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PART II. GROUP-LEVEL ELEMENTS: [NOTE: Code this Part once for each intervention group. (All project-level elements coded in Part I should apply to all intervention groups, so Part I should be coded only once for each project).] |
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43 Name of intervention group
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______________________ |
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App;
QRF |
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44 Code (site's abbreviation for group) |
_ _ _ _ [characters or #s] |
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PROGRAM IMPLEMENTATION EXPERIENCE |
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Facility (site of service delivery): |
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45 Type of service facility |
1 -Residential
2 -Nonresidential |
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46 Need to acquire facility |
0 -No 1 -Yes
(If No, skip to 52 |
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Preaward;
App; early BMC |
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47 Length of time required to acquire facility (weeks from Oct. 1, 1990) |
___ |
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BMC
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48 Was NIMBY-type problem encountered in siting service facility? |
0 -None
1 -Minor
2 -Moderate
3 -Severe |
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SVR; BMC; QRF |
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49 Did this NIMBY delay implementation? |
0 -No 1 -Yes |
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SVR; BMC; QRF
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50 What was done to resolve this problem? |
0 -Went ahead with siting
1 -Negotiated a resolution
2 -Took legal action
3 -Gave up/found new site |
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BMC; SVR; TA files; QRF
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51 a. Did we provide any TA on this?
b. [describe] |
0 -No 1 -Yes
_______________________ |
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52 Need to renovate facility |
0 -No
1 -Yes, moderate rehab
2 -Yes, extensive renovation |
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BMC
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53 Length of time required from acquisition to renovation of facility (weeks) |
_ _ _ 888 -NA |
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BMC; SVR
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54 a. Any program relocation during demo? b. Date of relocation
c. Reason [describe] |
0 -No 1 -Yes
/ / / /
_______________________ |
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BMC; SVR; LogMod |
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Staffing: |
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55 Able to transfer existing management staff vs. need to hire new managers |
1 -Existing
2 -Some new management |
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56 Extent of difficulty in recruiting staff
(management and line staff) |
0 -Low
1 -Medium
2 -High |
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None
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57a Extent of staff turnover (Clinical Director and supervisors) |
0 -Low (none)
1 -Medium (some)
2 -High |
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None
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57b Impact of staff turnover (Clinical Director and supervisors) |
0 -Low (no impact on ops)
1 -Medium (some impact)
2 -High (severe impact) |
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58a Extent of staff turnover (Counselors/therapists/case managers) |
0 -Low
1 -Medium
2 -High |
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SVR; BMC
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58b Impact of staff turnover (Counselors/therapists/case managers) |
0 -Low (no impact on ops)
1 -Medium (some impact)
2 -High (severe impact) |
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SVR; BMC
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59 Staff training issues:
a. Was any special training need i.d.'d in
TA plan?
b. Did project i.d. special training needs?
c. Types i.d.'d by either
d. Were all i.d.'d training needs met?
d. Did we provide TA?
e. How much? (days) |
0 -No 1 -Yes
0 -No 1 -Yes
_______________
0 -No 1 -Yes
0 -No 1 -Some 2 -All
__ __ |
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TA plan;
TA reports
SV materials; new BMC; |
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60a. Did new staff roles became necessary as the intervention was implemented?
b. What positions?
c. Number of added staff positions |
0 -No 1 -Yes
_______________________
_ _ _ |
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BMC; ContinApp;
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Program Design: |
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61a. Length of Phase I (weeks)
b. Did recyclers start over at "day 1"? |
_ _ _
0 -No 1 -Yes |
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LogMod; SVR; |
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62 Did Phase I length change during implementation? |
0 -No 1 -Yes
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LogMod; SVR; BMC
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63 Length of Phase II (weeks; NA if only one phase) |
_ _ _ 8 -NA |
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LogMod; SVR |
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64 Did Phase II length change during implementation? |
0 -No 1 -Yes 8 -NA
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LogMod; SVR; BMC
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65 Serving new population with existing program or starting new program? |
1 -Existing
2 -New program |
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App; Preaward
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66 Extent of change from proposed design
(panel judgments):
a. program structure
b. type of client served
c. treatment intensity
d. extent of community
resources
e. research design |
0-Low 1-Med 2-High
0-Low 1-Med 2-High
0-Low 1-Med 2-High
0-Low 1-Med 2-High
0-Low 1-Med 2-High |
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LogMod; SVR;
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67a. Was there a program manual?
b. When was it developed?
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0 -No 1 -Yes
0 -Prior to startup
1 -<6 mo. after startup
2 -between 6 mo. and
end of Yr. 1
3 -before end of Yr. 2
4 -before end of Yr. 3 |
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BMC; SVR; R.O.W.
