Coordinated Access Survey Question Title * 1. What type of Organization do you represent? Non-Profit For-Profit Government Individual Other OK Question Title * 2. Does your Organization receive any funding through the CoC? Yes No OK Question Title * 3. What Population do you serve? (Check all the apply) Literal Homeless Youth (18-24) Domestic Violence Victims Unaccompanied Youth (17 and under) Other OK Question Title * 4. What Counties do you serve? (Check all that apply) Hernando Lake Citrus Sumter OK Question Title * 5. Please rate the following in order of priority (1 being highest and 5 being lowest) 1 2 3 4 5 Families 1 2 3 4 5 Veterans 1 2 3 4 5 Youth (18-24) 1 2 3 4 5 Individuals 1 2 3 4 5 Unaccompanied Youth (17 and under) OK Question Title * 6. Select Two of the following you feel should be given priority over the others Chronic Homeless (individual with a disabling condition who has either experienced homelessness for 12 months or loner or has had 4 or more episodes in the past 3 years.) Those at Risk of being homeless Elderly Those fleeing Domestic Violence OK Question Title * 7. Select TWO of the following you feel should be given priority over the others Length of time homeless Substance abuse issues Mental Health Issues Length of time of the By Name List OK Question Title * 8. Select THREE of the following you feel should be given priority over the others Tri-morbidity (co-occurring disorder (psychiatric, substance abuse) with a chronic medical condition Current Palliative Health Care Acuity (Mental acuity is sharpness of the mind. Things considered in determining a person's mental acuity are memory, focus, concentration, and understanding) Physical/Chronic Health Issues Pregnancy in family OK Question Title * 9. Select TWO of the following you feel should be given priority over the others Sheltered (Emergency or Transitional Shelter) Unsheltered Length of time in CoC Working current reunification case plan OK Question Title * 10. High utilizer of Mental Health facility Select ONE of the following you feel should be given priority over the others High utilizer of Mental Health facility High utilizer of Correctional facility Hugh utilizer of Community Drop in Centers High utilizer of Substance Abuse Treatment facility OK DONE