CoC Community Examples for Program Design and Administration

The CoC Program is designed to promote community-wide planning and strategic use of resources to address homelessness; improve coordination and integration of mainstream resources with other programs targeted to people experiencing homelessness; improve data collection and performance measurement; and allow each community to tailor its homeless assistance programs to the particular strengths and challenges of that community.

The purpose of this page is to provide CoCs with a wide array of examples of CoC program design and administration documents that have been created by communities across the country. Ideally, by having these sample documents readily accessible online, communities will be able to identify aspects of CoC administration and implementation that may work well for their own community.


Disclaimer: These Community Example documents are not official HUD resources. These documents may not be in alignment with HUD guidance. Please review and use at your own risk.

Find by Topic

Client Forms - Intake

Emergency Assistance Voucher Intake Form

This intake form from Hennepin County’s prevention program is for emergency assistance voucher recipients. For agencies creating prevention programs, this form may provide a helpful outline of the type of information to collect.

Publication Information: Hennepin County, MN

Seasons of Sharing Intake Forms for Homeless Emergency Assistance

This spreadsheet is a client intake/budget information form used by the San Francisco Chronicle Season of Sharing Fund, an emergency assistance program. The spreadsheet can be used as a checklist to keep track of payment plans between landlords and clients. It also includes an intake form, and a monthly budget checklist.

Publication Information: San Francisco Chronicle Seasons of Sharing Fund

ROSIE Homeless Intake Form

At intake, it is important to ensure that all the information necessary for triage/assessment is gathered. This checklist from the Madison County CoC in Illinois provides a template to follow for agencies looking to standardize their intake procedures.

Publication Information: Madison County CoC

Pasadena Homeless Prevention Program Intake Form

This client intake/assessment form from the City of Pasadena Homeless Prevention Program includes a comprehensive needs assessment including income, housing status & cost, transportation, physical/mental health care, and budgeting, among other items. This may be helpful to agencies as they develop their own client assessment documents.

Publication Information: Pasadena, CA

San Francisco Housing Opportunities Made Equal Intake Form

This intake/assessment form from the San Francisco Housing Opportunities Made Equal (HOME) Program provides a comprehensive overview of a family’s information, housing history, income and employment, and creates an action plan moving forward. This document may provide guidance to communities developing client assessment documents.

Publication Information: San Francisco Housing Opportunities Made Equal

San Francisco Housing Opportunities Made Equal Completion of Homeless Intake Notice

This letter developed by the San Francisco Housing Opportunities Made Equal (HOME) Program is used to advise clients/families that they have completed the initial intake process, request missing documents, and let clients know what to expect if they are accepted into the program. This letter may help other agencies developing documents to use during the intake and assessment process.

Publication Information: San Francisco Housing Opportunities Made Equal

Minneapolis Public Schools Release of Information Form - Youth

This release of information form is used by the Minneapolis Public School system to obtain permission from homeless youth to share their information with other service providers in the community.

Publication Information: Minnesota Public Schools

Minneapolis Public Schools Homeless Youth Identification Form and Procedures

This tool is used by the Minneapolis Public School system to help identify homeless youth/families within their school system.

Publication Information: Minnesota Public Schools

Client Forms - Assessment

Homeless Prevention Pilot Assessment Form

This spreadsheet is a client assessment/intake form for a homeless prevention pilot program in Pickaway County, Ohio. The form collects information on the client's current living situation, nature of housing crisis, gross monthly income, and employment status. This may be useful to agencies developing client assessment documents.

Publication Information: Pickaway County, OH

Housing Resources Checklist

This is a checklist from the Amador Tuolome Community Action Association for the overview of documents needed for intake. There is a checklist for the completion of the application packet as well as the materials needed from each household. This may be helpful for agencies needing a succinct list of necessary application materials.

Publication Information: Amador Tuolome Community Action Association

Housing Resource Office Information/Service Request

This template from the Amador Tuolome Community Action Association provides an initial assessment for services when a call is received by the agency. It may be useful for agencies looking for a template of questions to ask and information to gather to determine next steps.

Publication Information: Amador Tuolome Community Action Association

Declaration of Income Statement for Homeless Providers

Most programs include an income verification form in case files. This document provides an example of the Texas Department of Housing and Community Affairs' form for documenting income. This document may be a useful template for documenting a family's income in their case file.