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CHARACTERISTICS OF SPECIFIC SERVICE COMPONENTS |
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Case management: |
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68 Duration of Phase I (weeks) |
_ _ |
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LogMod
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69 Duration of Phase II (weeks) |
_ _ |
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LogMod |
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70 Actual Average Ph. I duration |
_ _ |
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QRF data |
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71 Actual Average Ph. II duration |
_ _ |
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QRF data |
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72 Intensity:
a. caseload size (average)
b. frequency of contact
(per month)
c. time spent with client
(hours per month) |
_ _
_ _
_ _ |
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LogMod; BMC; SVR
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73 Case manager availability |
0 -Appointment
1 -Office hours
2 -All day, 5 days +
3 -24 hours |
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BMC; SVR LogMod
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74 Primary site of case management |
0 -Agency office
1 -Program residence
2 -Wherever the client is |
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LogMod
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75 Contact initiator |
1 -Client
2 -Case manager
3 -Either (no clear
emphasis)
4 -Changes over time
(as part of the model) |
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App; SVR;
BMC
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76 Caseload structure |
1 -Individual
2 -Dyad
3 -Team |
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LogMod
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77 Generalist vs. specialist case manager orientation |
1 -Generalist
2 -Specialist |
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App; LogMod; SVR |
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78 CM specializations:
a. housing
b. vocational
c. counseling
d. benefits acquisition |
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA |
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79 Primary orientation of case managers |
1 -primary provider
2 -service linkage and
client advocacy
3 -systems change
agent
4 -Other_______________ |
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SVR ; phone calls |
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80 Functions performed:
a. direct services
b. assessment, planning
c. linking
d. monitoring
e. client advocacy
f. representative payee
g. other________________________ |
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes |
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QRF; SVR; BMC
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81 Orientation (focus on case management or combination with AOD or mental health counseling) |
1 -Single focus: CM
2 -CM + AOD
3 -CM + MH
counseling
4 -CM + AOD + MH |
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App; LogMod
BMC
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82 Adequacy of community resources (resource-rich vs. resource-poor) |
0 -Poor
1 -Adequate ("fair")
2 -Rich |
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SVR; BMC;
Panel
judgment
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Alcohol and Other Drug Treatment: |
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83 Duration (Phase I; weeks)
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_ _ _ 888 -NA |
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BMC; LogMod; QRF
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84 Setting (Phase I) |
1 -Hospital/Medical
2 -Residential
3 -Outpt/Day prog
4 -Other |
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LogMod; QRF
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85 Provided by agency or referred out
(Phase I) |
1 -Agency provided
2 -Referral to other
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86 Intensity: (Phase II)
a. counselor/client ratio
b. frequency of contact (per week )
c. Number of required group meetings/wk
d. Number of self-help meetings/wk |
_ _ _
_ _
_ _
_ _ |
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App; BMC; LogMod; SVR;
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87 Duration (Phase II; weeks)
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_ _ _ 888 -NA |
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BMC; LogMod; QRF
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88 Setting (Phase II) |
1 -Hospital/Medical
2 -Residential
3 -Outpt/Day prog
4 -Other |
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LogMod; QRF
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89 Provided by agency or referred out
(Phase II) |
1 -Agency provided
2 -Referral to other
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90 Intensity: (Phase II)
a. counselor/client ratio
b. frequency of contact (per week )
c. Number of required group meetings/wk
d. Number of self-help meetings/wk |
_ _ _
_ _
_ _
_ _ |
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App; BMC; LogMod; SVR;
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91 Counselor requirements:
a. degreed
b. certified
c. recovering
d. culturally representative |
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes |
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NEP
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92 Treatment components:
a. individualized Tx plans
b. group counseling
c. individual counseling
d. educational groups
e. AA/NA
f. TC
g. recreation, socialization
h. aftercare group/services
i. sobriety monitoring
j. resident meetings
k. number of components |
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
0 -No 1 -Yes
_ _ |
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QRF; BMC; SVR; LogMod
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93 Philosophical approach |
_______________________
1 -Clinical (Medical)
2 -Social Model
3 -Mixed |
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App; SVR; BMC
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94 Relapse approach |
0 -No policy
1 -One and out
2 -2nd: discharge
3 -Flexible/individual
4 -No discharge |
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LogMod; WGM; SVR
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95 Pass policy |
0 -None
1 -Restrictive
2 -Flexible
3 -Liberal |
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BMC; Log Mod
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96 Transportation provided for outpatient clients |
0 -No
1 -Yes
8 -NA (inpt group) |
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App; SVR; LogMod; BMC
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Housing: |
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97 Housing type (Phase I) |
1 -Transitional
2 -ADF
3 -Residential Tx
4 -Group Home
5 -Shelter
6 -Continuum (mix)
8 -NA |
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QRF
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98 Facility type (Phase I) |
1 -SRO
2 -Single family
3 -Dormitory
4 -Apartment
5 -Other
8 -NA |
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QRF
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99 Duration in model (Phase I; weeks) |
_ _ _
(998=open)
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LogMod; SVR; BMC
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100 Average length of stay (Phase I; weeks) |
_ _ _ |
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SVR; BMC; QRF
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101 Share room with others (Phase I) |
0 -No 1 -Yes
8 -NA |
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NEP
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102 Type of supervision (Phase I) |
1 -Live-in manager
2 -Day staff
3 -Resident run
4 -Other (offsite mgr)
8 -NA |
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NEP
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103 Location of supportive services
(Phase I):
a. case management
b. AOD Tx
c. self-help meetings
d. ed/vocational |
0 -Offsite 1 -On
0 -Offsite 1 -On
0 -Offsite 1 -On
0 -Offsite 1 -On |
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NEP
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104 Housing relapse policy (Phase I) |
1 -One and out
2 -2nd: discharge
3 -Flexible/Ind.
