C1

SOFT CHECK: IF IV.B2=0: May I confirm that I have recorded your answer correctly – that is that [you are/YOUTH is] not covered by any kind of health insurance at this time. This includes private insurance, as well as any insurance you may get through government programs.

YOUTH covered by insurance (iV.B2=1)

[Are you/is YOUTH], [you have/YOUTH has] [STATE MEDICAID NAME] [PROGRAM STATE]

IV.B3. What kind of health insurance or health care plan are [are you/is YOUTH], now covered by? If [you have/ YOUTH has] more than one kind of insurance, please let me know. (P18M- IV.A3, 4, 5, 6 - rev/NHIS, rev)

PROBE: Anything else?

IF NEEDED:

Private health insurance includes any health insurance other than [STATE MEDICAID NAME], Medicare, or TRICARE.

[STATE MEDICAID NAME] is the name for the Medicaid program in [PROGRAM STATE]. Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

INTERVIEWER: IF THE YOUTH NO LONGER LIVES IN [PROGRAM STATE], BUT IS ENROLLED IN (HIS/HER) CURRENT STATE, RECORD AS ‘YES’ BELOW.

Medicare is the federal health insurance program for people with disabilities.

TRICARE is a health insurance program for military service members and their families.

The children’s health insurance program (S-CHIP) is free or low-cost health insurance for uninsured children under age 19. This program helps reach uninsured children whose families earn too much to qualify for Medicaid, but not enough to get private coverage.

Private health insurance 1

Medicaid [or STATE MEDICAID NAME] 2

Medicare 3

TRICARE 4

CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) OR [STATE NAME] 5

OTHER KIND OF INSURANCE NOT LISTED ABOVE 6

DON’T KNOW d

REFUSED r

SOFT CHECK: IF YOUTH IS REPORTED TO HAVE INSURANCE (IV.B2=1) BUT INSURANCE TYPE IS NOT REPORTED (IV.B3_1 THROUGH IV.B5_6 = 0) May I confirm I have correctly recorded that [you/YOUTH] have/has health insurance coverage?

If not covered return to iv.b2 to correct the response.

IF covered, return to APPLICABLE ITEM(S) to update type of coverage.

YOUTH COVERED BY PRIVATE INSURANCE (IV.B3_1=1)

[STATE MARKETPLACE NAME]

IV.B3A. Was this private insurance purchased through the Affordable Care Act or a health insurance exchange, sometimes called [state marketplace name or] Healthcare.gov, or ObamaCare? (P18M-IV.A9/NHIS, modified)

YES 1

NO 0

DON’T KNOW d

REFUSED r

SECTION IV. PART C - YOUTH ENGAGEMENT WITH CRIMINAL JUSTICE SYSTEMS

ALL CONSENTING (I.CONSENT = 1)

[you/YOUTH]

IV.C1. Young people sometimes get in trouble with the law. These next questions are about experiences [you/YOUTH] may have had with the police or courts. All of your answers will be kept private to the fullest extent of the law. (YB 2014, F0/YTD36M, IX.B1)

CONTINUE 1

ALL CONSENTING (I.CONSENT = 1)

[Have you/Has YOUTH]

IV.C2. [Have you/ Has YOUTH] ever been arrested or taken into custody for a crime or illegal offense? Please include probation or parole violations, but do not include minor motor vehicle violations. (YB2014, F1)

PROBE: An arrest includes being arrested with or without charges, or being arrested with charges dropped. An arrest is any time someone is taken into custody by police or legal authority. This excludes traffic citations, other citations (such as littering or loitering), testifying, or being questioned by the police.

YES 1

NO 0 GO TO BOX 8

DON’T KNOW d GO TO BOX 8

REFUSED r GO TO BOX 8

IF ARRESTED (iv.C2=1)

[have you/has YOUTH] [you/YOUTH] [you have/YOUTH has] [IV.D3]

IV.C3. How many times [have you/has YOUTH] been arrested or taken into custody for a crime or illegal offense? (YB2014, F2)

PROBE: An arrest includes being arrested with or without charges, or being arrested with charges dropped. An arrest is any time someone is taken into custody by police or legal authority. This excludes traffic citations, other citations (such as littering or loitering), testifying, or being questioned by the police.

