Organization and Project Contact Information

Colorado HMIS Project and

Housing Inventory Setup

This form serves two purposes—confirming adequate setup of projects in HMIS, which will be used to generate the Housing Inventory Count (HIC) submitted to the US Department of Housing and Urban Development (HUD). All projects dedicated to serving people who are homeless, regardless of whether or not they participate in HMIS, must complete the form. All projects in current operation, as well as those that are fully funded and scheduled to begin operation should complete the form. Additionally, because this form is used for HMIS participating project set-up, Service Projects should complete the form but will not be included on the HIC.Fill out one survey per project. Please complete all fields unless field is marked as optional.

All federally funded homeless projects are required to be set up in HMIS, and all except victim service providers are required to enter client-level data in their CoC’s HMIS implementation. The HMIS Data Standards require that project setup data be confirmed at least annually for accuracy.

Each year the U.S. Department of Housing and Urban Development (HUD) requires the Metro Denver Homeless Initiative to submit a comprehensive Housing Inventory Chart of all homeless beds in the seven-county Denver metropolitan area. Beds and units are categorized based on location, type of program, population(s) served and participation rate in the utilization of the Homeless Management Information System (HMIS). The Housing Inventory Count (HIC) is an important tool used by HUD to score the metro area’s annual application for homeless funding.

Organization and Project Contact Information

Organization Name:
Project Name:
Primary Contact/Staff (Project Director):
Primary Contact/Staff Job Title:
Primary Contact/Staff Phone:
Primary Contact/Staff Email:
Secondary Contact/Staff (Data Contact):
Secondary Contact/Staff Job Title:
Secondary Contact/Staff Phone:
Secondary Contact/Staff Email:
CoC (select all of the CoCs that are in this project’s service area) / ☐500 (Balance of State) / ☐503 (MDHI)
Administrative Office Address(locations of project service site(s) to be entered on the Bed/Unit Inventory page)
Victim Services Provider? / ☐Yes
☐No
Brief Description of Project

Project Type

Continuum Project (select all that apply)

A continuum project is not limited to those projects funded by HUD and should include all of the federal partner projects and all other federally or non-federally funded projects functioning within the continuum.

☐The primary intent of the project is to serve homeless persons.
☐The project verifies homeless status as part of its eligibility determination.
☐The actual project clients are predominantly homeless (or, for permanent housing, were homeless at entry).
Project Type(select only one)
☐Emergency Shelter (ES)
Method for tracking Emergency Shelter Utilization (select only one)
☐Entry/Exit Method
☐Night-by-Night Method / ☐Transitional Housing (TH)
☐Permanent Housing—Rapid Re-Housing (RRH) / ☐Permanent Housing—Permanent Supportive Housing (PSH) (disability required for entry)
☐Permanent Housing—Housing with Services (no disability required for entry) / ☐Permanent Housing—Housing Only
☐Street Outreach (SO)
Note: a street outreach project that also has a direct service component serving persons other than “street homeless” will require two separate projects to be set up in an HMIS – a “Street Outreach” and a “Services Only”. / ☐Services Only
Is your project affiliated with a Residential Project? (select only one)
☐Yes
☐No
☐ Safe Haven (SH) / ☐Day Shelter
☐Homelessness Prevention (HP) / ☐Coordinated Assessment
☐Other

Target Population

Target Population A

A population is considered a "target population" if the project is intended to serve that population and at least three-fourths (75 %) of the clients served by the project fit the target group descriptor. Select only one from the list of Target Population A.

☐Single Males 18 years old and over / ☐Single Females 18 years old and over
☐Single Males and Females 18 years old and over / ☐Couples Only, No Children
☐Households with Children / ☐Single Males 18 years old and over and Households with Children
☐Single Females 18 years old and over and Households with Children / ☐Single Males and Females 18 years old and over plus Households with Children
☐Youth Males under 25 years old / ☐Youth Females under 25 years old
☐Youth Males and Females under 25 years old

Target Population B

A population is considered a "target population" if the project is designed to serve that population and at least three-fourths (75%) of the clients served by the project fit the target group descriptor. Note that there might be some projects that serve a target population of domestic violence victims but that do not qualify as a “victim service provider.”

Select only one from the list of Target Population B.