Publication Information: Amador Tuolome Community Action Association

Minneapolis Public Schools Release of Information Form - Family

This release of information form is used by the Minneapolis Public School system to obtain permission from homeless and at-risk families to share their information with other service providers in the community.

Publication Information: Minnesota Public Schools

Minneapolis Public Schools Homeless Youth Self-Identification Form and Instructions

This tool is used by the Minneapolis Public School system to improve outreach to and identification of homeless youth/families within their school system.

Publication Information: Minnesota Public Schools

Homeless Client Home Safe Packet

This client screening packet used by the Amador-Tuolome Community Action Association includes a monthly budget plan, housing verification form, household composition form, and various consent forms, including: consent for exchange of information, client rights to confidentiality, and case management agreement. Statistics and referral information collected from the client are also included in the packet.

Publication Information: Amador Tuolome Community Action Association

Emergency Fund Client Service Form

This assessment form is used by Chicago's Homeless Prevention Emergency Fund. It includes a section for caseworkers to write a brief summary about the client's situation and the impact of the assistance received. This assessment also includes a section to keep track of monies received by the client through the program.

Publication Information: Chicago Emergency Fund

Barriers to Housing Stability Assessment

This Barriers to Housing Stability Assessment document, used by Hennepin County, allows heads of household, singles, and unaccompanied youth to identify any potential barriers they face and explain the reasons for those barriers. It may be a useful document for agencies looking to develop client assessment tools.

Publication Information: Hennepin County, MN

Home Visit Checklist

This form is used by case managers of the Amador Tuolome Community Action Agency when performing home visits. It provides a script of questions to ask and information to gather. This script may be helpful in leading a case manager through a home visit and with determining future case management plans.

Publication Information: Amador Tuolome Community Action Association

Amador Tuolome CAA Sample Homeless Case Management Progress Note Topper

This document from the Amador Tuolome Community Action Agency provides case managers a sample progress note to be included in case files. The example provides an outline for the type of information required by this agency for their documentation, which may need to be modified for individual agencies.

Publication Information: Amador Tuolome Community Action Association

2007-2008 Homeless Client Satisfaction Survey

This Client Satisfaction Survey created by the San Francisco Housing Opportunities Made Equal (HOME) allows clients to share their suggestions for program improvement and to rate their overall satisfaction with the program. Responses to this survey help to ensure that the program continues to be responsive and sensitive to the needs of all program participants. This survey may be helpful for agencies looking to develop a mechanism for receiving client feedback.

Publication Information: San Francisco Housing Opportunities Made Equal

Homeless Consumer Goal Plan

This Goal Plan from the Reinvestment in Communities of Gaston County, Inc. provides a format to assist the consumer in developing a short-term, intermediate, and long-term plan. This form may be useful for agencies working with clients on future planning.

Publication Information: Reinvestment in Communities of Gaston County, Inc.

ESGP Homelessness Prevention Assistance Application

This application from the Homeless Prevention Program at the Texas Department of Housing and Community Affairs provides an assessment of family/client needs, determines program eligibility, certifies a client’s homelessness status, provides multi-service coordination, and develops a plan of action for the future. This document may provide guidance to communities developing client assessment documents.

Publication Information: Texas Department of Housing and Community Affairs

San Francisco Housing Opportunities Made Equal Client Contract

This document from the San Francisco Housing Opportunities Made Equal (HOME) Program is a contract between the client and agency, outlining the client’s responsibilities and contains a form for developing an individual action plan to increase a client's income. It may be a useful document for agencies looking to develop rights and responsibilities papers for clients.

Publication Information: San Francisco Housing Opportunities Made Equal

Client Forms - Exit

Family Homelessness Prevention and Assistance Program Exit Assessment Form

This is a program exit assessment form developed by Wilder Research for the Family Homelessness Prevention and Assistance Program in Minnesota. The form asks why the client is leaving, where they are going, what type of housing they will be going to, if they will be receiving any subsidies, and their income and source of income at the time of exit. This assessment document may be helpful for creating an agency's own exit assessment documents.

Publication Information: Wilder Foundation (MN)

Discontinuation of Homeless Services

The Discontinuation of Services document was developed by the Amador Tuolumne Community Action Agency HOME Safe program. This one-page form provides documentation for a case file regarding the reasons a client or family is no longer participating in the program, with reasons including completion of program, failure to respond, no interest, moved, or no longer eligible.