IF YOUTH SAYS “0”, PROBE: In the last question, you said [you/YOUTH] had been arrested, but just answered [you were/ YOUTH was] arrested 0 times. Would you like to go back and change your answer about being arrested or change the number of times [you have/YOUTH has] been arrested?

| | | ARRESTS

(1-99)

DON’T KNOW d

REFUSED r

SOFT CHECK: IV.C3 = 15-99; I just want to be sure I recorded your answer correctly.

You said that [you have/YOUTH has] been arrested or taken into custody for a crime or illegal offense [IV.C3] times. Is this correct?

youth arrested >0 times (IV.C3 >0)

[Were you/Was YOUTH]

IV.C4. [Were you/Was YOUTH] ever convicted or did [you/YOUTH] ever plead guilty to of any charges? (YTD-36M-IX.D1, D2/JC-J26, rev)

IF NEEDED: A conviction means a person was proven or declared guilty of an offense. In the United States, a person is convicted after a legal trial.

YES 1

NO 0 GO TO IV.C7

DON’T KNOW d GO TO IV.C7

REFUSED r GO TO IV.C7

YOUTH convicted or if PLEAD GUILTY TO CHARGE (IV.C4= 1)

[you/YOUTH] [are you/is YOUTH]

IV.C5. Did [you/YOUTH] serve time or [are you/is YOUTH] currently serving time in a juvenile or adult prison, jail, or other correctional facility on (that conviction/those convictions) or guilty plea(s)? (YTD36M, IX.E2-rev/JC-30)

YES 1

NO 0 GO TO IV.C7

DON’T KNOW d GO TO IV.C7

REFUSED r GO TO IV.C7

SERVED TIME OR CURRENTLY SERVING TIME FOR CONVICTIONS (IV.C5= 1)

[have you/has YOUTH]

IV.C6. How much time in total [have you/has YOUTH] ever spent in a juvenile or adult prison, jail, or other correctional facility? You may answer in days, weeks, months or years. (YTD36M, IX.E6/JC-J35)

INTERVIEWER: IF NO TIME SPENT, LEAVE THIS FIELD BLANK AND CODE 5 ON THE NEXT SCREEN.

| | | TIME SPENT

(0-99)

DON’T KNOW d

REFUSED r

IV.C6_UNIT. INTERVIEWER: ENTER UNIT. IF NO TIME WAS SPENT, CODE ‘5’ BELOW.

PROGRAMMER: DO NOT ALLOW DK OR REFUSED.

DAYS 1

WEEKS 2

MONTHS 3

YEARS 4

NO TIME SPENT 5

HARD CHECK: IF IV.C6 = EMPTY AND IV.C6_unit 1 - 4; INTERVIEWER: IV.C6 UNIT CAN ONLY BE 5 SINCE YOU DID NOT ENTER AN AMOUNT. PLEASE CORRECT.

HARD CHECK: IF IV.C6 = 1 – 99 AND IV.C6_UNIT = 5; INTERVIEWER: IV.C6 IS NOT BLANK; YOU CANNOT CODE 5 HERE. PLEASE CORRECT.

YOUTH arrested, ever (IV.C2=1)

[Have you/Has YOUTH]

IV.C7. [Have you/ Has YOUTH] been arrested in the past year?

PROBE: An arrest includes being arrested with charges, being arrested without charges, or being arrested with charges dropped. An arrest is any time someone is taken into custody by police or legal authority. This excludes traffic citations, other citations (such as littering or loitering), testifying, or being questioned by the police. (NLTS2012-FU, B30).

YES 1 GO TO BOX 8

NO 0 GO TO BOX 8

DON’T KNOW d GO TO BOX 8

REFUSED r GO TO BOX 8

SECTION IV.D. HOUSEHOLD BENEFITS AND INCOME FOR INDEPENDENT YOUTH

box 8

CONTINUE TO IV.D-intro IF YOUTH IS INDEPENDENT OR STATUS IS UNKNOWN (I.Q5 = 3 OR 4, D OR R). ALL OTHERS (I.Q5= 1 OR 2) GO TO SECTION V BOX 9

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[your/YOUTH’s] [your/(his/her)]

IV.D.INTRO. The next set of questions ask about benefits [your/YOUTH’s] household may receive, as well as [your/ (his/her)] household income. This information helps researchers better understand how family finances affect students’ ability to go to college or pursue other goals after high school. Your answers are important to the success of this study and will be kept private. (NEW)

CONTINUE 1

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[Do you/Does YOUTH] [STATE NAME FOR TANF]

IV.D1. [Do you/Does YOUTH] or does anyone in your household receive assistance from temporary assistance for needy families or [STATE NAME FOR TANF]? (P18M XII.D1a/YTD36M-XI.B1)

IF NEEDED: The Temporary Assistance for Needy Families (TANF) program provides families with financial assistance and related support services. These programs may include childcare assistance, job preparation, and work assistance.