☐Domestic violence victims / ☐Persons with HIV/AIDS / ☐Not Applicable

Funding Sources

Funding Sources(select all that apply)
☐HUD: CoC – Permanent Supportive Housing / ☐HUD: CoC – Rapid Re-Housing / ☐HUD: CoC – Supportive Services Only / ☐HUD: CoC –Transitional Housing / ☐HUD: CoC – Safe Haven / ☐HUD: CoC –Single Room Occupancy (SRO)
☐HUD: ESG – Emergency Shelter (operating and/or essential services) / ☐HUD: ESG – Homelessness Prevention / ☐HUD: ESG – Rapid Re-Housing / ☐HUD: ESG – Street Outreach
☐HUD: HOPWA – Hotel/Motel Vouchers / ☐HUD: HOPWA – Housing Information / ☐HUD: HOPWA – Permanent Housing / ☐HUD: HOPWA – Short-Term Rent, Mortgage, Utility Assistance / ☐HUD: HOPWA – Short-Term Supportive Facility / ☐HUD: HOPWA – Transitional Housing (facility based or TBRA)
☐HUD: Rural Housing Stability Assistance Program / ☐HUD: HUD/VASH
☐HHS: PATH – Street Outreach & Supportive Services Only / ☐HHS: RHY – Basic Center Program (prevention and shelter) / ☐HHS: RHY – Maternity Group Home for Pregnant and Parenting Youth / ☐HHS: RHY – Transitional Living Program / ☐HHS: RHY – Street Outreach / ☐HHS: RHY – Demonstration Project
☐VA: Community Contract Emergency Housing / ☐VA: Community Contract Residential Treatment Program / ☐VA: Domiciliary Care / ☐VA: Community Contract Safe Haven Program / ☐VA: Grant and Per Diem Program / ☐VA: Compensated Work Therapy Transitional Residence / ☐VA: Supportive Services for Veteran Families
☐Denver’s Road Home / ☐Colorado Division Of Housing (state) / ☐City of Aurora / ☐City of Denver / ☐County of Denver
Grant Identifier(for each funding source selected)
Grant Start Date(for each funding source selected)
Grant End Date(for each funding source selected)
Grant Amount(for each funding source selected)
Funding Source Contact Name, Email Address, Phone Number (for each funding source selected)

Bed and Unit Inventory

Only lodging projects should complete this information. Service only projects should not complete this information.

Emergency ShelterOnly, the beds listed beloware (select one):

☐Facility-based: Beds (including cots or mats) located in a residential homeless assistance facility dedicated for use by persons who are homeless / ☐Voucher: Beds located in a hotel or motel and made available by the homeless assistance project through vouchers or other forms of payment / ☐Other: Beds located in a church or other facility not dedicated for use by persons who are homeless

Transitional HousingOnly: the TH units and beds listed below are (select one):

☐Single Site: Beds and units that are located on a single site (e.g., congregate or project-based) / ☐Multiple Sites: Beds and units that are located in multiple sites (e.g., scattered-site or clustered)

Year Round Beds/Units (should be completed by all lodging projects except RRH)

Beds / Units
Households without children
Households with at least one adult and one child
Households with only children
Year RoundStart Date / Year RoundBed End Date
Street Address of the Principal Project Service Site for Year Round Beds/Units(victim service providers are exempt from providing; for other providers, if this is a scattered site project, can enter address of administrative office)
Street Address of Additional Project Service Site(s) for Year Round Beds/Units

Seasonal Beds/Units (Emergency Shelter projects only)

This category is for seasonal shelter programs that are open seasonally (e.g. from October 1 to May 15 versus a shelter that only opens during inclement weather).

Beds / Units
Households without children
Households with at least one adult and one child
Households with only children
Seasonal Bed Start Date / Seasonal Bed End Date
Street Address of the Principal Project Service Site for Seasonal Beds/Units(victim service providers are exempt from providing; for other providers, if this is a scattered site project, can enter address of administrative office)
Street Address of Additional Project Service Site(s) for Seasonal Beds/Units

Overflow Beds(Emergency Shelter projects only)

Enter the numbers of beds, mats, spaces, or vouchers that are made available on a very temporary basis. This includes shelter and voucher programs that only activate during severe weather.

Beds / Units
Households without children
Households with at least one adult and one child
Households with only children
Street Address of the Principal Project Service Site for Overflow Beds/Units(victim service providers are exempt from providing; for other providers, if this is a scattered site project, can enter address of administrative office)
Street Address of Additional Project Service Site(s) for Overflow Beds/Units
Overflow Bed Start Date / Overflow Bed End Date

Dedicated Beds(Permanent Supportive Housing Projects only)

A dedicated bed is a bed that must be filled by the following subpopulations who qualifies for the project unless there are no subpopulation members within the geographic area who qualify. For example, a chronically homeless bed would be required to be utilized by a chronically homeless household unless there are no chronically homeless households in the geographic area who qualify.

Chronic Homeless Beds / Veteran Beds / Youth Beds
Households without children
Households with at least one adult and one child
Households with only children

For beds dedicated for Youth, does the project serve:

☐Only children under 18

☐Only young adults 18 – 24 (even if the cut off age is under 24, e.g., projects that target 18 – 21 year olds)

☐Persons up to 24

Street Address of the Principal Project Service Site for Overflow Beds/Units(victim service providers are exempt from providing; for other providers, if this is a scattered site project, can enter address of administrative office)
Street Address of Additional Project Service Site(s) for Overflow Beds/Units

Rapid Rehousing Beds/Units (Program participants the night of the PIT)

Beds / Units
Households without children
Households with at least one adult and one child
Households with only children