hOME sAFE iNSTRUCTION mANUAL...Home Safe Instruction Manual Column A - Reporting Agency This cell is automatically populated and is for CDSS use only. Column B - Report Month This

Home Safe Instruction Manual

Contents Column A - Reporting Agency ............................................................................................................................................. 6

Column B - Report Month ................................................................................................................................................... 6

1 Column C - Last Name ...................................................................................................................................................... 6

2 Column D - First Name ..................................................................................................................................................... 6

3 Column E - Last Four Digits of Social Security Number .................................................................................................... 7

4 Column F - Date of Birth ................................................................................................................................................... 7

5 Column G - Location of Participation ............................................................................................................................... 8

6 Column H - Method of Assessment ................................................................................................................................. 8

7 Column I - Assessment Score ........................................................................................................................................... 8

8 Column J - Gender Identity .............................................................................................................................................. 8

9 Column K - Race 1 ............................................................................................................................................................ 9

10 Column L - Race 2 ........................................................................................................................................................... 9

11 Column M - Ethnicity 1 ................................................................................................................................................. 10

12 Column N - Ethnicity 2 ................................................................................................................................................. 10

13 Column O - Current Marital Status .............................................................................................................................. 11

14 Column P - Number of Children ................................................................................................................................... 11

15 Column Q - Sexual Orientation .................................................................................................................................... 12

16 Column R - Preferred Language ................................................................................................................................... 12

17 Column S - Veteran Status ........................................................................................................................................... 13

18 Column T - Medi-Cal ..................................................................................................................................................... 13

19 Column U - Medicare ................................................................................................................................................... 14

20 Column V - Representative Payee or Conservator ....................................................................................................... 14

21 Column W - Living Situation Upon Entry to HSAPS ...................................................................................................... 15

22 Column X - Monthly Rent/Mortgage Contribution ...................................................................................................... 15

23 Column Y - Number of Adults in Household - Not Including Client ............................................................................. 15

24 Column Z – Number of Minor Children in Household ................................................................................................. 15

25 Column AA - Client Homeless Within the Last Three Years ......................................................................................... 15

26 Column AB - Number of Times Homelessness Occurred in the Last Three Years ....................................................... 16

27 Column AC - Total Duration of Homelessness ............................................................................................................. 16

28 Column AD - Last Period of Homelessness .................................................................................................................. 16

29 Column AE - Previous Evictions or Foreclosures .......................................................................................................... 16

30 Column AF - Number of Past Evictions or Foreclosures............................................................................................... 16

31 Column AG - Current Eviction or Foreclosures ............................................................................................................ 17

32 Column AH - Discharge from Institution in the Last Six Months.................................................................................. 17


33 Column AI - Household Trauma in the Last Six Months ............................................................................................... 17

34 Column AJ - Death of Household Member .................................................................................................................. 17

35 Column AK - Death of a Partner ................................................................................................................................... 17

36 Column AL - Breakup of Partnership ............................................................................................................................ 17

37 Column AM - Job Loss - Client ...................................................................................................................................... 18

38 Column AN - Job Loss - Household Member ................................................................................................................ 18

39 Column AO - Illness/ Injury/ Hospitalization - Client ................................................................................................... 18

40 Column AP - Illness/ Injury/ Hospitalization - Household Member ............................................................................. 18

41 Column AQ - Natural Disaster ...................................................................................................................................... 18

42 Column AR - Incarceration - Household Member ........................................................................................................ 18

43 Column AS - Additional Expense .................................................................................................................................. 19

44 Column AT - Other Causes of Housing Instability ........................................................................................................ 19

45 Column AU - Deaf ......................................................................................................................................................... 19

46 Column AV - Wheelchair .............................................................................................................................................. 19

47 Column AW - Cane/Walker .......................................................................................................................................... 19

48 Column AX - Other Ambulatory or Physical Difficulty .................................................................................................. 19

49 Column AY - Oxygen Therapy/ Respirator ................................................................................................................... 20

50 Column AZ - Kidney Dialysis ......................................................................................................................................... 20

51 Column BA - Depression .............................................................................................................................................. 20

52 Column BB - Anxiety ..................................................................................................................................................... 20

