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Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 7

F. Unmet Housing Need: Assessment of Unmet Housing Needs for HOPWA eligible Households.

In Chart 1, please identify your service area. If your service area operates within an area also served by formula funds, check

line a. If you are the single HOPWA service provider in your area, check line b. In Chart 2 item 1, provide an assessment of the

total number HOPWA-eligible households that require housing assistance, but are not served by HOPWA in this service area.

In Rows a through c, enter the total number of HOPWA-eligible households by type of housing assistance whose housing needs

remain unmet. Do not include clients who are already receiving HOPWA assistance.

Refer to Chart 3, and check all sources consulted to calculate unmet need. Reference any data from neighboring states’ or

municipalities’ Consolidated Plan or other planning efforts that informed the assessment of Unmet Need in your service area.

1. Service Area:

Program operates within an area also served with HOPWA formula funds [Unmet

Needs Assessment is optional for this group of competitive grantees]

b. Program operates in an area that is not eligible for HOPWA formula funds

2. Assessment of Area’s Unmet Needs for HOPWA-eligible Households

1. Total number of households that have unmet housing needs

From Item 1, identify the number of households with unmet housing needs by type of housing assistance.

a. Tenant-Based Rental Assistance (TBRA)

b. Short-Term Rent, Mortgage and Utility payments (STRMU)

c. Housing Facilities, such as community residences, SRO

dwellings, other housing facilities

3. Recommended Data Sources for Assessing Unmet Need (check all sources used)

= Data as reported in the area Consolidated Plan, e.g. in Table 1B, CPMP charts, and related narratives

= Data established by area HIV/AIDS housing planning and coordination efforts, e.g. Continuum of Care

= Data from client information provided in Homeless Management Information Systems (HMIS)

= Data from project sponsors or housing providers, including waiting lists for assistance or other assessments on needs

= Data from prisons or jails in the community on persons being discharged with HIV/AIDS, if mandatory testing is conducted

= Data from local Ryan White Planning Councils or reported in CARE Act Data Reports, e.g. number of clients with permanent housing

= Data collected for HIV/AIDS surveillance reporting or related care assessments, e.g. local health department or CDC surveillance data

Previous editions are obsolete

Page

form HUD-40110-C (Expiration Date: 12/31/2010)

Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 7