20,000 Homes Campaign: Reporting Form
Please submit community data for the previous month by the 15th (ex: November data by December 15th)!

This 20,000 Homes Campaign: Reporting Form (V1.1) is to be used by all 20,000 Homes Campaign communities to report their Housing Move-in Data and By-Name List Chronic Data on a monthly basis. If you have any questions regarding this form, please refer to the Reference Sheet and/or 20KHomes Report Webinar linked below or contact marie@caeh.ca.

Reference Sheet: https://goo.gl/Ecu2VT
Reporting Webinar: https://register.gotowebinar.com/recording/6648658138525806083

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FOR ANY QUESTIONS: IF YOU DO NOT KNOW THE RESPONSE OR DATA IS UNAVAILABLE FOR THAT QUESTION CATEGORY, PLEASE SKIP THE QUESTION

Please see the "ADDITIONAL NOTES" section at the bottom of this form for definitions and notes on specific questions.
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Updated for use: December, 2017

Email address *
What month is this Report for? *
Community Name *
Person Completing this Report *
Your answer
Email Address of Person Completing this Report *
Your answer
TOTAL PERMANENT HOUSING MOVE-INS
1. Total number of permanent housing move-ins - Chronic, Episodic, and/or High Acuity *
How many TOTAL people (including members in families) meeting the definition of Chronic, Episodic, and/or High Acuity Homelessness (and any combination of those three categories) moved into permanent housing during the month for which you are reporting? (If you do NOT know the response or the data is unavailable, please leave this text box blank.)
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Your answer
PERMANENT HOUSING MOVE-INS: CHRONIC, EPISODIC, HIGH ACUITY
2a. CHRONIC: Total number of permanent housing move-ins
Of the total number in Question 1 (above), how many people (including members in families) meeting the definition of Chronic Homelessness moved into permanent housing during the month for which you are reporting? This number MAY include people who ALSO meet the definition of High Acuity AND/OR Episodic Homelessness. (If you do NOT know the response or the data is unavailable, please leave this text box blank.)
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Your answer
2b. EPISODIC: Total number of permanent housing move-ins
Of the total number in Question 1, how many people (including members in families) meeting the definition of Episodic Homelessness moved into permanent housing during the month for which you are reporting? This number MAY include people who ALSO meet the definition of High Acuity AND/OR Chronic Homelessness. (If you do NOT know the response or the data is unavailable, please leave this text box blank.)
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Your answer
2c. HIGH ACUITY: Total number of permanent housing move-ins
Of the total number in Question 1, how many people (including members in families) meeting the definition of High Acuity Homelessness moved into permanent house during the month for which you are reporting? This number MAY include people who ALSO meet the definition of Chronic AND/OR Episodic Homelessness. (If you do NOT know the response or the data is unavailable, please leave this text box blank.)
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Your answer
PERMANENT HOUSING MOVE-INS: POPULATION GROUPS
3. ABORIGINAL/ABORIGINAL ANCESTRY: Of the total number in Question 1, how many people identified as Aboriginal or as having Aboriginal Ancestry?
(If you do NOT know the response or the data is unavailable, please leave this text box blank.)
Your answer
4. VETERANS: Of the total number in Question 1, how many people were veterans?
(If you do NOT know the response or the data is unavailable, please leave this text box blank.)
Your answer
5. YOUTH HEAD OF HOUSEHOLD (Unaccompanied Youth): Of the total number in Question 1, how many people identified as Youth (16-24) Head of Household?
(If you do NOT know the response or the data is unavailable, please leave this text box blank.)
Your answer
BY-NAME LIST REPORTING DATA ON INDIVIDUALS EXPERIENCING CHRONIC HOMELESSNESS (*IF YOUR COMMUNITY IS NOT ABLE TO REPORT THE FOLLOWING QUESTIONS BELOW, PLEASE SKIP THESE QUESTIONS AND SUBMIT THE FORM*)
INFLOW - NEWLY IDENTIFIED: How many people meeting the definition of Chronic Homelessness did your community assess for the first time during the month for which you are reporting?
Your answer
INFLOW - RETURNED (TO ACTIVE) FROM INACTIVE: How many people meeting the definition of Chronic Homelessness that had previously been DESIGNATED AS “Inactive" returned to your community’s Active List this month?
Your answer
INFLOW - RETURNED FROM HOUSING: How many people meeting the definition of Chronic Homelessness that had previously been housed returned to your community’s Active List this month?
Your answer
OUTFLOW - MOVED TO INACTIVE: How many people meeting the definition of Chronic Homelessness did your community designate as “Inactive” during the month for which you are reporting? (Inactive - after 90 days, those who cannot be found or contacted)
Your answer
ACTIVELY HOMELESS: As of the end of the month for which you are reporting, how many people meeting the definition of Chronic Homelessness remain actively homeless (sheltered, unsheltered, or in transitional housing) in your community?
Your answer
Quirks?
Are there any quirks in the data you are reporting that we should know about?
Your answer
***ADDITIONAL NOTES
PLEASE NOTE THE FOLLOWING DEFINITIONS THAT ARE RELEVANT TO THIS FORM:

**HIGH ACUITY**
Adult Singles – for VI-SPDAT v2.0, high acuity score 8 or higher. For full SPDAT v4.0, high acuity score 35 or higher.
Youth Singles – for VI-TAY-SPDAT v.1.0, high acuity score 8 or higher. For full Youth SPDAT v1.0, high acuity score 35 or higher.
Family - for Family VI-SDPAT v2.0, high acuity score 9 or higher. For full Family SPDAT v2.0, high acuity score 54 or higher.

**CHRONIC**
Refers to individuals, often with disabling conditions (e.g. chronic physical or mental illness, substance abuse problems), who are currently homeless and have been homeless for six months or more in the past year (i.e., have spent more than 180 cumulative nights in a shelter or place not fit for human habitation).

**EPISODIC**
Refers to individuals, often with disabling conditions, who are currently homeless and have experienced three or more episodes of homelessness in the past year (of note, episodes are defined as periods when a person would be in a shelter or place not fit for human habitation, and after at least 30 days, would be back in the shelter or inhabitable location).

**YOUTH HEAD OF HOUSEHOLD**
Youth ages 16-24 who are head of households and are legally able to rent on their own (if you cannot report down to age 16, age 18 can be the lower bound).

(Chronic and episodic definitions are aligned with HPS definitions [http://homelesshub.ca/solutions/prevention/addressing-chronic-homelessness].)

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ADDITIONAL NOTES:

If you are back-logging or re-submitting data for other months, please submit the form for each month - e.g. if you are submitting for both September 2017 and October 2017, then you will need to submit the form twice, one for September, one for October. If you are submitting back-logged housing placement data, please submit ONLY the ADDITIONAL housing placements from the previously reported number(s), for each month. If you would prefer to submit back-data in an Excel spreadsheet instead, please contact marie@caeh.ca

Numbers can be reported as far back as the date you enrolled. For those communities that have just joined us, please begin reporting from the date you joined the campaign. For communities that conducted a Registry Week before June 2015, you can include numbers as far back as your Registry Week.

If you are not able to currently capture all the data for your community, that is ok! Please send us what you have so we can get a sense of reporting in your community.

Communities who have reported 3+ consecutive months of housing move-in data, should have received an email with a link to their community's PERFORMANCE MANAGEMENT TRACKER (PMT). These reports will continue to roll out to communities reporting 3 or more consecutive months. If you have not received or can't find your PMT, please contact marie@caeh.ca

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