53 Column BC - Bipolar ..................................................................................................................................................... 20

54 Column BD - Post-Traumatic Stress Disorder .............................................................................................................. 21

55 Column BE - Schizophrenia .......................................................................................................................................... 21

56 Column BF - Dementia/ Cognitive Disorder ................................................................................................................. 21

56 Column BG - Substance Abuse ..................................................................................................................................... 21

58 Column BH Intellectual Disability ................................................................................................................................. 22

59 Column BI - Other Behavioral/ Mental Condition ........................................................................................................ 22

60 Column BJ - APS Reported Incident Date ..................................................................................................................... 22

61 Column BK - APS Reported Incident Location .............................................................................................................. 23

62 Column BL - Previous APS Involvement ....................................................................................................................... 23

63 Column BM - Self-Neglect - Physical Care .................................................................................................................... 23

64 Column BN - Self-Neglect - Financial ............................................................................................................................ 24

65 Column BO - Self-Neglect - Residence ......................................................................................................................... 24

66 Column BP - Physical Abuse ......................................................................................................................................... 24

67 Column BQ - Sexual Abuse ........................................................................................................................................... 25


68 Column BR - Neglect .................................................................................................................................................... 25

69 Column BS - Abandonment .......................................................................................................................................... 25

70 Column BT - Isolation ................................................................................................................................................... 26

71 Column BU - Abduction ................................................................................................................................................ 26

72 Column BV - Psychological/ Mental Suffering ............................................................................................................. 26

73 Column BW - Financial Abuse - Improper Use/Access ................................................................................................. 27

74 Column BX - Financial Abuse – Theft ........................................................................................................................... 27

75 Column BY - Financial Abuse – Fraud ........................................................................................................................... 27

76 Column BZ - Financial Abuse – Amount ....................................................................................................................... 27

77 Column CA - Alleged Abuser 1 - Identity ...................................................................................................................... 28

78 Column CB - Alleged Abuser 1 - Living with Client ....................................................................................................... 28

79 Column CC - Alleged Abuser 2 – Identity ..................................................................................................................... 28

80 Column CD - Alleged Abuser 2 - Living with Client....................................................................................................... 29

81 Column CE - Alleged Abuser 3 - Identity ...................................................................................................................... 29

82 Column CF - Alleged Abuser 3 - Living with Client ....................................................................................................... 29

83 Colum CG - Reporting Source ....................................................................................................................................... 30

84 Column CH - APS Incident Reported to Law Enforcement........................................................................................... 30

85 Column CI - Disability Income ...................................................................................................................................... 30

86 Column CJ - Social Security Income ............................................................................................................................. 30

87 Column K - Pension or Other Retirement .................................................................................................................... 31

88 Column CL - Private Health Insurance .......................................................................................................................... 31

89 Column CM - CalFresh .................................................................................................................................................. 31

90 Column CN - Work for Pay ........................................................................................................................................... 32

91 Column CO - Other Income .......................................................................................................................................... 32

92 Column CP - Case Start Date ........................................................................................................................................ 32

93 Column CQ - Client Referred to CES ............................................................................................................................. 32

94 Column CR - Referral to Longer-Term Assistance - Date ............................................................................................. 32

95 Column CS - Referral to Longer-Term Assistance - Amount ........................................................................................ 33

96 Column CT - HSAPS Intervention 1 - Type .................................................................................................................... 33

97 Column CU - HSAPS Intervention 1 - "Other" Explanation .......................................................................................... 33

98 Column CV - HSAPS Intervention 1 - Date.................................................................................................................... 33

99 Column CW - HSAPS Intervention 1 - Amount ............................................................................................................. 34

100 Column CX - HSAPS Intervention 1 - Mode of Disbursement .................................................................................... 34

101 Column CY - HSAPS Intervention 1 - Mode of Disbursement Explanation ................................................................ 34

102 Column CZ - HSAPS Intervention 2 - Type .................................................................................................................. 35


103 Column DA - HSAPS Intervention 2 - "Other" Explanation ........................................................................................ 35

104 Column DB - HSAPS Intervention 2 - Date ................................................................................................................. 35

105 Column DC - HSAPS Intervention 2 - Amount ............................................................................................................ 36

