HUD RR Survey Instrument TO HUD FINAL_20181217

Hello, my name is Alex/Amy Williams and I am calling from Decision Information Resources for the Rent Reform Demonstration Study. I am trying to reach [FLNAME] for a short, paid interview.

Please have [FLNAME] call us at 1-844-672-4088. Thank you.

A_LINTRO.

Hello, my name is Alex/Amy Williams.

INTERVIEWER: PLEASE PRESS “NEXT” TO CONTINUE.

CATI: IF A_TYPE=2, GO TO SRCE1; ELSE GO TO INT02

SRCE1. Are you...

1 Responding to a ‘Sorry I Missed You’ card that was left at your door? OR

2 Responding to a letter or postcard you received in the mail or voice mail message from Alex/Amy Williams or someone else?

7 DON’T KNOW

8 REFUSED

CATI: ALL GO TO INT02

INT01.

Hello, my name is Alex/Amy Williams and I work at Decision Information Resources, Inc.; we are working on a study of people’s experiences with the Rent Reform Demonstration at the [PHA NAME] . May I please speak to [FLNAME]?

INTERVIEWER: IF NECESSARY, READ:

“[FLNAME] is participating in a study about the [PHA NAME’S] Rent Reform Demonstration.”

1 RESPONDENT AVAILABLE – CONTINUE

19 RESPONDENT NOT AVAILABLE – ARRANGE CALLBACK AND ENTER CALL NOTE (GO TO RCONU)

22 SOFT REFUSAL (GO TO END INTERVIEW)

8 REFUSED – ENTER DISPOSITION CODE AND CALL NOTE DESCRIBING SITUATION IN THE CALL RECORD TEXT BOX (GO TO END INTERVIEW)

INT02.

Thank you for taking the time to speak with me today.

INTERVIEWER: IF R INDICATES READINESS TO PARTICIPATE AFTER THIS POINT OR SEEMS TO BECOME IMPATIENT WITH THE SCRIPT, STOP READING AND CONTINUE ON.

Decision Information Resources is conducting follow-up surveys with families who were enrolled in the HUD Rent Reform Demonstration study. You entered the study in [RAMY]. You may have received a letter recently to let you know that the survey was available and we might be calling soon.

The survey should take about [DURATION] minutes. We will mail you a $[INCENTIVE] gift card as a “thank you” for completing the survey.

CATI: GOTO SCRN1

SCRN1.

Before we begin, I’d like to confirm that I am speaking with the correct person. In order to do so, could you please tell me your date of birth?

____ ____ ____ ____

7 DON’T KNOW (GOTO INT3)

8 REFUSED (GOTO INT3)

CATI:

IF SCRN1= DOB FROM SAMPLE FILE GO TO INT4. RMNCONF = 1

IF (SCRN1 ≠ DOB) RMNCONF = 2; GOTO INT3

INT3.

There seems to be a technical problem with your file. Thank you for your time and patience. We will contact you as soon as we resolve this problem. Your information is important to us and to the success of this study. Have a nice day/evening.

(PRESS ANY KEY TO END SURVEY)

RCONU.

IF R IS CONFIRMED BUT UNAVAILABLE, READ:

Could you tell me a good time to reach her?

RECORD CALLBACK TIME.

Thank you, I will call back then.

IF SPEAKING WITH R, READ:

What is the best time for us to call you back to complete the survey?

RECORD CALLBACK TIME.

Thank you, I will call back then.

IF R NO LONGER LIVES THERE, READ:

Is there a number where [FLNAME] can be reached? May I have it please?

INTERVIEWER: MAKE NOTE OF NEW NUMBER AND MAKE PERMANENT MESSAGE.

Thank you for your assistance.

THEN TRY NEW NUMBER.

ENTER NEXT AND SET APPOINTMENT.

INT4.

Thank you for confirming this information with me.

The U.S. Department of Housing and Urban Development has hired Decision Information Resources (DIR) to conduct a study on the Rent Reform Demonstration at the [PHA NAME]. Before we begin, I am required to tell you that the questions in this survey have been reviewed by the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995. The survey should take about 30 minutes. HUD may not conduct or sponsor, and a person is not required to respond to, a collection information unless that collection displays a valid OMB control number 2528-0306, expiring xx-xx-xxxx.

We would like to ask you some questions about yourself and, if applicable, the people in your household, and your experiences with the voucher program. The information we collect will be kept confidential. The information requested under this collection is protected and held confidential and will be protected to the fullest extent possible by law, including 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130.

Your responses will be combined with about 6,000 other participants and will be reported only for groups of individuals. Your participation will not affect your participation in the voucher program, HUD Rent Reform Demonstration or any benefits you may receive now or in the future. Your responses will in no way affect your eligibility for housing assistance or the way your rent amount is calculated by [PHA_NAME].

Your responses to these questions are completely voluntary. You may choose not to answer any question if you wish.

And finally, this interview might be monitored or recorded for quality control purposes.

Do I have your consent to continue with this interview?

1 YES

2 NOT NOW (GO TO RCONU)

97 DON’T KNOW (GO TO RCONU)

98 REFUSED (GO TO END INTERVIEW)

CATI: RECORD END DATE (SECAEDDT) AND TIME (SECAEDTM)

SECTION B: EDUCATIONAL ATTAINMENT

CATI: RECORD START DATE (SECBSTDT) AND TIME (SECBSTTM)

B1. What, from this list, is the highest level of education that you have completed?

INTERVIEWER: READ LIST

Did not complete high school or receive GED (GO TO B2)
GED certificate
High school diploma
Some college
Associate’s degree/2-year college
Four-year college degree, or
Graduate degree?
DON’T KNOW
REFUSED

B1a. Did you receive your highest educational degree or certificate after [REF_DATE]?

INTERVIEWER: IF NECESSARY, READ: This is around when you would have gone in for recertification at [PHA_NAME] in [YEAR]?

BEFORE
AFTER

DON’T KNOW
REFUSED

B2. Do you have any type of trade license or training certification?

YES
NO (GO TO C1)
97 DON’T KNOW (GO TO C1)
REFUSED (GO TO C1)

B2a. What type of license or certification is it?

PROBE: What type of trade or work does it qualify you to do?

INTERVIEWER: IF RESPONDENT HAS MULTIPLE LICENSES/CERTIFICATES ASK ONLY ABOUT MOST RECENT.

___________________________________________

97 DON’T KNOW

98 REFUSED

B2b. Did you receive your trade license or training certification before [REF_DATE] or after [REF_DATE]?

INTERVIEWER: DATE IS MONTH AND YEAR R RECERTIFIED RENT WITH PHA IN [YEAR].

BEFORE
AFTER

DON’T KNOW
REFUSED

B3. Are you currently working toward ANY education degree or training license or training certificate?

1 YES

2 NOT NOW

97 DON’T KNOW

98 REFUSED

CATI: RECORD END DATE (SECBEDDT) AND TIME (SECBEDTM)

SECTION C: JOB HISTORY, WORK SEARCH, & BARRIERS TO EMPLOYMENT

CATI: RECORD START DATE (SECCSTDT) AND TIME (SECCSTTM)

C1. The next questions are about any paid work that you may be doing currently or have done at different times during the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1]. This includes working for a private employer, school or hospital, or government agency; or picking up temporary, seasonal, or odd jobs.

Please also include any type of self-employment or running your own business, such as providing child care or in-home nursing care, making home repairs, doing taxes for people, housecleaning, cooking and catering, sewing, doing nails or hair; or doing other paid work.

Please do not count volunteer work or unpaid internships or work experience jobs. Again, I would like to remind you that your answers will remain entirely confidential.

In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR -1], have you worked for pay or were self-employed? Please don't count unpaid work experience or unpaid volunteer work.

1 YES (GO TO C1b)

2 NO

97 DON’T KNOW

98 REFUSED

C1a. A lot of people have irregular, odd, or side jobs, or do extra work to make ends meet. Have you done any work like that for pay in the last 12 months?

Again, I want to assure you that none of your answers will be discussed with anyone.

1 YES

2 NO (GO TO C23)

97 DON’T KNOW (GO TO C25)

98 REFUSED (GO TO C25)

C1b. How many jobs have you held during the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1]?

INTERVIEWER: SELF-EMPLOYMENT OR TEMPORARY OR "TEMP" WORK IN THE SAME FIELD COUNTS AS ONE JOB.

INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10

________ [RANGE 1- 10]

NUMBER

97 DON’T KNOW

98 REFUSED

ASK IF C1b=0, ELSE GOTO C1c.

C1b_CONF

Earlier you said you have had a job in the past 12 months and now you are saying no jobs in the past 12 months. Can you help me with this?

R DID HAVE A JOB IN THE PAST 12 MONTHS (GOTO C1b AND REVISE ANSWER)
R DID NOT HAVE A JOB IN THE PAST 12 MONTHS (GOTO C23)

CATI: IF C1b_CONF =2, C1=2

C1c. Since [CURRENT MONTH] [CURRENT YEAR -1], about how many months were you working for pay or self-employed?

PROBE: Your best estimate is fine.

INTERVIEWER: ROUND UP IF RESPONSE IS NOT IN WHOLE MONTHS

________ [RANGE 1 -12]

MONTHS

97 DON’T KNOW (GO TO C2)

98 REFUSED (GO TO C2)

ASK IF C1c=0, ELSE GOTO C1d

C1c_CONF Earlier you said you had worked in the past 12 months and now you are saying you haven’t worked in the past 12 months. Can you help me with this?

R DID WORK IN THE PAST 12 MONTHS (GOTO C1c AND REVISE ANSWER)
R DID NOT WORK THE PAST 12 MONTHS (GOTO C1b AND REVISE ANSWER)

C1d. During these [C1c] months did you usually work full-time—that is, 35 or more hours a week?

INTERVIEWER: IF R SAYS "YES" BUT INDICATES WORKING LESS THAN 35 HOURS, SAY "So, did you usually work 35 hours or more?"

DON’T KNOW
REFUSED

C2. Are you currently working for pay, or self-employed?

1 YES

2 YES, CURRENTLY ON LEAVE, TEMPORARY LAY-OFF, OR VACATION

3 NO (GO TO C3)

97 DON’T KNOW (GO TO C3)

98 REFUSED (GO TO C3)

C2a. How many jobs do you currently have?

INTERVIEWER: SELF-EMPLOYMENT OR TEMPORARY OR "TEMP" WORK IN THE SAME FIELD COUNTS AS ONE JOB.

INTERVIEWER INSTRUCTION: IF GREATER THAN 5, CODE THE RESPONSE AS 5

________ [RANGE 1-5]

NUMBER

97 DON’T KNOW

98 REFUSED

[CATI: IF C2a = 1, 97, 98, GO TO C3 (WORKING 1 JOB OR DID NOT ANSWER)]

C2b. Thinking about all your current jobs, how many hours per week do you work?

INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84

________ [RANGE 1 – 84]

NUMBER

97 DON’T KNOW

98 REFUSED

C3. I'd like to ask you some questions about your [current/most recent] job.

[CATI: IF C2a=2-5, ADD] “Please focus on the job at which you work the most hours.”

[IF C2 = 3, 97, OR 98, ADD] “Please focus on the most recent job for which you worked for pay or were self-employed during the last 12 months.”]

What kind of business or industry is this? What do they make or do where you work?

INTERVIEWER: ENTER VERBATIM RESPONSE. PROBE AS NEEDED.

______________________________________________________

97 DON’T KNOW

98 REFUSED

C3a. What kind of work do you do? For example, teacher, nurse’s aide, home health aide, child care, cook, plumber, receptionist.

INTERVIEWER: ENTER VERBATIM RESPONSE. PROBE AS NEEDED.

______________________________________________________

97 DON’T KNOW

98 REFUSED

C3b. How would you best describe this job? Would you say you…

[work/worked] for an employer,
[are/were] self-employed, or
[are/were] working at a seasonal, temporary, or odd job?

DON’T KNOW
REFUSED

C4. What month and year did you start [CATI: IF C2 = 3, 97, or 98, INSERT: “and end”] this job?

INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02. IF STILL WORKING, ENTER 77/7777 FOR END DATE OF JOB.

C4a. START: ___ ___/___ ___ ___ ___

MONTH YEAR

97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR

98 REFUSED MONTH 9998 REFUSED YEAR

[CATI: IF C2 = 1, 2, GO TO C5]

C4b. END: ___ ___/___ ___ ___ ___

MONTH YEAR

77 STILL WORKING 7777 STILL WORKING

97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR

98 REFUSED MONTH 9998 REFUSED YEAR

C5. [IF C2 = 3, 97, OR 98, ADD "Now/Just before you left,"] Including overtime, how many hours per week [do/did] you usually work on this job?

INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84

[RANGE: 1- 84] (GO TO C6)

HOURS/WEEK

97 DON’T KNOW

98 REFUSED

C5a. Would you say that you usually [work/worked]…

1 to 20 hours per week,
21 to 34 hours per week, or
35 or more hours per week?

DON’T KNOW
REFUSED

C6. How many days per week [do/did] you usually work?

[RANGE: 1- 7]

DAYS/WEEK

97 DON’T KNOW

98 REFUSED

C7. What [are/were] your earnings from your job or income from self-employment [now/just before you left] before taxes? Please include tips, commissions, and regular overtime pay.

INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.

$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]

AMOUNT

999999.97 DON’T KNOW (GO TO C10)

999999.98 REFUSED (GO TO C10)

C8. [Is/Was] that…

1 Per hour,

2 Per week,

3 Every 2 weeks,

4 Twice a month,

5 Once a month,

6 Per year,

7 Per day, or

8 Some other way?

97 DON’T KNOW

98 REFUSED

CATI: IF C8=8, ASK C8_O, ELSE GO TO C9

C8_O. How often did you receive that amount?

________________________________________

97 DON’T KNOW

98 REFUSED

C9. [Is/Was] that before or after taxes?

1 BEFORE

2 AFTER

3 DON’T KNOW

4 REFUSED

CATI: IF C3b=2, GO TO C11.

C10. Now I’d like to ask a few questions about benefits that may be available at your job. Through your employer are you eligible for any of the following benefits? By eligible we mean the benefit is available for you now, even if you have decided to not receive it or have not needed it.

INTERVIEWER: SELECT “YES” IF R REPORTS THAT R WILL BE OFFERED BENEFITS AT A FUTURE TIME UPON REACHING A MILESTONE, SUCH AS COMPLETING A PROBATION PERIOD FOR NEW EMPLOYEES OR TRANSITIONING FROM PART-TIME TO FULL-TIME HOURS.

	YES	NO	DON’T KNOW	REFUSED
C10a. Any sick days with full pay?	1	2	7	8
C10b. Any vacation days with full pay?	1	2	7	8
C10c. Paid overtime?	1	2	7	8
C10d. A plan that gives you money for retirement?	1	2	7	8
C10e. A health plan or medical insurance, including any offered at a cost to you?	1	2	7	8

C11. Which of the following best describes your usual weekly work schedule at your job or business [now/during the last month you worked]? [Do/Did] you work a…

Regular daytime shift,
Regular evening shift,
Regular night shift,
Rotating shift (one that changes every few days or weeks),
Split shift (one consisting of two distinct periods each day),
An irregular schedule (one that changes from day to day), or
Something else?

DON’T KNOW
REFUSED

CATI: IF C11=7, ASK C11_O, ELSE GO TO CATI INSTRUCTIONS BELOW C11_O.

C11_O. What is your usual weekly work schedule like at this job?

________________________________________

97 DON’T KNOW

98 REFUSED

CATI:

IF C2=1 OR 2 AND C2A=1 OR 97 OR 98 GO TO C25.

IF C2=1 OR 2 AND C2A=2-5 ASK C12.

C12. Let’s talk about your second current job, the job with the second most hours per week. How would you best describe this job? Would you say you…

[work/worked] for an employer,
[are/were] self-employed, or
[are/were] working at a seasonal, temporary, or odd job?

DON’T KNOW
REFUSED

C12a. What month and year did you start this job?

INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.

C12b. START: ___ ___/___ ___ ___ ___

MONTH YEAR

97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR

98 REFUSED MONTH 9998 REFUSED YEAR

C13. Including overtime, how many hours per week do you usually work on this job?

INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84

[RANGE: 0- 84]

HOURS/WEEK

97 DON’T KNOW

98 REFUSED

C14. What are your earnings or income from this job, before taxes? Please include tips, commissions, and regular overtime pay.

INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.

