HMIS Project Set-Up

PROJECT INFORMATION

Desired Project Name *

Organization Name *

Which organization is this project a part of?

Description of Project *

Please describe in detail what services or programs this project will provide for the HMIS resource directory.

PROJECT LOCATION INFORMATION

Address Type *

Street Address *

City *

Zip Code *

Is this the primary address? *

PROJECT CONTACT INFOMRATION

Agency Phone Number *

Agency Website Address *

Project Manager

Who can we contact about data entry and programmatic questions?

Name *

Title *

Phone Number *

Email *

Contract Manager

Who can we contact regarding the grant/funding for this project?

Name

Title

Phone Number

PROJECT STANDARDS INFORMATION

Federal Employer ID Number *

Victim Services Provider? *

Project Operating Start Date *

Project Operating End Date

Target Population *

Secondary Target Population (OPTIONAL)

Provider Grant Type *

Principal Location *

Is the project located at the Agency/Organizations main/original location?

Project Type *

EMERGENCY SHELTER INFORMATION

Emergency Shelter Tracking Method

Shelter Type

What is the maximum number of days a client can stay in this project?

Is this project's inventory ONLY available seasonally or for overflow capacity?

TRANSITIONAL HOUSING INFORMATION

What is the maximum number of days a client is allowed to be continuously enrolled?

PSH/RRH INFORMATION

Housing Type

Will both housing AND services be documented through this single project ID? *

What project will be providing services? *

OTHER PERMANENT HOUSING INFORMATION

Housing Type

Will this project be providing services?

SERVICES ONLY PROJECTS

Including: Homelessness Prevention, Diversion, Rapid Exit, Supportive Services Only, and non-monetary service providers

Will this project be providing monetary assistance?

Will services provided be connected directly to housing outcomes?

BED/UNIT INVENTORY

The 'Bed Inventory' is a count of the total number of beds available for occupancy as of the ‘Inventory Start Date.' The number of beds is generally equivalent to the number of persons a lodging project can house on a given night.

The 'Unit Inventory' is a count of the total number of units (e.g., rooms, apartments, etc) available for occupancy as of the ‘Inventory Start Date.' Projects that do not have a fixed number of units (e.g., a congregate shelter project) may record the bed inventory, the number of residential facilities operated by the project, or the number of rooms available as the unit integer.

Inventory Start Date *

Inventory End Date

Skip if N/A

Bed Type

Total Number of Family Beds *

Please enter 0 if there are no family beds.

Total Number of Family Units

Total Number of Singles Beds *

Please enter 0 if there are no singles beds

Are any beds dedicated to the following options

Chronically Homeless
Veterans
Youth
N/A (all beds are non-dedicated)

Is this project McKinney Vento Funded?

SERVICE INFORMATION

Please list any services you would like included in the HMIS directory for this project:

Please list any services you would like added to the provider quick list for all data entry users:

FUNDING & GRANT INFORMATION

Please provide information on any Federal or Local grants or funding sources that fund this project.

Federal Grant Type *

If this is not a federally funded grant, select "Local or Other Funding Source".

(Please Specify) Local or Other Funding Source

If this project has a local or other funding source (not federally funded), please specify the name of the grantee or funding source.

Grant Identifier *

Please specify the ID number assigned by the grant or funding source. If no ID Specified, write N/A.

Grant Start Date *

Grant End Date

If there is no grant/ funding source end date, put the date that the grant cycle/funding cycle ends as specified in the grant contract or the date the grant/funding source is to be renewed.

ADDITIONAL INFORMATION

Who should be given an EDA to this project? *

Please provide names of each person who needs permission to enter data for this project.

Would you like to schedule a short follow-up meeting with the HMIS Administrator to review the project set-up after it is complete?

Do you have any other additional details to add regarding this project?

(Example: "This project's set up should be similar to another project's set-up", additional project contacts, questions, etc.)

HMIS Project Set-Up