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Master Contract No. 902012 <br />Procurement Contract No. 24823 <br />Exhibit B1 <br />Page 10 of 14 <br /> <br /> <br /> <br />MANUAL REPORTING FORM <br />ALL PROJECTS (EXCEPT COORDINATED ENTRY): All Projects Supplemental Outcomes <br /> <br />Supplemental Outcomes can likely be generated from your HMIS System. <br /> <br />Please refer to the Annual Report Instructions for additional guidance on completing this form. Reminder, do NOT include <br />Coordinated Entry projects. <br /> <br />If possible, use an APR that includes all HHAP-1 funded projects to help you complete this form. <br />Please report information in the space provided. <br /> <br />Report exits of persons/households(HHs) <br />served on all HHAP-1 funded projects <br />• Add the exits of persons/HHs served in <br />every HHAP-1 funded project. This <br />should be exits of persons/HHs served by <br />the entire project regardless of how <br />much of the project was funded by <br />HHAP-1. <br />Population of Interest <br /> Chronically Homeless <br />Permanent Destinations <br />Moved from one HOPWA funded <br />project to HOPWA PH <br /> <br />Owned by client, no ongoing housing subsidy <br /> <br />Owned by client, with ongoing housing subsidy <br /> <br />Rental by client, no ongoing housing subsidy <br /> <br />Rental by client, with VASH housing subsidy <br /> <br />Rental by client, with GPD TIP housing <br />subsidy <br /> <br />Rental by client, with other ongoing <br />housing subsidy <br /> <br />Permanent housing (other than RRH) for <br />formerly homeless persons <br /> <br />Staying or liv ing with family, permanent <br />tenure <br /> <br />Staying or liv ing with friends, permanent tenure <br /> <br />Rental by client, with RRH or equivalent subsidy <br /> <br />Rental by client, with HCV voucher <br />(tenant or project based) <br /> <br />Rental by client in a public housing unit <br />Subtotal <br />Temporary Destinations <br />Emergency shelter, including hotel or <br />motel paid for with emergency shelter <br />voucher, or RHY-funded Host Home shelter <br /> <br />Moved from one HOPWA funded <br />project to HOPWA TH <br /> <br />Transitional housing for homeless <br />persons (including homeless youth) <br /> <br />Staying or liv ing with family, temporary <br />tenure (e.g. room, apartment or house) <br /> <br />Staying or liv ing with friends, temporary <br />tenure (e.g. room, apartment or house) <br /> <br />Place not meant for habitation (e.g., a <br />vehicle, an abandoned building, bus / <br />train / subway station / airport or anywhere outside) <br /> <br />Safe Haven <br />Hotel or motel paid for without emergency shelter voucher <br /> <br />Host Home (non-crisis) <br />Subtotal <br />