$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]

AMOUNT

999999.97 DON’T KNOW (GO TO C17)

999999.98 REFUSED (GO TO C17)

C15. [Is/Was] that…

1 Per hour,

2 Per week,

3 Every 2 weeks,

4 Twice a month,

5 Once a month,

6 Per year,

7 Per day, or

8 Some other way?

97 DON’T KNOW

98 REFUSED

CATI: IF C15=8, ASK C15_O, ELSE GO TO C16

C15_O. How often did you receive that amount?

________________________________________

97 DON’T KNOW

98 REFUSED

C16. [Is/Was] that before or after taxes?

1 BEFORE

2 AFTER

3 DON’T KNOW

4 REFUSED

CATI: ASK IF C2a =3-5, ELSE GO TO C25.

C17. Let’s talk about your third current job, the job with the third most hours per week. How would you best describe this job? Would you say you…

[work/worked] for an employer ,
[are/were] self-employed, or
[are/were] working at a seasonal, temporary, or odd job?

DON’T KNOW
REFUSED

C18. What month and year did you start this job?

INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.

START: ___ ___/___ ___ ___ ___

MONTH YEAR

97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR

98 REFUSED MONTH 9998 REFUSED YEAR

C19. Now, including overtime, how many hours per week do you usually work on this job?

INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84

[RANGE: 0- 84]

HOURS/WEEK

97 DON’T KNOW

98 REFUSED

C20. What are your earnings or income from this job, before taxes? Please include tips, commissions, and regular overtime pay.

INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.

$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]

AMOUNT

999999.97 DON’T KNOW (GO TO C25)

999999.98 REFUSED (GO TO C25)

C21. [Is/Was] that…

1 Per hour,

2 Per week,

3 Every 2 weeks,

4 Twice a month,

5 Once a month,

6 Per year,

7 Per day, or

8 Some other way?

97 DON’T KNOW

98 REFUSED

CATI: IF C21=8, ASK C21_O, ELSE GO TO C22

C21_O. How often do you receive that amount?

________________________________________

97 DON’T KNOW

98 REFUSED

C22. [Is/Was] that before or after taxes?

1 BEFORE

2 AFTER

97 DON’T KNOW

98 REFUSED

cati: all go to c25.

C23. Some people may not be able to get a job even if they want to work. Other people may have personal or other reasons for not working for pay. What is the main reason you are not working for pay?

INTERVIEWER: DO NOT READ LIST; SELECT ONLY ONE RESPONSE.

INTERVIEWER: IF YOU ARE UNCERTAIN HOW TO CODE THE RESPONSE, READ THE OPTIONS ALOUD TO THE RESPONDENT.

ILLNESS, DISABILITY, SELF
ILLNESS, DISABILITY OTHER
Taking care of home or family MEMBERS
Unable to find (adequate) AND/OR Affordable child care
going to school, in training
unable to find work
Pregnancy
criminal record makes finding work hard
Poor Credit Score Makes Finding Work Hard
TEMPORARILY LAID OFF/ TEMPORARY LEAVE
Inadequate transportation options
RETIRED OR TOO OLD
NEED MORE EDUCATION
NEED MORE WORK EXPERIENCE
NEED/PREFER TO STAY HOME WITH CHILDREN
HAS JOB BUT TEMPORARILY ABSENT
WAITING FOR JOB TO BEGIN
DOES NOT WANT TO WORK
other SPECIFY

97. DON’T KNOW

98. refUSED

CATI: IF C23=19 ASK C23_O, ELSE GO TO C25

C23_O. What is the main reason you are not working for pay?

_______________________________

97 DON’T KNOW

98 REFUSED

CATI: IF C23=97 OR 98, GOTO C25

C24. Are there any other reasons for not working for pay?

INTERVIEWER: DO NOT READ LIST; SELECT ALL THAT APPLY.

INTERVIEWER: IF YOU ARE UNCERTAIN HOW TO CODE THE RESPONSE, READ THE OPTIONS ALOUD TO THE RESPONDENT.

CATI: ELIMINATE RESPONSE FROM C23 FROM LIST

ILLNESS, DISABILITY, SELF
ILLNESS, DISABILITY OTHER
Taking care of home or family MEMBERS
Unable to find (adequate) AND/OR Affordable child care
going to school, in training
unable to find work
Pregnancy
criminal record makes finding work hard
Poor Credit Score Makes Finding Work Hard
TEMPORARILY LAID OFF/ TEMPORARY LEAVE
Inadequate transportation options
RETIRED OR TOO OLD
NEED MORE EDUCATION
NEED MORE WORK EXPERIENCE
NEED/PREFER TO STAY HOME WITH CHILDREN
HAS JOB BUT TEMPORARILY ABSENT
WAITING FOR JOB TO BEGIN
DOES NOT WANT TO WORK
other SPECIFY

97. DON’T KNOW

98. refUSED

CATI: IF C23a=19 ASK C23a_O, ELSE GO TO C25

C24_O. What are the other reasons you are not working for pay?

_______________________________

97 DON’T KNOW

98 REFUSED

C25. In the last four weeks, have you looked for a full-time or part-time work?

1 YES

2 NO (GO TO C27)

97 DON’T KNOW (GO TO C27)

98 REFUSED (GO TO C27)

C26. Were you looking for full-time work—that is, 35 or more hours a week, or part-time work?

Full-time
Part-time
Both

DON’T KNOW
REFUSED

CATI: IF C1d<>1 AND C25=1 AND C26=1 GOTO D1

C27.

CATI: IF (C1d<>1 AND C25<>1) OR (C1d<>1 AND C25=1 AND C26<>1) ASK "According to what you’ve told us, you are currently working less than 35 hours per week and you are not looking for full-time work. Some people may not be able to get a full-time job even if they want to. Other people may have personal or other reasons for not working full-time. What is the main reason why you are not working full-time or looking for full-time work? "

CATI: IF C1>1 AND C1a>1 AND C25=1 ASK "According to what you’ve told us, you are not currently working but you are looking for work. Some people may not be able to get a job even if they want to work. Other people may have personal or other reasons for not working for pay. What is the main reason why you are not working? "

CATI: IF C1>1 AND C1a>1 AND C25>1 ASK "According to what you’ve told us, you are not currently working or looking for work. Some people may not be able to get a job even if they want to work. Other people may have personal or other reasons for not working for pay. What is the main reason why you are not looking for work? "

INTERVIEWER: DO NOT READ THE LIST, CHECK ALL THAT APPLY FROM REASONS R PROVIDES

YOU CAN’T FIND A JOB THAT PAYS ENOUGH.
YOU CAN’T FIND ANY JOB.
YOU CAN’T FIND SATISFACTORY CHILD CARE AT A REASONABLE COST.
YOU CAN’T ARRANGE TRANSPORTATION TO GET TO WORK.
YOU ARE AFRAID YOU WILL LOSE YOUR CURRENT HEALTH INSURANCE.
YOU ARE AFRAID YOU WILL LOSE YOUR HOUSING SUBSIDY OR THAT YOUR RENT WOULD GO UP.
YOU ARE AFRAID YOU WILL LOSE OTHER BENEFITS YOU MAY HAVE, SUCH AS FOOD STAMPS.
YOU NEED MORE SKILLS OR EDUCATION.
YOU NEED MORE EXPERIENCE.
YOU ARE PREGNANT OR HAD A BABY WITHIN THE PAST 3 MONTHS.
YOU WANT TO STAY HOME WITH YOUR CHILDREN.
YOU HAVE A CHILD WITH HEALTH PROBLEMS OR A DISABILITY.
YOU NEED TO CARE FOR SOMEONE IN YOUR FAMILY OTHER THAN A CHILD.
YOU HAVE HEALTH PROBLEMS.
YOU ARE CURRENTLY IN A SCHOOL OR TRAINING PROGRAM.
YOU ARE ON SSI OR DISABILITY.
YOU ARE GETTING FINANCIAL SUPPORT FROM A HUSBAND OR PARTNER.
A FORMER HUSBAND OR PARTNER IS HARASSING YOU OR OTHERWISE INTERFERING WITH YOUR ATTEMPT TO WORK.
YOU ARE FEELING DEPRESSED OR OVERWHELMED.
YOU ARE DEALING WITH A DRINKING OR DRUG PROBLEM.
OTHER

DON'T KNOW
REFUSED

CATI: IF C27=21 ASK C27_O, ELSE GO TO C28.

C27_O. ENTER VERBATIM RESPONSE

_______________________________

97 DON’T KNOW

98 REFUSED

C28.