4 -Not discharged |
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NEP
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105 Sobriety monitoring (Phase I)
(Urine testing; breathalyzer) |
0 -No 1 -Yes |
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NEP
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106 Implementation difficulty (Phase I) |
0 -Existing
1 -Low
2 -Med
3 -High |
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BMC; LogMod; SVR
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107 Was NIMBY-type problem encountered?
(Phase I) |
0 -None (If None, skip to 108)
1 -Minor
2 -Moderate
3 -Severe |
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SVR; BMC; QRF |
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108 Did it delay implementation? |
0 -No 1 -Yes |
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SVR; BMC; QRF |
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109 What was done to resolve this problem? |
0 -Went ahead with siting
1 -Negotiated a resolution
2 -Took legal action
3 -Gave up; found new site |
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BMC; SVR; TA files; QRF |
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110a. Did we provide any TA on this?
b. [describe] |
0 -No 1 -Yes
_____________________ |
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TA files; QRF |
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111 Housing type (Phase II) |
1 -Transitional
2 -ADF
3 -Residential Tx
4 -Group Home
5 -Shelter
6 -Continuum (mix)
8 -NA |
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QRF
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112 Facility type (Phase II) |
1 -SRO
2 -Single family
3 -Dormitory
4 -Apartment
5 -Other
8 -NA |
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QRF
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113 Average length of stay (Phase II; weeks) |
_ _ _ |
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SVR; BMC; QRF
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114 Duration in model (Phase II; weeks) |
_ _ _
(998=open)
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LogMod; SVR; BMC
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115 Share room with others (Phase II) |
0 -No
1 -Yes
2 -Mix
8 -NA |
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NEP
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116 Type of supervision (Phase II) |
1 -Live-in manager
2 -Day staff
3 -Resident run
4 -Other
8 -NA |
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NEP
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117 Location of supportive services
(Phase II):
a. case management
b. AOD Tx
c. self-help meetings
d. ed/vocational |
0 -Offsite 1 -On
0 -Offsite 1 -On
0 -Offsite 1 -On
0 -Offsite 1 -On |
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NEP
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118 Housing relapse policy (Phase II) |
1 -One and out
2 -2nd: discharge
3 -Flexible/Ind.
4 -Not discharged |
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NEP
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119 Sobriety monitoring (Phase II)
(Urine testing; breathalyzer) |
0 -No 1 -Yes |
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NEP
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120 Implementation difficulty (Phase II) |
0 -Existing
1 -Low
2 -Med
3 -High |
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BMC; LogMod; SVR
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121 Was NIMBY-type problem encountered? (Phase II) |
0 -None (If None, skip to 121)
1 -Minor
2 -Moderate
3 -Severe |
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SVR; BMC; QRF |
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122 Did it delay implementation? |
0 -No 1 -Yes |
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SVR; BMC; QRF |
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123 What was done to resolve this problem? |
0 -Went ahead with siting
1 -Negotiated a resolution
2 -Took legal action
3 -Gave up; found new site |
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BMC; SVR; TA files; QRF |
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124 Availability of permanent housing resources (Overall) |
0 -No 1 -Yes |
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NEP; CC
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125 Availability of shelter for non-resident clients (Overall) |
0 -Extremely limited
1 -Somewhat limited
2 -Generally available
8 -NA (residential group) |
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BMC; SVR; LogMod
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126 Vocational rehabilitation components:
a. basic education skills instruction
b. basic literacy instruction
c. job counseling
d. job search assistance
e. OJT
f. preemployment skills
(job prep training, vocational and occupational skills training, work experience)
g. number |
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
__ __ |
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127 Other supportive services provided?
a. transportation
b. child care
c. health care
d. mental health treatment/counseling
e. independent living skills/life skills
f. money management/budgeting
g. number |
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
0 -No 1 -Yes 8 -NA
_ _ |
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QRF
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