YES 1

NO 0 GO TO IV.D2

DON’T KNOW d GO TO IV.D2

REFUSED r GO TO IV.D2

YOUTH’S household receives benefits from tanf (IV.D1=1)

[your/YOUTH’s] [STATE NAME FOR TANF]

IV.D1a. How much money did [your/YOUTH’s] household get from TANF, or [STATE NAME FOR TANF] last month? (YTD 36M XI.B1a, rev)

PROBE: Your best guess is fine.

INTERVIEWER: RECORD IN WHOLE DOLLARS.

| | | | | dollars

(0-9,000)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.E1a > $500: May I confirm I have correctly recorded last month’s TANF benefit as [IV.D1a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[Do you/Does YOUTH] [or STATE NAME FOR SNAP] [your/YOUTH’s]

IV.D2. [Do you/Does YOUTH] or does anyone in [your/YOUTH’s] household receive assistance from SNAP, the Supplemental Nutrition Assistance Program [or STATE NAME FOR SNAP]? (P18M XII.D1b/YTD36M-XI.B2)

IF NEEDED: SNAP provides a monthly supplement for purchasing nutritious food. Benefits are provided on an electronic card, called an EBT card that is used like an ATM card and accepted at most grocery stores. This program was formerly known as “food stamps.”

YES 1

NO 0 GO TO IV.D3

DON’T KNOW d GO TO IV.D3

REFUSED r GO TO IV.D3

YOUTH’S HOUSEHOLD receives snap benefits (IV.D2=1)

[your/YOUTH’s] [or STATE NAME FOR SNAP]

IV.D2a. How much did [your/YOUTH’s] household get from food stamps [or STATE NAME FOR SNAP] last month? (YTD 36-m, XI.B2a, rev)

PROBE: Your best guess is fine.

INTERVIEWER: record in whole dollars.

| | | | | dollars

(0-1,500)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.D2a >$500: May I confirm I have correctly recorded last month’s SNAP benefit as [IV.D2a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[Do you/Does YOUTH] [your/ YOUTH’s]

IV.D3. [Do you/Does YOUTH] or does anyone in [your/YOUTH’s] household receive any government housing assistance in paying rent, such as through public housing or Section 8? (P18M-XII.D1c/YTD36M-XI.B3)

IF NEEDED: This is also known as the Housing Choice Voucher Program. Section 8 provides funding to help people pay their rent.

YES 1

NO 0 GO TO IV.D4

DON’T KNOW d GO TO IV.D4

REFUSED r GO TO IV.D4

YOUTH household receives income from public-housing or section 8 (iV.D3=1)

[your/YOUTH’s]

IV.D3a. How much did [your/YOUTH’s] household receive from housing assistance in paying rent (such as through public housing or Section 8) last month? (YTD 36M XI.B3a rev)

PROBE: Your best guess is fine.

INTERVIEWER: record in whole dollars.

| | | | | dollars

(0-5,000)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.D3a > $1,500: May I confirm I have correctly recorded last month’s housing benefit as [IV.D3a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[your/ YOUTH’s] [YOUTH]

IV.D4. Does anyone in [your /YOUTH’s] household receive any income from SSI or SSDI because of a disability? (P18M-XII.D1d, rev/YTD36M-XI.C1)

IF NEEDED: SSI and SSDI provides payments to aged, blind, and disabled persons (including children).

YES 1

NO 0 GO TO IV.D5

DON’T KNOW d GO TO IV.D5

REFUSED r GO TO IV.D5

YOUTH reports household income ssi or ssdi (IV.D4 = 1)

[your/ YOUTH’s]

IV.D4a. How much did [your/ YOUTH’s] household receive from SSI or SSDI last month? (YTD36M-XI.C2)

PROBE: Your best guess is fine.

