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AB 557 created a new, expanded temporary HA program for CalWORKs applicants fleeing DV.  Please see ALL COUNTY LETTER (ACL) NO. 18-78 for more information.  This survey is being used to collect data on these families in your county from July 2021 to June 2022.  Please respond to the survey to the best of your ability with the data currently available.  If there are ongoing barriers to collecting this data, please specify in question 15.
 
Additionally, as of September 1, 2022, SB 1065 updated eligibility for AB 557 Expanded Temporary HA for Victims of DV (All County Information Notice (ACIN) I-70-22). Under SB 1065, HA applicants who are provided Expanded Temporary HA for Victims of DV are eligible for the second 16-day payment of temporary shelter assistance regardless of whether the applicant becomes a recipient of CalWORKs during the first 16-day period (WIC 11450 (f)(4)(I)(ii)). Please note that while SB 1065 does not impact the FY 21-22 AB 557 Expanded Temporary HA for CalWORKs Applicants Fleeing DV Caseload Survey, counties will need to take SB 1065 into consideration when completing future surveys. For more information about the changes occasioned by the passage of SB 1065, please see ACL NO. 21-121.

Asterisks indicate required questions.  For information on accessing this document using a screen reader, please go to the following link: Taking a Survey with a Screen Reader.

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* 1. County:

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* 2. Full Name of Person Completing Survey:

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* 3. Email of Person Completing Survey:

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* 4. Date of completion

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* 5. What is the total number of AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests that your county received between July 1, 2021 and June 30, 2022?

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* 6. How many AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests were denied?

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* 7. Below are potential reasons for denying AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests.  In the box next to each reason, indicate how many of these requests were denied for the given reason.  For example, if 3 requests were denied because the client was over income/assets, type 3 next to that reason.

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* 8. If AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests were denied for other reasons than those listed in the previous question, please provide a description of other reasons for denial and the number of instances for each reason. 

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* 9. How many AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests were approved for the initial 16 days?

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* 10. Of those who were approved for the initial 16 days (total for #8), how many families requested an additional 16 days?

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* 11. Of those who were approved for the initial 16 days and requested the additional 16 days (total for #9), how many families were denied?

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* 12. Below are potential reasons for denying additional AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests.  In the box next to each reason, indicate how many of these requests were denied for the given reason. 

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* 13. If additional AB 557 expanded temporary HA for CalWORKs applicants fleeing DV requests was denied for other reasons than listed in the previous question, please provide a description of other reasons for denial and the number of instances for each reason.

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* 14. What noticing/outreach efforts have been made by the county to get word out regarding AB 557 expanded temporary HA for CalWORKs applicants fleeing DV?  For example: informational campaigns to local shelter partners; social media outreach; etc.

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* 15. Please describe any ongoing barriers the county may face in collecting the data.

0 of 15 answered
 

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