CATI: IF (C1d<>1 AND C25<>1) OR (C1d<>1 AND C25=1 AND C26<>1) ASK "Are there any other reasons why you are not working full-time or looking for full-time work?"

CATI: IF C1>1 AND C1a>1 AND C25=1 ASK "Are there any other reasons why you are not working?"

CATI: IF C1>1 AND C1a>1 AND C25>1 ASK "Are there any other reasons why you are not looking for work?"

INTERVIEWER: DO NOT READ THE LIST, CHECK ALL THAT APPLY FROM REASONS R PROVIDES

YOU CAN’T FIND A JOB THAT PAYS ENOUGH.
YOU CAN’T FIND ANY JOB.
YOU CAN’T FIND SATISFACTORY CHILD CARE AT A REASONABLE COST.
YOU CAN’T ARRANGE TRANSPORTATION TO GET TO WORK.
YOU ARE AFRAID YOU WILL LOSE YOUR CURRENT HEALTH INSURANCE.
YOU ARE AFRAID YOU WILL LOSE YOUR HOUSING SUBSIDY OR THAT YOUR RENT WOULD GO UP.
YOU ARE AFRAID YOU WILL LOSE OTHER BENEFITS YOU MAY HAVE, SUCH AS FOOD STAMPS.
YOU NEED MORE SKILLS OR EDUCATION.
YOU NEED MORE EXPERIENCE.
YOU ARE PREGNANT OR HAD A BABY WITHIN THE PAST 3 MONTHS.
YOU WANT TO STAY HOME WITH YOUR CHILDREN.
YOU HAVE A CHILD WITH HEALTH PROBLEMS OR A DISABILITY.
YOU NEED TO CARE FOR SOMEONE IN YOUR FAMILY OTHER THAN A CHILD.
YOU HAVE HEALTH PROBLEMS.
YOU ARE CURRENTLY IN A SCHOOL OR TRAINING PROGRAM.
YOU ARE ON SSI OR DISABILITY.
YOU ARE GETTING FINANCIAL SUPPORT FROM A HUSBAND OR PARTNER.
A FORMER HUSBAND OR PARTNER IS HARASSING YOU OR OTHERWISE INTERFERING WITH YOUR ATTEMPT TO WORK.
YOU ARE FEELING DEPRESSED OR OVERWHELMED.
YOU ARE DEALING WITH A DRINKING OR DRUG PROBLEM.
OTHER

DON'T KNOW
REFUSED

CATI: IF C28=21 ASK C28_O, ELSE GO TO D1

C28_O. ENTER VERBATIM RESPONSE

_______________________________

97 DON’T KNOW

98 REFUSED

CATI: RECORD END DATE (SECCEDDT) AND TIME (SECCEDTM)

SECTION D: HOUSEHOLD COMPOSITION & CHILD CARE

CATI: RECORD START DATE (SECDSTDT) AND TIME (SECDSTTM)

D1. Now I’m going to ask you some questions about you and your household.

Which situation best describes your marital status. Are you currently…

INTERVIEWER: READ LIST

Married, living with spouse (GO TO D2)
Single, never married
Separated or living apart from your spouse
Divorced
Widow/Widower

DON’T KNOW
REFUSED

D1a. Are you currently living with a partner?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

D2. Next, think about the people who lived in your household at least two nights a week last month.

How many adults age 18 years or older lived in your household for at least two nights a week during the month of [PRIOR MONTH]? Please include yourself, [CATI: IF D1 = 1, INSERT “your spouse” IF D1a = 1, INSERT “ your partner”], adult family members, and any other adults age 18 years or older who lived in your household for at least two nights a week during the month of [PRIOR MONTH]?

INTERVIEWER: IF R SAYS ZERO, REMIND R TO INCLUDE SELF IN THE COUNT.

INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10

_________ [RANGE 1-10]

# ADULTS

97 DON’T KNOW

98 REFUSED

IF (D1=1 OR D1a=1) AND D2=1, ASK

D2 CONF

Earlier you said you lived with a spouse or partner but now you are saying only 1 adult, you, live in your household. Can you help me with this?

1) R DOES NOT LIVE WITH SPOUSE (GOTO D1 AND REVISE ANSWER)

2) R DOES LIVE WITH SPOUSE (GOTO D2 AND REVISE ANSWER)

D3. How many children, age 17 or younger lived in your household for at least two nights a week during the month of [PRIOR MONTH]? Please include your own children and any other children who lived in your household?

INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10

_________________ [RANGE 0-10]

# ANY CHILDREN

97 DON’T KNOW

98 REFUSED

CATI: CREATE VARIABLE “OHHMBR” WHERE

IF D2=2-20 OR D3=1-20, OHHMBR=1 (YES OTHERS IN HHLD)

ELSE OHHMBR=0 (NO OTHERS IN HHLD OR UNKNOWN)

CATI: IF D3 = 0, 97, OR 98, GO TO SECTION E. ELSE, CONTINUE WITH D3a.

D3a. Of these children you just mentioned, how many were children of your own who were age 17 or younger in [PRIOR MONTH]? Please include biological, adopted, step, foster children, or children for whom you are their parent or guardian.

INTERVIEWER INSTRUCTION: IF GREATER THAN 20, CODE THE RESPONSE AS 20

_________________ [RANGE 0-20]

# OWN CHILDREN

97 DON’T KNOW

98 REFUSED

IF D3a >D3, ASK

D3a CONF

Earlier you said that, including children that are not your own, fewer children lived with you than you report here. Can you help me with this?

1) R WOULD LIKE TO REVISE D3 (GOTO D3 AND REVISE)

2) R WOULD LIKE TO REVISE D3a (GOTO D3a AND REVISE)

CATI: ASK IF RA_CODE=P (PROGRAM GROUP ONLY)

D4.

In the past 12 months, did you …

	YES	NO	DON'T KNOW	REFUSED
D4a. add someone to the household and put that person on the lease	1	2	8	9
D4b. remove someone from the household and drop that person from the lease	1	2	8	9

CATI: RECORD END DATE (SECDEDDT) AND TIME (SECDEDTM)

SECTION E: INCOME, FOOD SECURITY, & MATERIAL HARDSHIP

CATI: RECORD START DATE (SECESTDT) AND TIME (SECESTTM)

CATI: IF OHHMBR=0, USE FIRST TEXT FILL THROUGHOUT SECTION. ELSE USE SECOND TEXT FILL.

E1_INTRO: Now, I am going to ask you some questions about the income that came into your household in [PRIOR MONTH].

CATI: OHHMBR=1, ADD:

Unless the question concerns income for a specific person, like you, please include any income from all adults and children who lived together in your household for at least two nights a week in [PRIOR MONTH].

CONTINUE, ALL: Again, I want to assure you that none of your answers will be discussed with anyone.

Monthly Income

During [PRIOR MONTH]:

E1. Did you work for pay?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

CATI: IF OHHMBR=1, ASK E1a. ELSE GO TO E2.

E1a. Did any other adults or children who lived in your household work for pay or were self-employed?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

E2. In [PRIOR MONTH], did you [CATI: IF OHHMBR=1, INSERT “or anyone else in your household”] receive:

	YES	NO	DON’T KNOW	REFUSED
E2a. SNAP, also known as Food Stamps, including EBT cards from the government that can be used at the store to buy food?	1	2	7	8
E2b. Child Support?	1	2	7	8
E2c. TANF or [CATI: insert state program name] or any cash assistance, not including child support money or child care payments?	1	2	7	8
E2d. Unemployment Insurance Benefits or UI?	1	2	7	8
E2e. Social Security Disability Insurance benefits, or SSDI	1	2	7	8
E2f. Supplemental Security Income benefits, or SSI	1	2	7	8
E2g. The Special Supplemental Nutrition Program for Women, Infants, and Children or WIC?	1	2	7	8
E2h. Heating or Cooling Assistance?	1	2	7	8
E2i. Free or reduced-price school lunch?	1	2	7	8
E2j. Alimony?	1	2	7	8
E2k. Medicaid, CHIP, [CATI: IF CITY=DISTRICT OF COLUMBIA, INSERT" DC Healthy Families, DC Healthcare Alliance, Immigrant Children’s Program (ICP) "; IF CITY IS LEXINGTON OR LOUISVILLE, INSERT" Kentucky HEALTH "; IF CITY IS SAN ANTONIO, INSERT"CHIP, STAR, STAR KIDS, STAR PLUS"] ,or other government health insurance?	1	2	7	8

E3. In [PRIOR MONTH] did you [CATI: IF OHHMBR=1, INSERT “or anyone else in your household”] receive money from any other source, such as rent from boarders, a pension, other government benefits, or any other income we have not already talked about?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

E4. What was the total monthly income for you [CATI: IF OHHMBR=1, INSERT: “and everyone else living together in your household”] in [PRIOR MONTH]? Please include income from all of the sources that you just mentioned, plus any other income.