106 Column DD - HSAPS Intervention 2 - Mode of Disbursement ................................................................................... 36

107 Column DE - HSAPS Intervention 2 - Mode of Disbursement Explanation ................................................................ 36

108 Column DF - HSAPS Intervention 3 - Type ................................................................................................................. 37

109 Column DG - HSAPS Intervention 3 - "Other" Explanation ........................................................................................ 37

110 Column DH - HSAPS Intervention 3 - Date ................................................................................................................. 37

111 Column DI - HSAPS Intervention 3 - Amount ............................................................................................................. 38

112 Column DJ - HSAPS Intervention 3 - Mode of Disbursement ..................................................................................... 38

113 Column DK - HSAPS Intervention 3 - Mode of Disbursement Explanation ................................................................ 38

114 Column DL - HSAPS Intervention 4 - Type .................................................................................................................. 39

115 Column DM - HSAPS Intervention 4 - "Other" Explanation ....................................................................................... 39

116 Column DN - HSAPS Intervention 4 - Date ................................................................................................................. 39

117 Column DO - HSAPS Intervention 4 - Amount ........................................................................................................... 40

118 Column DP - HSAPS Intervention 4 - Mode of Disbursement .................................................................................... 40

119 Column DQ - HSAPS Intervention 4 - Mode of Disbursement Explanation ............................................................... 40

120 Column DR - HSAPS Intervention 5 - Type ................................................................................................................. 41

121 Column DS - HSAPS Intervention 5 - "Other" Explanation ......................................................................................... 41

122 Column DT - HSAPS Intervention 5 - Date.................................................................................................................. 41

123 Column DU - HSAPS Intervention 5 - Amount ........................................................................................................... 42

124 Column DV - HSAPS Intervention 5 - Mode of Disbursement .................................................................................... 42

125 Column DW - HSAPS Intervention 5 - Mode of Disbursement Explanation .............................................................. 42

126 Column DX - HSAPS Intervention 6 - Type ................................................................................................................. 43

127 Column DY - HSAPS Intervention 6 - "Other" Explanation ......................................................................................... 43

128 Column DZ - HSAPS Intervention 6 - Date .................................................................................................................. 43

129 Column EA - HSAPS Intervention 6 - Amount ............................................................................................................ 44

130 Column EB - HSAPS Intervention 6 - Mode of Disbursement .................................................................................... 44

131 Column EC - HSAPS Intervention 6 - Mode of Disbursement Explanation ................................................................ 44

132 Column ED - Legal Services ........................................................................................................................................ 45

133 Column EE - In Home Assistance ................................................................................................................................ 45

134 Column EF - Case Management ................................................................................................................................. 46

135 Column EG - Assistance with Benefits ....................................................................................................................... 46

136 Column EH - Payee Services ....................................................................................................................................... 47

137 Column EI - Financial Management ........................................................................................................................... 47


138 Column EJ - Other Services ........................................................................................................................................ 48

139 Column EK - Other Services – Explanation ................................................................................................................. 48

140 Column EL - Case Closure Date .................................................................................................................................. 48

141 Column EM - Living Situation at Exit .......................................................................................................................... 49

142 Column EN - Six Month Follow-Up Living Situation Verified Date ............................................................................. 49

143 Column EO - Six Month Follow-Up - Method ............................................................................................................. 49

144 Column EP - Six Month Follow-Up - Living Situation Assessment .......................................................................... 50

145 Column EQ - Six Month Follow-Up - Homelessness Assessment ........................................................................... 50

146 Column ER - Six Month Follow-Up - Substantiated APS Reports ............................................................................... 50

147 Column ES - Twelve Month Follow-Up - Living Situation Verified Date .................................................................... 50

148 Column ET - Twelve Month Follow-up - Method ....................................................................................................... 51

149 Column EU - Twelve Month Follow-Up - Living Situation .......................................................................................... 51

150 Column EV - Twelve Month Follow-Up – Homelessness ........................................................................................... 51

151 Column EW - Twelve Month Follow-Up - Substantiated APS Reports....................................................................... 51

152 Column EX - Comments ............................................................................................................................................. 51


Column A - Reporting Agency This cell is automatically populated and is for CDSS use only.