Publication Information: Amador Tuolome Community Action Association

Consumer Exit Check Sheet

The Consumer Exit Check Sheet from Reinvestment in Communities of Gaston County, Inc. is used to gather information on consumers exiting from their program. The checklist includes reason for leaving, destination, etc. The form also includes a section for follow-up with the consumer. This check sheet may be helpful for agencies looking to do exit interviews with clients.

Publication Information: Reinvestment in Communities of Gaston County, Inc.

Family Rapid Exit Ledger

This is a service ledger for the Family Rapid Exit program in Hennepin County. This spreadsheet allows the program to track service type, dollar amount expended, and service start and end dates for each client household. It also includes the appropriate AIRS taxonomy descriptions, codes, and explanations.

Publication Information: Hennepin County, MN

Housing Search

Housing Search and Advocacy Training -- in English and Spanish

There are many challenges in finding and securing subsidized housing: What kinds of resources are out there? Who is eligible for them? How do you overcome some of the barriers to housing, such as criminal history or bad credit? AHC’s Housing Search and Advocacy Training addresses these questions and many more. Each section contains detailed notes from AHC's training presentation as well as additional handouts and related materials. While some of the material is specific to Massachusetts, much of it also covers federal programs and universal challenges related to housing. AHC has also translated these notes into Spanish and is in the process of converting them to plain text for persons with disabilities.

Publication Information: AIDS Housing Corporation (Massachusetts)

How To Get To A Place Called Home: A Consumer Housing Guide

Online edition of a handbook to help people living with HIV/AIDS understand the housing search process in Massachusetts. The handbook includes step-by-step instructions for conducting a housing search, answers to common questions about housing, explanations of housing options, and phone numbers and contact names.

Publication Information: AIDS Housing Corporation (Massachusetts)

Notice of Homeless Subsidies to Landlord

The San Francisco Housing Opportunities Made Equal (HOME) program uses this letter to describe the HOME project to landlords. The letter includes an explanation of how and when subsidy checks are issued and describes the responsibilities of the landlord upon receipt. For agencies looking to work directly with landlords using housing subsidies, this letter may provide a useful template.

Publication Information: San Francisco Housing Opportunities Made Equal

Landlord Memorandum of Understanding (MOU) for Rental Assistance Programs

This is a Memorandum of Understanding (MOU) document from the Reinvestment in Communities of Gaston County, Inc. used between the agency and landlord. It outlines the roles and responsibilities of both the agency and the landlord. This MOU may be helpful for agencies working directly with landlords in rental assistance programs.

Publication Information: Reinvestment in Communities of Gaston County, Inc.

Oahu Housing Guide

The Oahu Housing Guide offers a comprehensive listing of apartments and amenities that may be affordable to clients looking for housing options. This guide may be useful for agencies in other communities looking to develop housing search materials for clients.

Publication Information: Catholic Charities Elderly Services, Oahu, Hawaii

Deposit Agreement for Homeless Clients

The Deposit Agreement form is a template for agreements between the Amador Tuolome Community Action Agency and landlords regarding the return of deposit money following a client's tenancy. This template may provide guidance for agencies looking for a simple contract between the agency and landlords regarding deposit returns.

Publication Information: Amador Tuolome Community Action Association

Colorado Housing Search Website

Colorado’s resource website for connecting people in need of housing with available affordable housing can be used as model for HPRP housing search and placement assistance. It is a joint effort between the State Division of Housing, Colorado Housing and Finance Authority, the City and County of Denver, and a number of other partners, with each entity contributing a list of properties it had funded. The database and internet provider of this resource is SocialServe.com.

Publication Information: State of Colorado

Program Design and Requirements

Effective Homeless Board Composition

This training presentation is intended for organizations seeking advice on effective board composition. It includes general information on how to build an effective board of directors, suggested tools for board member recruitment, strategies to make a board more effective, strategies for board evaluation, and contact information for questions.

Publication Information: Utah Housing Coalition

Harris County NEST Plan

This strategic plan provides an overview of NEST, a collaborative of Houston/Harris County community stakeholders charged with preventing and ending homelessness for adolescents and young adults who identify as lesbian, gay, bisexual, or transgender or who are questioning their sexual or gender identity (LGBTQ). This plan describes NEST's vision and goals and the key activities needed to achieve the desired outcome of preventing and ending homelessness for adolescents and young adults that identify as LGBTQ by 2020.