PROBE: Your best estimate is fine.

$ ___ ___ ___ ,___ ___ ___. [RANGE = 0 – 999996]

AMOUNT

999997 DON’T KNOW

999998 REFUSED

CATI:

IF E4 IS LESS THAN OR EQUAL TO $10,000, GO TO E6.

IF E4 IS GREATER THAN $10,000 AND LESS THAN 999997, ASK E4_confirm.

IF E4 = 999997 OR 999998, GO TO E5a.

E4_confirm. Just to confirm, you said that the total monthly income for you [CATI: IF OHHMBR=1, INSERT: “and everyone else living together in your household”] in [PRIOR MONTH] was [INSERT E4]. Is that correct?

1 YES (GOTO E6)

2 NO

97 DON’T KNOW (GO TO E5a)

98 REFUSED (GO TO E5a)

E4_revised. What would you say was the correct amount of total monthly income for everyone living together in your household?

$ ___ ___ ___ ,___ ___ ___. [RANGE = 0 – 999996]

AMOUNT

999997 DON’T KNOW

999998 REFUSED

CATI: IF E4_revised IS LESS THAN 999997, GO TO E6. ELSE, CONTINUE WITH E5a.

E5a. Would you say it was more or less than $1,500?

INTERVIEWER: DO NOT READ LIST

1 MORE THAN $1,500 (GO TO E5b)

2 EXACTLY $1,500 (GO TO E6)

3 LESS THAN $1,500 (GO TO E5c)

97 DON’T KNOW (GO TO E6)

98 REFUSED (GO TO E6)

E5b. Would you say it was:

INTERVIEWER: READ LIST

1 More than $1,500 but less than $2,000,

2 At least $2,000 but less than $2,500, or

3 $2,500 or more?

97 DON’T KNOW

98 REFUSED

CATI: ALL E5b GO TO E6

E5c. Would you say it was:

INTERVIEWER: READ LIST

1 At least $1,200 but less than $1,500,

2 At least $800 but less than $1,200,

3 At least $500 but less than $800, or

4 Less than $500?

97 DON’T KNOW

98 REFUSED

BANKING / USE OF FINANCIAL SERVICES

E6. Do you currently have a checking or savings account of any kind at a bank or a credit union?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

Savings

E7. Do you [CATI: IF D1 = 1 , INSERT “or your spouse”. IF D1a = 1, INSERT “or your partner”] have any savings? This would include money at home, in a savings account, savings bond, money market fund, credit union, retirement account, Individual Development Account or IDA, pension fund, stocks or bonds, or certificates of deposit.

1 YES

2 NO (GO TO E8)

97 DON'T KNOW (GO TO E8)

98 REFUSED (GO TO E8)

E7a. How much, altogether, do you [CATI: IF D1 = 1 , INSERT “and your spouse” IF D1a = 1, INSERT “and your partner”] have in savings? Your best estimate is fine.

INTERVIEWER INSTRUCTION: IF GREATER THAN 50,000, CODE THE RESPONSE AS 50,000

$ ___ ___ ___ ___ ___ [RANGE = 1-50,000] (GO TO E8)

SAVINGS AMOUNT

99997 DON’T KNOW (GO TO E7b)

99998 REFUSED (GO TO E7b)

E7b. Would it be…

Up to $200
$201 to $500
$501 to $1,000
$1,001 to $1,500
$1,501 to $2,000, or
More than $2,000?

DON'T KNOW
REFUSED

Debt

E8. Next, I’d like to ask you about loans and any debt or money you might owe,

Right now, do you have any debt where you owe money for things like medical bills, credit card bills, student loans, store accounts, and so on? Please do not count any mortgages or home loans that you may have.

1 YES

2 NO (GO TO E10)

97 DON’T KNOW (GO TO E10)

98 REFUSED (GO TO E10)

E9. When you think about all your outstanding loans and debts, what is the total amount you owe? If you have a mortgage, do not count that in the total amount.

PROBE: Your best estimate is fine.

$ ___ ___ ___ ,___ ___ ___. [RANGE = 1 – 999996] (GO TO E10)

DEBT AMOUNT

999997 DON’T KNOW (GO TO E9a)

999998 REFUSED (GO TO E9a)

E9a. When you think about all your outstanding loans and debts, not including a mortgage if you have one, would you say that the total amount is …

1 $1 to $500,

2 $501 to $1,000,

3 $1,001 to $5,000,

4 $5,001 to $10,000,

5 $10,001 to $20,000, or

6 More than $20,000?

97 DON’T KNOW

98 REFUSED

Financial Strain

E10. How much do you agree or disagree with each of the following statement?

My financial situation is better than it was last year at this time.

Would you say you…

Strongly Agree
Agree Somewhat
Neither Agree nor Disagree
Disagree Somewhat, or
Strongly Disagree?

Material Hardship Scale

E11a. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], was there ever a time when, [you/you or your household] did not pay the full amount of the rent?

YES
NO (GO TO E11b)

DON’T KNOW (GO TO E11b)
REFUSED (GO TO E11b)

E11a.1 In the last 12 months, about how many months has this happened?

1
2-3
4-6
7 OR MORE

DON’T KNOW
REFUSED

E11b. In the last 12 months, has there been a time when [you/you or your household] had service turned off by the gas or electric company, or the oil company would not deliver oil because payments were not made?

YES
NO (GO TO E11c)

DON’T KNOW (GO TO E11c)
REFUSED (GO TO E11c)

E11b.1 In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], about how many months has this happened?

1
2-3
4-6
7 OR MORE

DON’T KNOW
REFUSED

E11c. In the last 12 months, have [you/you or your household] had cellular or land service disconnected because payments were not made?

YES
NO (GO TO E11d)

DON’T KNOW (GO TO E11d)
REFUSED (GO TO E11d)

E11c.1 In the last 12 months, about how many months has this happened?

1
2-3
4-6
7 OR MORE

DON’T KNOW
REFUSED

E11d. In the last 12 months, was there ever a time when, because of cost, [you/you or your household] were not able to buy food?

YES
NO (GO TO E11e)

DON’T KNOW (GO TO E11e)
REFUSED (GO TO E11e)

E11d.1 In the last 12 months, about how many months has this happened?

1
2-3
4-6
7 OR MORE

DON’T KNOW
REFUSED

CATI: THE NEXT TWO QUESTIONS DO NOT HAVE A FOLLOW-UP QUESTION IF R ANSWERS “YES.”

E11e. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], was there ever a time when, because of cost, [you/you or your household] were not able to buy prescription medicine?

DON’T KNOW
REFUSED

E11f. In the last 12 months, was there ever a time when, because of cost, [you/you or members of your household] were not able to see a doctor or get medical assistance?

DON’T KNOW
REFUSED

Assistance/Services & Transportation Assistance

E12. Do you have reliable access to a vehicle?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

Job Search Assistance

E13. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR -1], have you attended any workshops or received any assistance with [CATI: IF C2>2, SHOW "finding a job" IF C2=1 OR 2 SHOW "finding a better job"] from a program or agency? Assistance could include help in preparing a resume, finding job openings, calling employers, interviewing for a job, or completing a job application?

1 YES

2 NO

97 DON’T KNOW

98 REFUSED

Food Insufficiency

E14. Which of these statements best describes the food eaten by [you/you and the people in your household who usually ate with you] in [PRIOR MONTH]: Did you have…

Enough of the kinds of food you wanted,

2 Enough but not always the kinds of food you wanted to eat,

3 Sometimes not enough to eat, or

4 Often not enough to eat?

97 DON’T KNOW

98 REFUSED

E14a. In [PRIOR MONTH], did you or anyone in your household ever skip a meal because there wasn't enough money for food?

1 YES

2 NO (GO TO E15)

7 DON’T KNOW (GO TO E15)

8 REFUSED (GO TO E15)

[CATI: ASK IF E14a=1, ELSE GO TO E15]

E14b. In the past 12 months, about how many months has this happened?