Column B - Report Month This cell is automatically populated and is for CDSS use only

1 Column C - Last Name Information is collected on the Client Details page -> Last Name.

2 Column D - First Name Information is collected on the Client Details page -> First Name.


3 Column E - Last Four Digits of Social Security Number Information is collected on the Client Details page -> SSN.

4 Column F - Date of Birth Information is collected on the Client Details page -> Date of Birth.


5 Column G - Location of Participation Information is collected on the Client details page -> Address -> City

6 Column H - Method of Assessment Report is going to populate PR VI SPDAT or VI SPDAT

7 Column I - Assessment Score Information is auto populated from the PR VI SPDAT assessment or VI SPDAT

8 Column J - Gender Identity Information is collected on the Client Details page -> Gender.


9 Column K - Race 1 Information is collected on the Client Details page -> Race

10 Column L - Race 2 There isn’t a field to collected second Race information. Report is going to show the default value “Data not collected.”


11 Column M - Ethnicity 1 Information is collected on the Client Details page -> Ethnicity

12 Column N - Ethnicity 2 There isn’t a field to collect second Ethnicity information. Report is going to show the default value “Data not collected.”


13 Column O - Current Marital Status Information is collected on the Client Details page -> Marital Status

14 Column P - Number of Children Information is collected from the PR VI SPDAT Assessment.


15 Column Q - Sexual Orientation Information is collected on the Client Details page -> Sexual Orientation

16 Column R - Preferred Language Information is collected on the Client Details page -> Language


17 Column S - Veteran Status Information is collected on the Client Details page -> Veteran Status

18 Column T - Medi-Cal Information is collected on the Client Details page -> Resources sub tab -> Resource drop down = Medi-Cal


19 Column U - Medicare Information is collected on the Client Details page -> Resources sub tab -> Resource drop down = Medicare

20 Column V - Representative Payee or Conservator Information is collected on the Collaterals tab -> Collaterals sub tab -> Resource Type = Representative Payee or

Conservator.


21 Column W - Living Situation Upon Entry to HSAPS Information is collected from the PR VI SPDAT Assessment.

22 Column X - Monthly Rent/Mortgage Contribution Information is collected from the PR VI SPDAT Assessment

23 Column Y - Number of Adults in Household - Not Including Client Information is collected from the PR VI SPDAT Assessment

24 Column Z – Number of Minor Children in Household Information is collected from the PR VI SPDAT Assessment

25 Column AA - Client Homeless Within the Last Three Years Information is collected from the PR VI SPDAT Assessment


26 Column AB - Number of Times Homelessness Occurred in the Last Three Years Information is collected from the PR VI SPDAT Assessment

27 Column AC - Total Duration of Homelessness Information is collected from the PR VI SPDAT Assessment

28 Column AD - Last Period of Homelessness Information is collected from the PR VI SPDAT Assessment

29 Column AE - Previous Evictions or Foreclosures Information is collected from the PR VI SPDAT Assessment

30 Column AF - Number of Past Evictions or Foreclosures Information is collected from the PR VI SPDAT Assessment


31 Column AG - Current Eviction or Foreclosures Information is collected from the PR VI SPDAT Assessment

32 Column AH - Discharge from Institution in the Last Six Months Information is collected from the PR VI SPDAT Assessment

33 Column AI - Household Trauma in the Last Six Months Information is collected from the PR VI SPDAT Assessment

34 Column AJ - Death of Household Member Information is collected from the PR VI SPDAT Assessment

35 Column AK - Death of a Partner Information is collected from the PR VI SPDAT Assessment

36 Column AL - Breakup of Partnership Information is collected from the PR VI SPDAT Assessment


37 Column AM - Job Loss - Client Information is collected from the PR VI SPDAT Assessment

38 Column AN - Job Loss - Household Member Information is collected from the PR VI SPDAT Assessment

39 Column AO - Illness/ Injury/ Hospitalization - Client Information is collected from the PR VI SPDAT Assessment

40 Column AP - Illness/ Injury/ Hospitalization - Household Member Information is collected from the PR VI SPDAT Assessment