INTERVIEWER: record in whole dollars

| |,| | | | dollars

(0-9,999)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.D4a > $1,000: May I confirm I have correctly record last month’s SSI/SSDI benefit as [IV.D4a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[Do you/Does YOUTH] [your/YOUTH’s]

IV.D5. [Do you/Does YOUTH] or does anyone in [your/YOUTH’s] household receive retirement income from social security, a retirement plan, pension, 401k, or any other source of retirement income? (NEW)

IF NEEDED:

When you work and pay Social Security taxes, you earn “credits” toward Social Security benefits. Once you retire, and so long as you accumulated enough credits you are eligible to receive a Social Security benefit payment each month. It is based on how much you earned during your working career, and the age at which you decide to retire.

Survivors’ benefits are an extension of the Social Security program that pays out a portion, or all of the benefits, of a deceased individual to their surviving spouse or dependent children.

Under a retirement plan, such as a 401(k) or 403(b), the employee or employer (or both) contribute percent of employee’s earnings annually. These contributions are then invested, and the employee ultimately receives the balance following retirement.

A pension plan promises a specified monthly benefit at retirement. It may state this benefit as an exact dollar amount or may calculate through a formula using salary and years of service.

YES 1

NO 0 GO TO IV.D5

DON’T KNOW d GO TO IV.D5

REFUSED r GO TO IV.D5

YOUTH’S HOUSEHOLD HAS retirement income from social security (IV.D5=1)

[your/YOUTH’s]

IV.D5a. How much did [your/YOUTH’s] household receive in retirement income from all sources last month? (New)

PROBE: Your best guess is fine.

INTERVIEWER: record in whole dollars

| |,| | | | retirement income for household

(0-9,999)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.D5a > $1,500: May I confirm I have correctly recorded last month’s retirement income as [III.D5a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[PRIOR CALENDAR MONTH of YEAR] [IF IV.D5=1 FILL: retirement earnings, or] [your/YOUTH’s]

IV.D6. What were the total earnings of all persons in your household last month that is in [PRIOR CALENDAR MONTH of YEAR]?

Please include wages, salary, commissions, bonuses and tips from all jobs that all household members worked before taxes. Do not include [Fill: retirement earnings,] public benefits or other sources of income [your/ YOUTH’s] household may have received. (PROMISE 18M-XII.D3, rev)

INTERVIEWER: if no income that MONTH, record “0.”

| | | |,| | | | dollars (ALLOWABLE RANGE: 0-99,999) GO TO IV.E7

DON’T KNOW d GO TO IV.D6a

REFUSED r GO TO IV.D6a

Refused or dON’T KNOW household income for last year (IV.D6=D OR R)

[PRIOR CALENDAR YEAR] [your/YOUTH’s]

IV.D6a. I understand you may not be able to provide an exact number for [your/YOUTH’s] household’s earnings from salaries and other work. However, it would be extremely helpful if you could tell us which of the following ranges best describes your total household earnings from salaries and other work before taxes [PRIOR CALENDAR YEAR]. Was your total household earnings… (PROMISE 18M, XII.D3-rev)

PROBE: Do not include earnings from [retirement earnings or,] public benefits, or other sources of income outside of jobs or wages that [your/YOUTH’s] household may have received.

Less than $500, 1

$500 to less than $1,500, 2

$1,500 to less than $2,500, 3

$2,500 to less than $3,500, 4

$3,500 to less than $4,500, 5

$4,500 to less than $5,500, 6

$5,500 to less than $6,500, or 7

$6,500 or more? 8

DON’T KNOW d

REFUSED r

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

[your/YOUTH’s] [you/YOUTH]

IV.D7. [Do you/Does YOUTH] or does anyone in [your/YOUTH’s] household receive money from any source you have not already told me about - such as other kinds of public assistance, money from child support or alimony, interest, dividends, or money from friends and family?

Please do not include wages, salary, commissions, bonuses and tips from all jobs that all household members worked. (YTD36M, XI.F1-rev)

YES 1

NO 0 GO TO IV.D8

DON’T KNOW d GO TO IV.D8

REFUSED r GO TO IV.D8

YOUTH’S HOUSEHOLD HAS income from other sources (iv.D7=1)

[your/YOUTH’s]

IV.D7a. How much money did [your/YOUTH’s] household receive from these other sources last month? Please do not include wages, salary, commissions, bonuses and tips from all jobs that all household members worked. (YTD-36M, XI.F2-rev)

PROBE: Your best guess is fine.

