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EXHIBIT 2 RE-ENTRY AND INSTITUTIONAL SETTING CERTIFICATION FOR EMERGENCY HOUSING VOUCHERS a 4 (7 71 e ENTRY SYSTEM Client Name: Date of Birth: This is to certify that the above -named individual's current or previous residence in an institutional setting. This certificate must be completed by a representative of an institution or component of the system of care, such as a health care facility, a mental health facility, foster care or other youth facility, or correction program or institution. The individual above must also be experiencing homelessness or at -risk of homelessness as defined in the McKinney-Vento Homeless Assistance Act. Please check the applicable section(s). ❑ Current Living Situation: Institutional Setting The person named above is currently living in a publicly funded institution, including a foster care home or foster care group home, hospital or other residential non -psychiatric medical facility, jail, prison or juvenile detention facility, long-term care facility or nursing home, psychiatric hospital or other psychiatric facility, or a substance abuse treatment facility or detox center, and will be discharged to a community setting. The expected discharge date for this person is: ❑ Prior Living Situation: Institutional Setting In the past 90 days, the person named above was living in an institutional setting, including a foster care home or foster care group home, hospital or other residential non -psychiatric medical facility, jail, prison or juvenile detention facility, long-term care facility or nursing home, psychiatric hospital or other psychiatric facility, or a substance abuse treatment facility or detox center. The discharge date for this person was: ❑ Criminal Justice Supervision The person named above is currently receiving criminal justice supervision such as probation or parole. I certify that that the information reported above is accurate and correct. Name: Title: Signature: City Council Phone #: Agency: Date: 31 — 33 version 06/25/2021 Page 26 of 29