41 Column AQ - Natural Disaster Information is collected from the PR VI SPDAT Assessment

42 Column AR - Incarceration - Household Member Information is collected from the PR VI SPDAT Assessment


43 Column AS - Additional Expense Information is collected from the PR VI SPDAT Assessment

44 Column AT - Other Causes of Housing Instability Information is collected from the PR VI SPDAT Assessment

45 Column AU - Deaf Information is collected from the PR VI SPDAT Assessment

46 Column AV - Wheelchair Information is collected from the PR VI SPDAT Assessment

47 Column AW - Cane/Walker Information is collected from the PR VI SPDAT Assessment

48 Column AX - Other Ambulatory or Physical Difficulty Information is collected from the PR VI SPDAT Assessment


49 Column AY - Oxygen Therapy/ Respirator Information is collected from the PR VI SPDAT Assessment

50 Column AZ - Kidney Dialysis Information is collected from the PR VI SPDAT Assessment

51 Column BA - Depression Information is collected from the Client Detail page -> Behavioral Condition = Depression

52 Column BB - Anxiety Information is collected from the Client Detail page -> Behavioral Condition = Anxiety

53 Column BC - Bipolar Information is collected from the Client Detail page -> Behavioral Condition = Bipolar


54 Column BD - Post-Traumatic Stress Disorder Information is collected from the Client Detail page -> Behavioral Condition = PTSD (Post-Traumatic Stress Disorder)

55 Column BE - Schizophrenia Information is collected from the Client Detail page -> Behavioral Condition = Schizophrenia

56 Column BF - Dementia/ Cognitive Disorder Information is collected from the Client Detail page -> Behavioral Condition = Dementia or Cognitive Disorder

56 Column BG - Substance Abuse Information is collected from the Client Detail page -> Behavioral Condition = Substance Abuse


58 Column BH Intellectual Disability Information is collected from the Client Detail page -> Vulnerability = Intellectual Disability

59 Column BI - Other Behavioral/ Mental Condition Information is collected from the Client Detail page. This part of the report is going to show any behavioral conditions

other than Depression, Anxiety, Bipolar, PTSD, Schizophrenia, Dementia/Cognitive Disorder, and Substance Abuse as

Other Behavioral/Mental Condition.

60 Column BJ - APS Reported Incident Date System auto populate this information entered on the Incident Info tab at intake -> Date and Time of this incident.


61 Column BK - APS Reported Incident Location Information is collected from the Intake Report page/ Incident info -> Client Address -> City

62 Column BL - Previous APS Involvement System auto populates this information if the client has had a previous involvement with APS -> Overview Page ->

Related Reports.

63 Column BM - Self-Neglect - Physical Care Information is collected from the Findings tab -> Allegations = Physical Care (Physical Care, Malnutrition, or Medical

Care)


64 Column BN - Self-Neglect - Financial Information is collected from the Findings tab -> Allegations = Financial

65 Column BO - Self-Neglect - Residence Information is collected from the Findings tab -> Allegations = Residence (Health & Safety)

66 Column BP - Physical Abuse Information is collected from the Findings tab -> Allegations = Financial


67 Column BQ - Sexual Abuse Information is collected from the Findings tab -> Allegations = Sexual Abuse

68 Column BR - Neglect Information is collected from the Findings tab -> Allegations = Neglect

69 Column BS - Abandonment Information is collected from the Findings tab -> Allegations = Abandonment


70 Column BT - Isolation Information is collected from the Findings tab -> Allegations = Isolation

71 Column BU - Abduction Information is collected from the Findings tab -> Allegations = Abduction

72 Column BV - Psychological/ Mental Suffering Information is collected from the Findings tab -> Allegations = Psychological/Mental Abuse


73 Column BW - Financial Abuse - Improper Use/Access Information is collected from the Findings tab -> Allegations = Financial -> Financial Detail = Improper Use of Assets

74 Column BX - Financial Abuse – Theft Information is collected from the Findings tab -> Allegations = Financial -> Financial Detail = Theft

75 Column BY - Financial Abuse – Fraud Information is collected from the Findings tab -> Allegations = Financial -> Financial Detail = Fraud (Scam)

76 Column BZ - Financial Abuse – Amount Information is collected from the PR VI SPDAT Assessment


77 Column CA - Alleged Abuser 1 - Identity Information is collected from the Coll/Perp tab -> Perpetrators sub tab -> Perpetrator Association -> Relationship

78 Column CB - Alleged Abuser 1 - Living with Client Information is collected from the Coll/Perp tab -> Perpetrators sub tab-> Alleged Perpetrator Information -> Lives with

Client checkbox.