1 1 Month

2 2 or 3 months

3 4 to 6 months

4 7 or more months

7 DON’T KNOW

8 REFUSED

Overall Financial Well-Being

E15. In general, how do [your/your household] finances usually work out at the end of the month? Is there…

1 Some money left over,

2 Just enough to make ends meet, or

3 Not enough money to make ends meet?

97 DON’T KNOW

98 REFUSED

E15a. Do you ever borrow from family and/or friends to get cash for basic household necessities, such as food, rent, or utilities?

1 YES

2 NO (GO TO E15c)

7 DON’T KNOW (GO TO E15c)

8 REFUSED (GO TO E15c)

E15b. How often do you do this?

1 Every week

2 A couple times a month

3 Every month

4 A couple times a year

5 Once a year

7 DON’T KNOW

8 REFUSED

CATI: RECORD END DATE (SECEEDDT) AND TIME (SECEEDTM)

SECTION F: HEALTH STATUS – SUB-MODULE

CATI: RECORD START DATE (SECFSTDT) AND TIME (SECFSTTM)

F1. The next few questions are about your general health. I’d like to remind you, again, that all your answers to these questions are confidential.

In general, how would you rate your overall health now? Is it…

1 Excellent,

2 Very good,

3 Good,

4 Fair, or

5 Poor?

97 DON’T KNOW

98 REFUSED

F2. Do you have problems doing usual activities such as work, studying, homework, family or leisure activities because of your health? Do you have…

1 No problems

2 Slight problems

3 Moderate problems

4 Severe problems

5 Unable to

97 DON’T KNOW

98 REFUSED

F3. Taken all together, how would you say things are these days; would you say that you are very happy, pretty happy, or not too happy?

1 VERY HAPPY

2 PRETTY HAPPY

3 NOT TOO HAPPY

97 DON’T KNOW

98 REFUSED

F4. Now I am going to ask you some questions about feelings that you may have experienced during the past 30 days.

How much of the time during the past 30 days have you felt…

	All of the time	Most of the time	Some of the time	A little of the time	None of the time	DK	REF
F4A. So sad that nothing could cheer you up?	1	2	3	4	5	97	98
F4B. Nervous?	1	2	3	4	5	97	98
F4C. Restless or fidgety?	1	2	3	4	5	97	98
F4D. Hopeless?	1	2	3	4	5	97	98
F4E. That everything was an effort?	1	2	3	4	5	97	98
F4F. Worthless?	1	2	3	4	5	97	98

F5. Do you currently have any type of health coverage from private health insurance, for example, private insurance that you get through a current or former employer, a family member, or that you purchase on your own? Please include any private coverage you may have through the Affordable Care Act (or HealthCare.Gov) or a state-funded website.

1 YES

2 NO

97 DON'T KNOW

98 REFUSED

CATI: ASK IF D3 > 0 AND <97,98; IF D3 = 0, missing, 97, OR 98 (GO TO NEXT SECTION)

F6. Are all, some, or none of your children covered by any type of private health insurance or through a program run by the city, state, or federal government? Please include any private coverage you may have through the Affordable Care Act (or HealthCare.Gov) or a state-funded website.

1 ALL

2 SOME

3 NONE

97 DON’T KNOW

98 REFUSED

CATI: RECORD END DATE (SECFEDDT) AND TIME (SECFEDTM)

SECTION G: HOUSING AND MOVING

CATI: RECORD START DATE (SECGSTDT) AND TIME (SECGSTTM)

Home & Neighborhood Quality

G1a. These questions are about your housing and your neighborhood.

Overall, how satisfied are you with your current apartment or home? Would you say you are…

Very satisfied,
Somewhat satisfied,
Neither satisfied nor dissatisfied,
Somewhat dissatisfied, or
Very dissatisfied?

97 DON’T KNOW

98 REFUSED

G1b. Overall, how satisfied are you with conditions in your neighborhood? Would you say you are…

Very satisfied,
Somewhat satisfied,
Neither satisfied nor dissatisfied,
Somewhat dissatisfied, or
Very dissatisfied?

DON’T KNOW
REFUSED

G2. Do you currently:

INTERVIEWER: READ ALL OF THE FOLLOWING OPTIONS EVEN IF RESPONDENT INTERRUPTS WITH ANSWER.

Own your own home or apartment, (GO TO G5)
Rent your home or apartment
Live with family or friends and pay part of the rent or mortgage payment,
Live with family or friends and not pay rent (GO TO G5)
Live in a group shelter (GO TO G5)
Live in some other arrangement? (GO TO G5)

INTERVIEWER: DO NOT READ. CODE IF RESPONDENT VOLUNTEERS THE INFORMATION.

7 HOMELESS AND LIVING ON THE STREET (GO TO G5)

8 JAIL (GO TO G5)

9 ALONE AND RENT-FREE (GO TO G5)

97 DON’T KNOW (GO TO G5)

98 REFUSED (GO TO G5)

Housing Assistance

G3. Some rental agreements include a special recertification process that determines the amount of rent a renter has to pay. Rental agreements with re-certification REQUIRE a renter to report everyone who lives with them, and all jobs, savings, and sources of income for all household members. This information is used to determine the amount of the rent payment.

G3a. Do you have to re-certify to determine the amount of rent you pay?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

G3b. Is your rent amount lower because you are in either a Federal, State or local government housing program?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

G3c. Does your household have a housing voucher?

IF NECESSARY: A housing voucher gives a renter the right to choose where they live AND it helps pay for rent.

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

G3d. Is the housing authority your landlord?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

Assistance with Housing/Landlord Issues

G4. Sometimes landlords and tenants have problems. I am going to read you a list of problems that you may have had with your landlord. Please tell me if in the last 12 months if you have experienced any of problems with.

INTERVIEWER: SELECT ALL THAT APPLY

CATI 8, 97, 98 ARE UNIQUE RESPONSES – CANNOT BE SELECTED WITH ANY OTHER RESPONSE

1 Paying your rent in full or on time

2 Problems/issues with the landlord over utilities

3 Repair or maintenance needs of your unit

4 Pest control

5 Unauthorized access of your apartment by your landlord

6 Lease violations of some type by you or your landlord

7 Sexual harassment by your landlord, property manager, or maintenance worker

8 Something else I have not mentioned? (Please specify:_____________)

9 NO PROBLEMS (GO TO G5)

97 DON’T KNOW (GO TO G5)

98 REFUSED (GO TO G5)

CATI IF G4=8, ASK G4_O. ELSE GO TO G5

G4_O. What other problem or problems did you experience?

___________________________________________

97 DON’T KNOW

98 REFUSED

CATI: IF G3c.<>2 GOTO G5.

G4a. People stop receiving housing vouchers for different reasons. What would you say was the main reason you no longer have a housing voucher?

INCOME TOO HIGH/OVER INCOME/NO LONGER ELIGIBLE
RENT OR UTILITIES GOT TOO HIGH
EVICTED
LOST SUBSIDY DUE TO PROBLEM WITH PHA (BROKE RULES, VIOLATED LEASE, ETC.)
LANDLORD WOULD NOT TAKE HOUSING VOUCHER/SECTION 8
WANTED TO OWN A HOME
BOUGHT A HOME
OTHER (SPECIFY)

DON'T KNOW
REFUSED

CATI: IF G4a. <> 8 GOTO G4b.

G4a_O. ENTER VERBATIM RESPONSE

________________________________

CATI: IF G4a. <>4 GOTO G5.

G4b. Why did you lose your housing voucher? Was it because of…

NONPAYMENT OF RENT OR LATE RENT,
NONPAYMENT OF MORTGAGE BY YOU OR SOMEONE ELSE
ABSENT FROM UNIT FOR 90 OR MORE DAYS,
PROBLEMS WITH VISITORS (STAYED MORE THAN 7 DAYS OR BEHAVIOR),
DAMAGING UNIT,
HOUSEKEEPING VIOLATIONS,
ONE-STRIKE VIOLATION,
INCOME INCREASE, OR
SOME OTHER REASON, SPECIFY____________________

DON’T KNOW
REFUSED

CATI: IF G4b<> 9 GOTO G5.

G4b_O. ENTER VERBATIM RESPONSE

________________________________

DON’T KNOW
REFUSED

Residential Moves and Housing

G5. Have you moved since [REF_DATE]?

1 YES

2 NO (GO TO NEXT SECTION)

97 DON’T KNOW (GO TO NEXT SECTION)

98 REFUSED (GO TO NEXT SECTION)

G5a. How many times have you moved since [REF_DATE]?

INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10

_________________ [RANGE: 1 to 10]

NUMBER OF TIMES MOVED

97 DON’T KNOW

98 REFUSED

G5b. How long have you lived where you live currently?

______________________________[ENTER RESPONSE VERBATIM]

97 DON’T KNOW MONTH

98 REFUSED MONTH

G5c. What was the main reason you moved?

(CATI: IF G5a> 1, INCLUDING 97 OR 98): What was the main reason you moved the last time?

INTERVIEWER: DO NOT READ LIST

WANTED A CHEAPER PLACE
WANTED A SMALLER PLACE
WANTED A BIGGER PLACE
WANTED A NICER PLACE
WANTED YOUR OWN PLACE
WANTED A SAFER NEIGHBORHOOD
WANTED A PLACE CLOSER TO WORK/CLOSER TO SCHOOL
WANTED TO MOVE CLOSER TO FAMILY OR FRIENDS
WANTED A NEIGHBORHOOD WITH BETTER SCHOOLS
UNIT NEEDED REPAIRS/MAINTENANCE
BUILDING CONDEMNED
BUILDING IN FORECLOSURE
LANDLORD CHOSE NOT TO RENEW LEASE
OTHER REASON (SPECIFY ______)

DON’T KNOW
REFUSED

G5d. At the time you moved, were you or the people you were staying with caught up with the rent at this place?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

Evictions EVIC

G6. Were you, or a person you were staying with ever evicted, or forced by your landlord to move when you didn't want to, since [REF_DATE]?

1 YES (GO TO G9)

2 NO (GO TO G7)

3 IN THE MIDST OF AN EVICTION (GO TO G9)

7 DON’T KNOW (GO TO G7)

8 REFUSED (GO TO G7)

G7. A landlord might force you to move because you didn't pay your rent, because you damaged the property, or for any number of other reasons. Sometimes a landlord gives you a paper, or tapes a paper to your door, saying you have to move. Sometimes you go to court; other times you don't. Whatever the case, has a landlord made you move out when you didn't want to since [REF_DATE]?

1 YES

2 NO (GO TO NEXT SECTION)

3 IN THE MIDST OF AN EVICTION

7 DON’T KNOW (GO TO NEXT SECTION)

8 REFUSED (GO TO NEXT SECTION)

CATI: COMPUTE: IF G6=1 OR G7=1 EVICRECRD – Universe – EVIC = 1

G8. Why were you, or the person you were staying with, forced to move or evicted?

INTERVIEWER: DO NOT READ LIST, SELECT ALL THAT APPLY

NONPAYMENT OF RENT OR LATE RENT,
NONPAYMENT OF MORTGAGE BY YOU OR SOMEONE ELSE
ABSENT FROM UNIT FOR 90 OR MORE DAYS,
PROBLEMS WITH VISITORS (STAYED MORE THAN 7 DAYS OR BEHAVIOR),
DAMAGING UNIT,
HOUSEKEEPING VIOLATIONS,
ONE-STRIKE VIOLATION,
INCOME INCREASE, OR
SOME OTHER REASON, SPECIFY____________________

DON’T KNOW
REFUSED

CATI ASK IF G8=9, ELSE GOTO NEXT SECTION.

G8_O. What was the reason for the eviction?

___________________________________________

97 DON’T KNOW

98 REFUSED

G9. Were you, or the person you were staying with, forced to move because your landlord refused to renew your lease?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: RECORD END DATE (SECGEDDT) AND TIME (SECGEDTM)

SECTION H: PROGRAM GROUP EXPERIENCES

CATI: RECORD START DATE (SECHSTDT) AND TIME (SECHSTTM)

CATI: IF G3c=1 USES FIRST (PRESENT TENSE) TEXT FILL, ELSE USE SECOND (PAST TENSE) TEXT FILL

Rent Reform Group Only (Excluding LMHA Opt-outs)

You may recall that starting in [REF_DATE] [PHA NAME] changed the way it calculated your rent. [PHA NAME] may have referred to this as the “new rent rules” or the “alternative rent rules.” I would like to ask you a few questions about the way in which your rent is being calculated and how that affects you.

I will also use the term “income review” OR “recertification.” This is when you provide information on your income to the housing authority to determine whether you’re still eligible for a Section 8 voucher and how much you have to pay in rent.

Knowledge and awareness

H1. Thinking about how [PHA NAME] [calculates/calculated] your household’s rental assistance, which of the following rent rules [apply/applied] to you? For each one, would you say…..Yes, no, or you’re not sure?

	Yes	No	Not Sure	Refused
H1a. [CATI: IF CITY=”Louisville”, “San Antonio”, OR “Lexington” SHOW] Required income reviews are now conducted every 3 years – in other words, my household only needs to have its income reviewed every three years instead of every year [CATI: IF CITY= “DC”, SHOW] Required income reviews are now conducted every 3 years – in other words, my household only needs to have its income reviewed every three years instead of every two.	1	2	8	9
H1b. Every family has to pay at least some of their own money directly to the landlord for rent.	1	2	8	9
H1c. If I [have/had] difficulty paying my rent, I may [be/have been] able to have my rent lowered through a request to the housing authority.	1	2	8	9
H1d. The housing authority usually [looks/looked] at my household’s income in the 12 months prior to my income review to calculate my rent.	1	2	8	9
H1e. During the three-year period before my required income review, I [do/did] not have to report to the housing authority any earnings increases for me or for anyone in my household.	1	2	8	9
H1f. If another adult [moves/moved] into my household and [goes/went] on the lease during the three-years before my required income review, my rent [won’t/wouldn't] change unless I [need/needed] to move to bigger unit and get a larger voucher.	1	2	8	9

Minimum rent

H2. [Do you currently/Did you] pay a rent that’s:

1. Above the minimum, (GO TO H4)

2. Exactly the minimum, or

3. Below the minimum. (GO TO H4)

8. DON’T KNOW (GO TO H4)

9. REFUSED (GO TO H4)

H3. How difficult [has it been/was it] for you to pay this minimum rent each month? Would you say

1. Very difficult

2. Somewhat difficult

3. Not very difficult

4. Not difficult at all?

8. DON’T KNOW

9. REFUSED

Interims

H4. [CATI: IF CITY=”Louisville”, “San Antonio”, OR “Lexington” SHOW] [PHA NAME] requires you to review your income with the housing authority every three years, rather than every year. That means if your income goes up during that three-year period, you don’t need to report it until the three years is up.

[CATI: IF CITY= “DC”, SHOW] [PHA NAME] requires you to review your income with the housing authority every three years, rather than every two years. That means if your income goes up during that three-year period, you don’t need to report it until the three years is up.

At any point in the past three years, did your household income go down?

YES
NO (GO TO H10a)

8. DON’T KNOW (GO TO H10a)

9. REFUSED (GO TO H10a)

H5. At any point in the past three years, did you request the [PHA NAME] to lower your rent because your income went down?

YES
NO (GO TO H9)

8. DON’T KNOW (GO TO H10a)

9. REFUSED (GO TO H10a)

H6. About how many times did you ask for a reduction? Would you say:

1. Just once

2. Two or three times

3. Four or five times

4. Six to ten times, or

5. More than ten times?

8. DON’T KNOW

9. REFUSED

H7. [CATI: IF H6=2,3,4,5, 8, 9 SHOW] Thinking about [when/the last time] you submitted a request, did the housing authority lower your rent?

[CATI: IF H6=1 SHOW] Thinking about when you submitted a request, did the housing authority lower your rent?

1. YES (GO TO H10a)

2. NO

8. DON’T KNOW (GO TO H10a)

9. REFUSED (GO TO H10a)

H8. Were you told any of the following reasons why the housing authority did not reduce your rent?

1. Your income didn’t go down enough (GO TO H10a)

2. You didn’t have the right documentation (GO TO H10a)

3. Some other reason (Please specify:___________) (GO TO H8_0)

4. Or, they never gave you a reason (GO TO H10a)

8. DON’T KNOW (GO TO H10a)

9. REFUSED (GO TO H10a)

CATI ASK IF H8=3, ELSE GOTO H10a

H8_O. What was the reason?

___________________________________________

97 DON’T KNOW

98 REFUSED

H9. Which of the following best describes why you didn’t request a reduction:

1. Your income did not fall very much, so it wouldn’t have affected your rent very much.

2. You didn’t know such reductions were sometimes allowed.

3. You didn’t want to have to deal with the housing authority.

4. You just never got around to submitting a request.

5. Some other reason (Please specify:___________)

8. DON’T KNOW

9. REFUSED

CATI ASK IF H9=5, ELSE GOTO H10a

H9_O. What was the reason?