Publication Information: The Montrose Center

Hamilton County Safe and Supported Plan

This document provides an overview of the Hamilton County Safe and Supported Community Plan. This initiative consists of developing and implementing a plan for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth homelessness prevention and intervention. The goals are to learn more about (1) preventing homelessness for LGBTQ youth and (2) intervening early to prevent chronic homelessness among LGBTQ youth.

Publication Information: Lighthouse Youth Services | Strategies to End Homelessness

Seasons of Sharing Eligibility Requirements for Homeless Emergency Assistance Programs

This document is used by the San Francisco Chronicle Seasons of Sharing Fund’s homeless assistance prevention program to determine client eligibility for their emergency assistance program. It also provides instructions for client's submitting applications, states the maximum amount of the grant, and outlines documentation needed.

Publication Information: San Francisco Chronicle Seasons of Sharing Fund

Chicago Emergency Fund: Financial Assistance Criteria

This sample tool from Chicago describes how their emergency assistance fund is managed and outlines both eligible and ineligible expenditures. Communities operating emergency assistance programs may want to create a similar document to ensure program rules are understood (both by clients and case managers) and to ensure funds are distributed in a consistent and fair manner.

Publication Information: Chicago Emergency Fund

An Influenza Pandemic Planning Guide for Homeless and Housing Service Providers

This planning guide is intended for homeless and housing service providers seeking information about preparing for an influenza pandemic. It includes an overview of pandemic influenza, why homeless service providers should be concerned, information on preparedness roles and resources, and guidance for homeless and housing service providers before, during, and after a pandemic. Additional resources at the end of the guide include information on how to care for someone with influenza, preventing the spread of influenza, and a glossary of terms.

Publication Information: Seattle and King County, Public Health Department

Linking Rural Housing and Social Services: Case Studies

Case studies on:

  1. Organizations that started as health or social service providers and incorporated housing later
  2. Organizations that started as housing providers and incorporated social services later.

Some of which, directly responding to rural homelessness.

Publication Information: has community examples/case studies

Emergency Fund Partnership Criteria

When developing a new partnership, it is important that all program and potential partners are clear, honest, and realistic about allotment expectations, service capabilities, and other key functions to successful partnership. This document is used by the Chicago Emergency Fund to describe the criteria required to become one of their partners. It may be a useful document for agencies looking to partner in developing and/or administering new programs.

Publication Information: Chicago Emergency Fund

Homeless Referral Form/Application

This document provides referring agencies with an overview of the program, including minimum eligibility requirements and qualities that make a good candidate, as well as a form for initial applicant screening. This document may be helpful for agencies looking to develop a mechanism for fielding referrals from other agencies.

Publication Information: San Francisco Housing Opportunities Made Equal

Special Populations

Homeless Older Adults Strategic Plan

With home foreclosures on the rise and fewer public service dollars available, homeless older adults (62+) are among the fastest growing and most vulnerable homeless populations in Los Angeles. The new strategic plan by Shelter Partnership, Inc., along with its key findings and policy recommendations, was released and discussed on March 20, 2008 at a special meeting of the Los Angeles City Council's Ad Hoc Committee on Homelessness at New Image Emergency Shelter near downtown, where the field research was conducted.

Publication Information: Shelter Partnership, Inc (Los Angeles)

Vets@Home Toolkit: Identifying and Engaging Homeless Veterans

This toolkit provides information on best practices to identify and engage veterans experiencing homelessness. It provides guidance and resources to assist mayors, local officials, communities, and Continuums of Care (CoCs) to put goals and processes in place to end veteran homelessness.

Publication Information: HUD

Vets@Home Toolkit: Effective Homeless Crisis Response Systems

This toolkit provides resources and concepts for transforming homeless services to crisis response systems to prevent homelessness and rapidly return those experiencing homelessness back to stable housing. The US Interagency Council on Homelessness (USICH) provides a framework to retool the homeless crisis system in Objective 10 of the Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. Given the immediacy of the Federal goal of ending veteran homelessness by the end of 2015, this toolkit is geared towards veteran specific resources.

Publication Information: HUD

Vets@Home Toolkit: Housing Stability

This toolkit provides resources and concepts for housing stability related to veterans and their families who have experienced homelessness and are now housed.

Publication Information: HUD