INTERVIEWER: record in whole dollars

|__||__|,|__|__|__| DOLLARS (1-99,999)

DON’T KNOW d

REFUSED r

SOFT CHECK: IF IV.D7 > $1500: May I confirm I have correctly recorded [III.D7a]?

INDEPENDENT YOUTH OR WHERE INDEPENDENCE NOT KNOWN (I.Q5=3, 4, D, OR R)

IV.D8. INTERVIEWER CHECK POINT: IF R IS CONTINUING, SELECT ‘ABLE TO CONTINUE’ BELOW. if not able to continue and parent case not complete – select continue with EP and set callback for youth. if ep interview is complete or ep is unavailable, set callback OR STATUS youth AS REFUSAL, AS APPLICABLE.

YOUTH SURVEY R ABLE TO CONTINUE 1 GO TO BOX 9

YOUTH SURVEY R BREAK OFF – CONTINUE WITH PARENT I-VIEW 2 SET CALLBACK

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
V.	Youth’s self-determination and expectations for the future	YES	NO

PROGRAMMER BOX 9

this section is asked If youth is self-reporting YOUTH ONLY.

INTERVIEWS NOW IN PROXY MODE (i.prxy_avail=1) SHOULD GO TO section vi. box 10.

eLSE, IF IN SELF-REPORTING MODE (I.supt = 0 or 2), CONTINUE TO V.A1.

ACROSS THIS SERIES, THE SOURCE IS THE Adolescent Self-Determination Scale-Short Form, derived from The Arc’s Self-Determination Scale. ABBREVIATED TO (“aRC sd sCALE, qxx”).

SECTION V. PART A. Self-Determination: Autonomy

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.A1. Now I am going to read some statements. For each, please tell me the answer that best tells how you act in that situation. There are no right or wrong answers. (P18M- XI.A1)

PROBE: Tell me the answer that best tells how you act in this situation. If your disability limits you from actually performing the activity, but you have control over the activity – such as a personal care attendant, answer as if you performed that activity.

PROGRAMMER: DO NOT RANDOMIZE SEQUENCE OF THESE ITEMS.

	I do not do that even if I have the chance	I do that sometimes when I have the chance	I do that most of the time I have the chance	I do that every time I have the chance	DK	REF
a. “My friends and I choose activities that we want to do.” The choices are… (ARC SD Scale, 14)	1	2	3	4	d	r
b. “I write letters, texts, or talk on the phone to friends and family.” The choices are… (ARC SD Scale, 15)	1	2	3	4	d	r
c. “I go to restaurants that I like.” The choices are…(ARC SD Scale, 18)	1	2	3	4	d	r
d. “I choose gifts to give to family and friends.” IF NEEDED: The choices are…(ARC SD Scale, 30)	1	2	3	4	d	r
e. “I go to movies, concerts, and dances.” IF NEEDED: The choices are … (ARC SD Scale, 19)	1	2	3	4	d	r
f. “I plan weekend activities that I like to do.” IF NEEDED: The choices are… (ARC SD Scale, 12)	1	2	3	4	d	r
g. “I decorate my own room.” IF NEEDED: The choices are… (ARC SD Scale, 31)	1	2	3	4	d	r

SECTION V. PART B. Self-Determination: Psychological Empowerment

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B1. Next, I am going to read you two statements. Please tell me the one that best describes you. Choose only one answer. There are no right or wrong answers. (P18M-XI.B1-/ARC SD Scale, 47)

Trying hard at school doesn't do me much good, or 1

Trying hard at school will help me get a good job 2

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B2. Which statement best describes you? (P18M-XI.B2-/ARC SD Scale, 49)

PROBE: There are no right or wrong answers.

