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Itasca County Health and Human Services
Housing Support Needs Survey
Itasca County is gathering information about housing needs as part of a review of the Housing Support Program. Your answers are anonymous, and we thank you for taking the time to participate in this survey.
1.
Where do you live now?
Rental unit
Own my own house
Emergency Shelter
Hospital, treatment facility, detox center, or nursing home
Place not meant for housing (anywhere outside, a vehicle, an abandoned building, or a bus/train/airport)
With family or friends
Service Provider - foster care, group home, assisted living
Jail, prison, or juvenile detention center
Hotel or motel
Other (please specify)
2.
What is your monthly income category?
Less than $250
$251 - $499
$500 - $649
$650-899
$900 - $1249
$1,250 or more
3.
What are your Income Sources? (Check all that apply)
Job
Self-employment
Unemployment
Social Security Disability Insurance (SSDI)
Supplemental Security Income (SSI)
MFIP (Minnesota Family Investment Program)
GA (General Assistance)
Retirement Benefits
Veterans Benefits
Child Support
Worker's Compensation
Tribal Payments
No Income
Other (please specify)
None of the above
4.
How long have you lived in Itasca County
I don't live in Itasca County?
Less than one month
1 month to 6 months
6 months to 1 year
More than 1 year
Not Sure
5.
How many people are part of your household?
1
2
3
4
5 or more
6.
What is your age category
Under 18
18-24
25-34
35-44
45-54
55-64
65+
7.
Do you have any of these Disabling Conditions? (Check all that apply)
Developmental Disability
Learning Disability
Mental Health condition
Physical illness, injury, or incapacity
Substance Abuse Disorder/Chemical Dependency
Unsure
Other (please specify)
None of the above
8.
Have you ever applied for benefits at Itasca County Health and Human Services?
Yes
No
Not Sure
9.
If yes, how satisfied were you with the experience of applying for benefits at Itasca County?
Very Dissatisfied
1 star
Dissatisfied
2 stars
Neither Satisfied or Dissatisfied
3 stars
Satisfied
4 stars
Very Satisfied
5 stars
Comments on your experience?
10.
What Benefits do you currently receive?
Food Assistance (SNAP)
Diversionary Work Program (DWP)
GA (General Assistance)
MFIP ( Minnesota Family Investment Program)
MN Supplemental Aid (MSA)
Refugee Cash Assistance (RCA)
Child Care Assistance
Other (please specify)
None of the above
11.
Would you be interested in working with a case manager to help you maintain your housing?
Yes
No
I already have a case manager
I already have a case manager
Not sure
12.
Would you be interested in a housing option (Housing Support) where your rent would be paid and you would receive assistance with food?
Yes
No
Not Sure
13.
If yes, what housing options would you be interested in? (Check all that apply)
Living alone in your own apartment
Living in a house with roommates
Living in a home with other people and a Service Provider
Living in a facility with other people and a Service Provider
None of the above
Thank you for your valuable input. If you have further questions or comments, you can contact:
Itasca County Housing Resource Specialist at Housing.Support@co.itasca.mn.us