79 Column CC - Alleged Abuser 2 – Identity Information is collected from the Coll/Perp tab -> Perpetrators sub tab-> Perpetrator Association -> Relationship


80 Column CD - Alleged Abuser 2 - Living with Client Information is collected from the Coll/Perp tab -> Perpetrators sub tab-> Alleged Perpetrator Information -> Lives with

Client checkbox.

81 Column CE - Alleged Abuser 3 - Identity Information is collected from the Coll/Perp tab -> Perpetrators sub tab-> Perpetrator Association -> Relationship

82 Column CF - Alleged Abuser 3 - Living with Client Information is collected from the Coll/Perp tab -> Perpetrators sub tab -> Alleged Perpetrator Information -> Lives with

Client checkbox.


83 Colum CG - Reporting Source Information is collected from the Coll/Perp tab -> Collaterals sub tab-> Reporter -> Collateral Association

84 Column CH - APS Incident Reported to Law Enforcement Information is collected from Findings tab -> Agencies sub tab -> Agency drop down = Law enforcement

85 Column CI - Disability Income Information is collected from the Client Details page -> Resources sub tab -> Resources drop down = Disability Income

86 Column CJ - Social Security Income Information is collected from the Client Details page -> Resource sub tab -> Resources drop down = Social Security

Income


87 Column K - Pension or Other Retirement Information is collected from the Client Details page -> Resource sub tab -> Resource drop down = Pension or Other

Retirement.

88 Column CL - Private Health Insurance Information is collected from the Client Details page -> Resources sub tab -> Resource drop down = Private Health

Insurance.

89 Column CM - CalFresh Information is collected from the Client Details page -> Resources sub tab -> Resource drop down = CalFresh


90 Column CN - Work for Pay Information is collected from the Client Details page -> Resources sub tab -> Resource drop down = Work for Pay

91 Column CO - Other Income Information is collected from the Client Details page -> Resources sub tab -> Resource drop down = Other Income

92 Column CP - Case Start Date System auto populates this information from the Overview page

93 Column CQ - Client Referred to CES Information is collected from the PR VI SPDAT Assessment.

94 Column CR - Referral to Longer-Term Assistance - Date Information is collected from the PR VI SPDAT Assessment


95 Column CS - Referral to Longer-Term Assistance - Amount Information is collected from the PR VI SPDAT Assessment

96 Column CT - HSAPS Intervention 1 - Type Information is collected from the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

97 Column CU - HSAPS Intervention 1 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider type is not from the Home Safe list

98 Column CV - HSAPS Intervention 1 - Date Information is collected from the Service Plan tab -> Service Item Start Date


99 Column CW - HSAPS Intervention 1 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

100 Column CX - HSAPS Intervention 1 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

101 Column CY - HSAPS Intervention 1 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


102 Column CZ - HSAPS Intervention 2 - Type Information is collected form the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

103 Column DA - HSAPS Intervention 2 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider Type is not from the Home Safe list

104 Column DB - HSAPS Intervention 2 - Date Information is collected from the Service Plan tab -> Service Item Start Date


105 Column DC - HSAPS Intervention 2 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

106 Column DD - HSAPS Intervention 2 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

107 Column DE - HSAPS Intervention 2 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


108 Column DF - HSAPS Intervention 3 - Type Information is collected form the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

109 Column DG - HSAPS Intervention 3 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider Type is not from the Home Safe list

110 Column DH - HSAPS Intervention 3 - Date Information is collected from the Service Plan tab -> Service Item Start Date


111 Column DI - HSAPS Intervention 3 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

112 Column DJ - HSAPS Intervention 3 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

113 Column DK - HSAPS Intervention 3 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


114 Column DL - HSAPS Intervention 4 - Type Information is collected form the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

115 Column DM - HSAPS Intervention 4 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider Type is not from the Home Safe list

116 Column DN - HSAPS Intervention 4 - Date Information is collected from the Service Plan tab -> Service Item Start Date