___________________________________________

97 DON’T KNOW

98 REFUSED

Triennial recerts

H10a. Did your household recently complete a three-year income review in [TRI_DATE] to adjust your rent payment and subsidy?

1. YES

2. NO (GO TO H17)

8. DON’T KNOW (GO TO H17)

9. REFUSED (GO TO H17)

H10b. Since your three-year income review, have you been notified of the new amount that you’ll need to start paying?

1. YES

2. NO (GO TO H17)

8. DON’T KNOW (GO TO H17)

9. REFUSED (GO TO H17)

H11. Did your rent increase, decrease, or stay the same after that income review in [TRI_DATE]?

1. Increase

2. Decrease (GO TO H17)

3. Stay the same (GO TO H17)

8. DON’T KNOW (GO TO H17)

9. REFUSED (GO TO H17)

H12. How much did your rent go up by?

Less than $50
$51-$100
$101-$200
$201-$300
$301-$500
More than $501

8. DON’T KNOW

9. REFUSED

H13. Would you say that this increase is:

1. Much higher than you expected

2. Somewhat higher than you expected

3. About what you expected

4. Less than what you expected, or

5. You weren’t sure what to expect?

8. DON’T KNOW

9. REFUSED

H14. How difficult [CATI: IF TRI_DATE>TODAY, SHOW "has it been"; if TRI_DATE <=TODAY, SHOW "do you think it will be"] for you to pay this higher rent amount?

1. Very difficult

2. Somewhat difficult

3. Not difficult

8. DON’T KNOW

9. REFUSED

H15. In order to pay this higher cost for your rent and utilities, [CATI: IF TRI_DATE > TODAY, SHOW "have you had"; if TRI_DATE <=TODAY, SHOW "will you have"] to make any changes in how your family budgets or spends its money?

1. YES

2. NO (GO TO H17)

8. DON’T KNOW (GO TO H17)

9. REFUSED (GO TO H17)

H16. What kinds of changes have you made or do you expect to make?

__________________________________________[ENTER RESPONSE VERBATIM]

8. DON’T KNOW

9. REFUSED

Retrospective Income

H17. Under the alternative rules, to calculate your rent and subsidy, the housing authority uses your family income from the 12 months before your income review. Compared with the old rules, how much harder was it for you to provide the income documentation required under the alternative rules? Would you say it was:

1. Much harder

2. Somewhat harder

3. About the same, or (GOTO H19)

4. Not as hard? (GOTO H19)

8. DON’T KNOW (GOTO H19)

9. REFUSED (GOTO H19)

H18. What types of documents were more difficult to provide? I am going to read you a list of possible documents, please tell me all of the ones that were difficult for you to provide…

[INTERVIEWER: PLEASE SELECT ALL THAT APPLY.]

1. Paystubs for your most recent job

2. Paystubs for a previous job you held

3. Paystubs for other household members

4. Cash assistance documentation

5. Child support documentation

6. Documentation for contributions from friends and family

7. Some other form of documentation? (Please specify:____________)

8. DON’T KNOW (CATI CANNOT BE SELECTED WITH OTHER RESPONSES)

9. REFUSED (CATI CANNOT BE SELECTED WITH OTHER RESPONSES)

CATI ASK IF H18=7, ELSE GOTO H19

H18_O. What documents were difficult to provide?

___________________________________________

97 DON’T KNOW

98 REFUSED

Overall impressions

H19. What, if anything, do you like about the way the [PHA NAME] is currently calculating your rent and housing subsidy?

___________________________________ENTER RESPONSE VERBATIM

8. DON’T KNOW

9. REFUSED

H20. What, if anything, do you dislike about the alternative rent rules?

___________________________________ENTER RESPONSE VERBATIM

8. DON’T KNOW

9. REFUSED

H21. If you had a choice, would you prefer to continue with the way the [PHA NAME] calculates your rent now, or would you prefer to go back to the old rules?

Continue with alternative rules
Go back to the old rules

8. DON’T KNOW

9. REFUSED

CATI: RECORD END DATE (SECHEDDT) AND TIME (SECHEDTM)

SECTION Z: CLOSING SECTION/INCENTIVE PAYMENT

CATI: RECORD START DATE (SECZSTDT) AND TIME (SECZSTTM)

Z1. Those are all the questions I have to ask you today. Thank you for the time you’ve spent talking with me and for your participation in this study. In order to send your gift card, I need to confirm your name and address.

I have your name listed as [FLNAME] and spelled as (INTERVIEWER: SPELL NAME). Is that correct?

1 YES (GO TO Z4)

2 NO (GO TO Z3)

8 REFUSED (GO TO Z2)

Z2. In order to send your gift card, I am required to verify the spelling of your name. I have your name listed as [FLNAME] and spelled as INTERVIEWER: SPELL NAME. Is that correct?

1 YES (GO TO Z4)

2 NO (GO TO Z3)

8 REFUSED (GO TO Z4)

CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED NAME WHILE ORIGINAL NAME IS DISPLAYED FOR COMPARISON PURPOSES

Z3. INTERVIEWER: ENTER CORRECTED NAME.

[FLNAME]

Z4. Is this your current address? [FULLADD, RCITY, RSTATE, RZIP]

INTERVIEWER: READ ADDRESS TO R, SPELLING EACH WORD.

INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without a correct mailing address.

1 YES (GO TO Z6)

2 NO (GO TO Z5)

8 REFUSED (GO TO Z6)

CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED ADDRESS WHILE ORIGINAL ADDRESS IS DISPLAYED FOR COMPARISON PURPOSES

CATI: CREATE CDMO USING DATA ENTERED AT Z5 TO REPLACE:

FULLADD – FULL ADDRESS

RCITY – CITY

RSTATE – STATE

RZIP – ZIP

Z5. Please tell me your address.

ADDRESS _________________________

CITY _________________________

STATE _________________________

ZIP _________________________

8 REFUSED

INTERVIEWER: ENTER CORRECTED ADDRESS. READ BACK THE ADDRESS INFORMATION TO R, SPELLING THE WORDS.

INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without a correct mailing address.

Z6. Is there another address you would like me to use to send your $[INCENTIVE] gift card?

1 YES

2 NO (GO TO Z8)

8 REFUSED (GO TO Z8)

CATI: PROVIDE TEXT BOX FOR ENTRY OF SUPPLEMENTAL ADDRESS

Z7. What address would you like me to use?

Street: __________________________

City: __________________________

State: __________________________

Zip: __________________________

Z8. I also need to confirm your phone number in case we have any questions about the interview.

CATI: DISPLAY RPHONE1

INTERVIEWER: READ THE PHONE NUMBER. Is this correct?

1 YES (GO TO Z10)

2 NO (GO TO Z9)

8 REFUSED (GO TO THANK)

CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED PHONE NUMBER. DISPLAY ORIGINAL PHONE NUMBER FOR COMPARISON PURPOSES

Z9. INTERVIEWER: ENTER CORRECTED PHONE NUMBER. READ BACK TO R TO CONFIRM.

Z10. Is this a home, work, or cell phone number?

1 Home

2 Work

3 Cell

8 REFUSED

GO TO THANK

THANK. Thank you very much for your time and assistance. You should receive your gift card in about 3 weeks. If you have any questions about the study or your gift card, you can contact XXX at DIR, the company in charge of conducting this survey. The toll-free number is XXX-XXX-XXXX.

INTERVIEWER: PRESS “NEXT” TO END SURVEY.

END INTERVIEW.

Thank you for taking the time to speak with me today. I’m sorry that you aren’t able to participate in our study. If you change your mind and decide you would like to participate, please call 1-844-672-4088.

INTERVIEWER: PLEASE PAUSE A MOMENT TO GIVE R TIME TO WRITE NUMBER DOWN AND REPEAT IF NEEDED

INTERVIEWER: PRESS “NEXT” TO END SURVEY.

CATI: RECORD END DATE (SECZEDDT) AND TIME (SECZEDTM)

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Cynthia Walsh
File Modified	0000-00-00
File Created	2022-09-25

HUD RR Survey Instrument TO HUD FINAL_20181217

The Rent Reform Demonstration: 6-Year Long-Term Follow-Up.