It is no use to keep trying because that won't change things, or 1

I keep trying even after I get something wrong 2

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B3. READ IF NECESSARY: Which statement best describes you? (P18M-XI.B3-/ARC SD Scale, 51)

I don't know how to make friends, or 1

I know how to make friends 2

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B4. READ IF NECESSARY: Which statement best describes you? (P18M-XI.B4-/ARC SD Scale, 53)

I do not make good choices, or 1

I can make good choices 2

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B5. READ IF NECESSARY: Which statement best describes you? (P18M-XI.B5-/ARC SD Scale, 57)

My choices will not be honored, or 1

I will be able to make choices that are important to me 2

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.B6. READ IF NECESSARY: Which statement best describes you? (P18M-XI.B6-/ARC SD Scale, 55)

I will have a hard time making new friends, or 1

I will be able to make friends in new situations 2

DON’T KNOW d

REFUSED r

SECTION V. PART C. Self-Determination: Self-Realization

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.C1. Now I am going to read some statements. Please tell me whether you think each of these describes how you feel about yourself or not. IF NEEDED: There are no right or wrong answers. (P18M-XI.C1/ARC SD Scale)

IF NEEDED: You agree or you don’t agree?

PROGRAMMER: DO NOT RANDOMIZE SEQUENCE OF THESE ITEMS.

	Agree	Don’t agree	DK	REF
a. I know what I do best. (Q65)	1	2	d	r
b. I like myself. (Q68)	1	2	d	r
c. I am confident in my abilities. (Q72)	1	2	d	r
d. Other people like me. (Q71)	1	2	d	r
e. It is better to be yourself than to be popular. (Q63)	1	2	d	r
f. I know how to make up for my limitations. (Q70)	1	2	d	r
g. I am loved because I give love. (Q64)	1	2	d	r

SECTION V. PART d. Self-Determination: Agentic Action

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.D1. IF NEEDED: Please tell me whether you think this statement describes how you feel about yourself or not. There are no right or wrong answers. (Self-Determination Inventory: Student Report SDI: SR, Agentic Action series)

IF NEEDED: You agree or you don’t agree?

PROGRAMMER: DO NOT RANDOMIZE SEQUENCE OF THESE ITEMS.

	Agree	Don’t agree	DK	REF
a. I think of more than one way to solve a problem. (Q2)	1	2	d	r
b. I set my own goals. (Q7)	1	2	d	r
c. I figure out ways to get around obstacles. (Q11) IF NEEDED: An obstacle is something that gets in your way.	1	2	d	r
d. I think about each of my goals. (Q14)	1	2	d	r
e. I take action when new opportunities come my way. (Q19) IF NEEDED: An opportunity is a chance or a possibility.	1	2	d	r
f. I come up with ways to reach my goals. (Q21)	1	2	d	r

SECTION V PART E. YOUTH’S EXPECTATIONS FOR THE FUTURE

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E-Intro My next questions are about what you think will happen in the future. (P18M- XI.D.Intro)

CONTINUED 1

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E1. How far do you think you will get in school? (P18M- XI.D1)

PROBE: What is the highest level of schooling you think you will complete?

INTERVIEWER: Code a certificate of completion or attendance as “HIGH SCHOOL DIPLOMA.” if “college” probe as to whether that is a 2-year oR a 4-year college.

Less than high school - will not graduate or get a GED 1

High school diploma or certificate of completion, 2

GED, 3

Vocational, technical, or trade school, 4

2-year or community college, 5

4-year college or university, or a 6

Master’s, PhD, or other advanced degree? 7

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E2. When you are age 25, do you think you will be living ... (P18M- XI.D2)

With parent/guardian(s), sibling(s) or other relative(s), 1

On your own or with a spouse or partner, 2

In a group home or institution, or in an, 3

Other living situation? 4

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E3. When you are age 25, how likely do you think it is that you will earn enough to support yourself without financial help from your family? Do you think you … (P18M- XI.D3, rev)

Definitely will, 1

Probably will, 2

Probably won’t, or 3

Definitely won’t? 4

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E4. When you are age 25, how likely do you think it is that you will earn enough to support yourself without financial help from government benefit programs? Do you think you … (P18M- XI.D3)

Definitely will, 1

Probably will, 2

Probably won’t, or 3

Definitely won’t? 4

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E5. When you are age 25, how likely do you think it is that you will be working at a paid job? Do you think you … (P-18M-XI.D4)

Definitely will, 1

Probably will, 2

Probably won’t, or 3

Definitely won’t? 4

DON’T KNOW d

REFUSED r

SELF-REPORTING YOUTH (I.supt = 0 or 2)

V.E6. INTERVIEWER CHECK POINT:

IF R IS CONTINUING, SELECT ‘ABLE TO CONTINUE’ BELOW. if not able to continue and parent case not complete – select continue with EP and set callback for youth. if ep interview is complete or ep is unavailable, set callback OR STATUS youth AS REFUSAL, AS APPLICABLE.