117 Column DO - HSAPS Intervention 4 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

118 Column DP - HSAPS Intervention 4 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

119 Column DQ - HSAPS Intervention 4 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


120 Column DR - HSAPS Intervention 5 - Type Information is collected form the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

121 Column DS - HSAPS Intervention 5 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider Type is not from the Home Safe list

122 Column DT - HSAPS Intervention 5 - Date Information is collected from the Service Plan tab -> Service Item Start Date


123 Column DU - HSAPS Intervention 5 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

124 Column DV - HSAPS Intervention 5 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

125 Column DW - HSAPS Intervention 5 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


126 Column DX - HSAPS Intervention 6 - Type Information is collected form the Service Plan tab -> Provider Type = Provider Type is from the Home Safe list

127 Column DY - HSAPS Intervention 6 - "Other" Explanation Information is collected from the Service Plan tab -> Provider Type = Provider Type is not from the Home Safe list

128 Column DZ - HSAPS Intervention 6 - Date Information is collected from the Service Plan tab -> Service Item Start Date


129 Column EA - HSAPS Intervention 6 - Amount Information is collected from the Service Plan tab -> Provider Name = Entered Amount

130 Column EB - HSAPS Intervention 6 - Mode of Disbursement Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is from the Home Safe list

131 Column EC - HSAPS Intervention 6 - Mode of Disbursement Explanation Information is collected from the Service Plan tab -> Service Item Status = Service Item Status is not from the Home Safe

list


132 Column ED - Legal Services Information is collected from the Service Plan tab -> Service Item Type = Legal Services

133 Column EE - In Home Assistance Information is collected from the Service Plan tab -> Service Item Type = In Home Assistance


134 Column EF - Case Management Information is collected from the Service Plan tab -> Service Item Type = Case Management

135 Column EG - Assistance with Benefits Information is collected from the Service Plan tab -> Service Item Type = Assistance with Benefits


136 Column EH - Payee Services Information is collected from the Service Plan tab -> Service Item Type = Payee Services

137 Column EI - Financial Management Information is collected from the Service Plan tab -> Service Item Type = Financial Management


138 Column EJ - Other Services Information is collected from the Service Plan tab -> Service Item Type = Service Item Type is not from the Home Safe list

139 Column EK - Other Services – Explanation Information is collected from the Service Plane tab -> Service Item Type = Explanation of Service Item Type that is not

from the Home Safe list.

140 Column EL - Case Closure Date Information is collected from the Overview page -> Investigation Complete Date


141 Column EM - Living Situation at Exit Information is collected from the PR VI SPDAT or Case Closure Assessment depending on the county.

142 Column EN - Six Month Follow-Up Living Situation Verified Date Information is collected from the Six-Month Follow-Up Assessment

143 Column EO - Six Month Follow-Up - Method Information is collected from the Six-Month Follow-Up Assessment


144 Column EP - Six Month Follow-Up - Living Situation Assessment Information is collected from the Six-Month Follow-Up Assessment

145 Column EQ - Six Month Follow-Up - Homelessness Assessment Information is collected from the Six-Month Follow-Up Assessment

146 Column ER - Six Month Follow-Up - Substantiated APS Reports LEAPS system auto calculates this report based on the confirmed related cases.

147 Column ES - Twelve Month Follow-Up - Living Situation Verified Date Information is collected from the Twelve-Month Follow-Up Assessment


148 Column ET - Twelve Month Follow-up - Method Information is collected from the Twelve-Month Follow-Up Assessment

149 Column EU - Twelve Month Follow-Up - Living Situation Information is collected from the Twelve-Month Follow-Up Assessment

150 Column EV - Twelve Month Follow-Up – Homelessness Information is collected from the Twelve-Month Follow-Up Assessment

151 Column EW - Twelve Month Follow-Up - Substantiated APS Reports LEAPS system auto calculates this based on the confirmed related cases

152 Column EX - Comments LEAPS is not populating any information on this column – not mandatory.

Documents

hOME sAFE iNSTRUCTION mANUAL...Home Safe Instruction Manual Column A - Reporting Agency This cell is automatically populated and is for CDSS use only. Column B - Report Month This