Laserfiche WebLink
Chart 1b., Line 4: Sources of Medical Insurance and Assistance include, but are not limited to the following <br />(Reference only) <br />• MEDICAID Health Insurance Program, or • Veterans Affairs Medical Services <br />use local program AIDS Drug Assistance Program (ADAP) Ryan White-funded Medical or Dental <br />name State Children's Health Insurance Program Assistance <br />• MEDICARE Health Insurance Program, or (SCH1P), or use local program name <br />use local program name <br />Chart lb., Row 5: Sources of Income include, but are not limited to the following (Reference out <br />• Earned Income • Child Support • General Assistance (GA), or use local <br />• Veteran's Pension • Social Security Disability Income (SSDI) program name <br />• Unemployment Insurance • Alimony or other Spousal Support • Private Disability Insurance <br />• Pension from Former Job • Veteran's Disability Payment • Temporary Assistance for Needy <br />• Supplemental Security Income (SSI) • Retirement Income from Social Security Families (TANF) <br />Worker's Compensation • Other Income Sources <br />lc. Households that Obtained Employment <br />Column [1]: Of the households identified as receiving services from project sponsors/subrecipients that provided HOPWA <br />housing subsidy assistance as identified in Chart I a., Row I d. above, report on the number of households that include <br />persons who obtained an income-producing job during the operating year that resulted from HOPWA-funded Job training, <br />employment assistance, education or related case management/counseling services. <br />Column [2]: Of the households identified as receiving services from project sponsors/subrecipients that did NOT provide <br />HOPWA housing subsidy assistance as reported in Chart I a., Row 2b., report on the number of households that include <br />persons who obtained an income-producing job during the operating year that resulted from HOPWA-funded Job training, <br />employment assistance, education or case management/counseling services. <br />Note: This includes jobs created by this project sponsor/subrecipients or obtained outside this agency. <br />Note: Do not include jobs that resulted from leveraged job training, employment assistance, education or case <br />manageniendeounseling services. <br /> 11 For project sponsors/subrecipients that 121 For project sponsors/subrecipients that did <br />Categories of Services Accessed provided HOPWA housing subsidy NOT provide HOPWA housing subsidy assistance, <br /> assistance, identify the households who identify the households who demonstrated the <br /> demonstrated the followin : followin : <br />Total number of households that <br />obtained an income- roducin job <br />End of PART 4 <br />Previous editions are obsolete Page 16 form HUD-40110-D (Expiration Date: 10/3112014) <br />25D-31