YOUTH SURVEY R ABLE TO CONTINUE 1 GO TO BOX VI.INTRO

YOUTH SURVEY R BREAK OFF – CONTINUE WITH PARENT I-VIEW 2 SET CALLBACK

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
VI.	Knowledge of SSA benefits and work incentives	YES	NO

PROGRAMMER BOX 10

continue to VI.intro if self-reporting youth (I.SUPT=0 OR 2).

if proxy (I.PRXY_AVAIL=1) go to VII.A1.

self-reporting youth (I.SUPT=0 OR 2)

VI.INTRO. Next, I’ll ask about some Social Security Administration policies and about some specific programs. Not everyone is familiar with these, so if you don’t know the answer to a question, that’s OK – just let me know and we will move on.

CONTINUE 1

self-reporting youth (I.SUPT=0 OR 2)

VI.A1. I’m going to read you a statement. Please tell me if you think it is true or not true.

IF NEEDED: Is that statement true or not true?

PROBE: If you are not sure, that’s OK, you can tell me that, as well.

PROGRAMMER: RANDOMIZE SEQUENCE OF THESE ITEMS.

	CODE ONE PER ROW
	TRUE	NOT TRUE	DK	REF
a. Children receiving SSI are automatically eligible for SSI as adults.	1	2	d	r
b. People who get SSI (Supplemental Security Income) are not allowed to work at a job for pay. (NEW)	1	2	d	r
c. People who receive SSI benefits must report any money they get from working to the Social Security Administration (SSA). (NEW)	1	2	d	r

self-reporting youth (I.SUPT=0 OR 2)

VI.A2. My next question is about the “Student Earned Income Exclusion (SEIE).”

SEIE is for youth under age 22 who are in school when they are working. In 2018, you could earn up to $1,820 per month or up to $7,350 per year and not have it not counted when Social Security figured your benefit.

Have you ever heard of the student earned-income exclusion before today? (YTD36M-V.E2 rev, NBS-E12, rev)

INTERVIEWER: IF ‘DON’T KNOW’, PROBE TO SEE IF RE-READING THE DEFINITION WOULD BE USEFUL. IF NOT, CODE AS DON’T KNOW.

YES 1

NO 0

DON’T KNOW d

REFUSED r

PROGRAMMING NOTE: THIS ITEM WILL GET AN ANNUAL TEXT UPDATE ONCE THE NEW INCOME LIMITS ARE POSTED FOR 2019 AND 2020.

self-reporting youth (I.SUPT=0 OR 2)

VI.A3. Social Security offers something called a “Plan for Achieving Self-Support” or a “PASS Plan.” It lets you set aside money to be used to help you reach a work goal. The money set aside does not affect your benefits.

Have you ever heard of the Plan for Achieving Self-Support or a PASS Plan before today? (YTD36M-V.B3/NBS E3, rev)

INTERVIEWER: IF ‘DON’T KNOW’, PROBE TO SEE IF RE-READING THE DEFINITION WOULD BE USEFUL. IF NOT, CODE AS DON’T KNOW.

YES 1

NO 0

DON’T KNOW d

REFUSED r

self-reporting youth (I.SUPT=0 OR 2)

VI.A4. Social Security has a rule called the 1 for 2 earnings exclusion where one-half of your earnings over $85 are not counted when Social Security figures your SSI benefit.

Have you ever heard of the 1 for 2 earnings exclusion before today? (NBS modified)

IF NEEDED: (Only if respondent questions the $85 figure) Social Security does not count $20 of income from any source and $65 of earnings before applying the 1 for 2 earnings exclusion.

INTERVIEWER: IF ‘DON’T KNOW’, PROBE TO SEE IF RE-READING THE DEFINITION WOULD BE USEFUL. IF NOT, CODE AS DON’T KNOW.

YES 1

NO 0

DON’T KNOW d

REFUSED r

self-reporting youth (I.SUPT=0 OR 2)

VI.A5. There is now a special kind of savings account called an ABLE account. ABLE stands for “Achieving a Better Life Experience.” Up to $100,000 saved in an ABLE account does not count as a resource under SSI rules.

