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Homeless History Tracking Form - Key
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Click here to be redirected to the full ICA instructional guide and webinar recording on Chronic Homeless and the HHTF
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The Header Table
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The Timeline Table
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Picklists for Timeline Table
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Housing SituationUsage Notes
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Place not meant for habitationSome examples could be in a vehicle, park, abandoned building,apartment building hallway, uninsulated garage.
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ES / SH / Agency-paid Hotel"ES" = Emergency Shelter; "SH" = Safe Haven
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Transitional Housing
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Hospital / Psych / Detox
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Jail / Prison
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Foster Care / Group Home
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Apt / House (rented or owned)
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Friend / Family
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Self-paid Hotel / Halfway House
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Gap (need self-report)Use when there is a gap that covers at least an entire calendar month.
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Gap (presumed homeless)Use when there is a gap between stays in ES/SH within a calendar month without evidence of a break.
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Documentation Source (Obtained or Anticipated)Usage Notes
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HMIS ES / SH / SO record(s)This allows for multiple consecutive project enrollments to be captured in a single row, if needed.
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3rd Party Letter
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Self-Certification Letter
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Month Already CountedApplies for "Gap (presumed homeless)" or client self-report of homelessness within a month for which there is already documentation.
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N/AApplies for any non-homeless situation.
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Documentation ObtainedUsage Notes
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YesHMIS ES / SH / SO record(s) and Month Already Counted should always be "Yes".
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PendingUse for 3rd Party Letters & Self-Cert Letters still being gathered.
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N/AApplies for any non-homeless situation.
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