Have you ever heard of an ABLE account before today? (NEW)

INTERVIEWER: IF ‘DON’T KNOW’, PROBE TO SEE IF RE-READING THE DEFINITION WOULD BE USEFUL. IF NOT, CODE AS DON’T KNOW.

YES 1

NO 0

DON’T KNOW d

REFUSED r

		Asked of Self-Reporting Youth	Asked of Youth’s Proxy
VII.	Youth Contact Information	YES	YES

ALL CONSENTING (I.CONSENT=1)

VIIA.INTRO. The last set questions will be about how to contact [you/YOUTH]. (NEW)

ENTER 1 TO CONTINUE 1

ALL CONSENTING (I.CONSENT = 1)

[YOUR/youth’s] [YOUTH MAILING ADDRESS FROM SAMPLE FILE] [do you/does YOUTH]

VII.A1. What is [your/YOUTH’s] home address? [IF ADDRESS NE . FILL: Is it [YOUTH MAILING ADDRESS FROM SAMPLE FILE]?

IF NEEDED: This is where we will mail [your/ YOUTH’s] thank you letter and payment for this interview. (P18M-XIII.B1/YTD-BL-Q5 rev)

PROBE: What street [do you/does YOUTH] live on? In what town? If you don’t know the full address, that’s OK, just share as much as you can remember.

SAME ADDRESS AS SHOWN ABOVE 1 GO TO VII.A3

ADDRESS ABOVE NOT CORRECT – UPDATE AS FOLLOWS: 99 GO TO VII.A2

DON’T KNOW d GO TO VII.A3

REFUSED r GO TO VII.A3

YOUTH ADDRESS UPDATED: (VII.A1= 99)

[YOUR/youth’s]

VII.A2. What is [your/YOUTH’s] home address? (P18M- XIII.B1)

INTERVIEWER: IF REFUSES, PROBE FOR ZIP CODE.

STREET 1/APT #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r

ALL CONSENTING (I.CONSENT = 1)

[YOUR/(YOUTH)’S], POPULATE FILL FOR [YOUTH PHONE] FROM SAMPLE FILE

VII.A3. What is the best telephone number to reach [you/ (YOUTH)] at? Is it [youth phone] or another number? (P18M- XIII.B2)

SAME PHONE NUMBER AS ABOVE …1 GO TO VII.A5

DIFFERENT PHONE NUMBER – UPDATE BELOW 99

DON’T KNOW d GO TO VII.A5

REFUSED r GO TO VII.A5

YOUTH PHONE UPDATED (VII.A3 = 99)

[YOUR/(YOUTH)’S]

VII.A4. What is the best telephone number to reach [you/ (YOUTH)] at? (P18M-XIII.B2)

| | | | - | | | | - | | | | |

(0-999) (0-999) (0-9999)

ALL CONSENTING (I.CONSENT = 1)

FILL PHONE IF I.MODE=1 OR 3/FILL FIELD IF I.MODE = 2.

VII.A5. Thanks for answering these questions. We’ll [send/give] [you/YOUTH] a gift card for completing this interview. Would [you/YOUTH] like a card to Walmart, Target, or a VISA gift card?

PHONE: The gift card will be mailed with a thank you letter. It should arrive in the next 2-3 weeks.

FIELD: In just a moment, I’ll need you to sign your name on this tablet to show that you received it.

WALMART 1

TARGET 2

VISA CARD 3

ALL CONSENTING (I.CONSENT = 1) WHERE PARENT SURVYE IS COMPLETE

FILL PHONE IF I.MODE=1 OR 3/FILL FIELD IF I.MODE = 2.

VII.A5. Thanks for your time today, we appreciate it! Have a great day.

YOUTH INTERVIEW IS COMPLETE 1 TERMINATE

all consenting (i.consent = 1) WHERE PARENT SURVEY NOT COMPLETE

[ep]

VII.A6. Thanks for your time today, we appreciate it! Now I’d like to begin the next interview with [EP]. Would (he/she) be available to speak now?

IF NEEDED: The parent interview should take about 25-35 minutes to complete.

BEGIN PARENT INTERVIEW NOW 1 GO TO PARENT

SET APPT FOR PARENT INTERVIEW 2 SET CALLBACK