Instruments

Data Collection for a National Evaluation of the American Data Rescue Plan

Instruments

OMB: 3090-0332

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OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix A. Key Informant Interview Recruitment
Outreach and Consent Forms
B

Outreach Emails to Health Center Providers and Staff
Initial outreach email
Dear [NAME],

My name is [NAME] and I am a [researcher/RA] with the American Institutes for Research (AIR).
AIR was contracted by the General Services Administration (GSA) to conduct a study of
behavioral health care programs that received funding through the American Rescue Plan. We
aim to understand decision-making processes used during the COVID-19 public health
emergency, how ARP funding was allocated, which populations were prioritized for ARP
programs, and how behavioral health programs plan to meet community needs going forward.
We would like to schedule an interview with you to understand your experience and unique
perspective on the implementation and use of ARP funding for your [state or organization’s]
behavioral health services. We are not evaluating you or your organization, nor are we
conducting a compliance review; rather, we are seeking to understand your experiences related
to the provision of behavioral health crisis care and your organizations’ use of ARP funds.
The interview will last about one hour and will take place via Zoom, using phone or computer
(your preference). We would like to schedule the interview in the coming weeks. Please use this
link to answer a few introductory questions and view available times.
Attached please find a description of the study, along with consent and confidentiality
information. If you have any questions about this study, please contact the Project Director,
Melissa Hafner, at mhafner@air.org, or the GSA team at arp.national.evaluation@gsa.gov. If
you have concerns or questions about your rights as a participant, contact the Chair of AIR’s
Institutional Review Board at IRBChair@air.org, by phone toll-free at 1-800-634-0797 or c/o
AIR, 1400 Crystal Drive, 10th floor, Arlington, VA 22202-3289.
We look forward to hearing from you soon.
Sincerely,
NAME OF INTERVIEWER
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the outreach and consent is an estimated 0.17 hours per response,
including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information
collection. This information collection is voluntary and respondents will be informed of all planned uses of the data and that their information
will be kept private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for
improving this form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Officer.

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Key Informant Interview Consent (to be shared via email prior to interview)
Thank you for agreeing to participate in an interview about your experience with behavioral
health crisis funding from the American Rescue Plan. The American Institutes for Research (AIR)
is working to understand how [states, local administrators, behavioral health service providers]
like you(rs) implemented American Rescue Plan funds and how the funds were used to advance
equitable access to behavioral health crisis response. We are not evaluating you or your
organization, nor are we conducting a compliance review; rather, we are seeking to understand
your experiences related to the provision of behavioral health crisis care and your
organizations’ use of ARP funds.
CONFIDENTIALITY: Everything that you say during the interview will be kept confidential. Your
name and the names of any individuals that you mention will not appear on any report or other
publications, and the recording of the conversation, along with any notes, will be stored on a
secure server that is only accessible to members of our research team. The reports we produce
will summarize the information gathered and will never be associated with an identifiable
individual. We will destroy the interview recording from this study 5 years after the study ends.
PARTICIPANT RIGHTS: Taking part in this study is voluntary. If you choose not to participate,
there will be no repercussions to you or your position at your organization.
RISKS AND BENEFITS OF PARTICIPATING IN THE STUDY: The interview will ask about your
experience with American Rescue Plan funding and how the funds were used to advance
equitable access to behavioral health crisis. Answering these questions might cause you to feel
uncomfortable. We hope that your participation in this study will shed light on the benefits and
challenges of using the funding and provide insights that may be valuable to policymakers in
the future.
VERBAL CONSENT: There are no right or wrong answers to the questions we will ask today, so
feel free to share your thoughts. You may choose not to answer every question, and we can
stop the discussion at any time. Your participation in this interview is voluntary and you do not
have to answer any questions you don’t want to.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the interview is an estimated 1 hour per response, including the time
to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Officer.

Key Informant Interview Consent
Introduction
Thank you for participating in our conversation about your experience with behavioral health
crisis funding from the American Rescue Plan. My name is ___________, and my colleague(s)
________ and I work for an organization called American Institutes for Research (AIR). We are
working to understand how [states, local administrators, behavioral health service providers]
like you(rs) implemented American Rescue Plan funds and how the funds were used to advance
equitable access to behavioral health crisis response. We are not evaluating you or your
organization, nor are we conducting a compliance review; rather, we are seeking to understand
your experiences related to the provision of behavioral health crisis care and your
organizations’ use of ARP funds.
[FOR ZOOM MEETINGS:] Before we get started, are you familiar with navigating Zoom? [If yes,
skip to next paragraph, if no, provide the following explanation:]
The mute and video button are at the bottom left side of the Zoom toolbar. We would like
everyone to turn their videos on during the meeting if you can and feel comfortable doing so.
Are there any questions about Zoom?
I’d like to go over some disclosures and information about informed consent before we
proceed.
CONFIDENTIALITY: First, I would like to assure you that everything that you say during this
conversation will be kept anonymous. Your name and the names of any individuals that you
mention will not appear on any report or other publications, and the recording of today’s
conversation, along with any notes, will be stored on a secure server that is only accessible to
members of our research team. The reports we produce will summarize the information
gathered and will never be associated with an identifiable individual. We will destroy the
interview recording from this study 5 years after the study ends.
PARTICIPANT RIGHTS: Taking part in this study is voluntary. If you choose not to participate,
there will be no repercussions to you or your position at your organization.
RISKS AND BENEFITS OF PARTICIPATING IN THE STUDY: This interview asks about your
experience with American Rescue Plan funding and how the funds were used to advance
equitable access to behavioral health crisis. Answering these questions might cause you to feel
uncomfortable. We hope that your participation in this study will shed light on the benefits and
challenges of the funding and provide insights that may be valuable to policymakers in the
future.
VERBAL CONSENT: There are no right or wrong answers to the questions we will ask today, so
feel free to share your thoughts. You may choose not to answer every question, and we can
stop the discussion at any time. Your participation in this interview is voluntary and you do not
have to answer any questions you don’t want to. Do you consent to participate in this study?
Our discussion will take approximately 60 minutes. We would like to record the session for
note-taking accuracy. However, we will not record if there are any concerns about the
3

recording, and instead will take notes. Do you have any objection to being recorded? Do you
have any other questions about the study or your participation before we begin?
Wonderful, we are going to begin the recording and start the discussion.

Start recording if there are no objections.

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix B: Integration of ARP Funding to Increase Equitable Access to Behavioral
Health Crisis Services Key Informant Interview Screener
Introduction
Thank you for your interest in participating in an interview about your experience with behavioral
health crisis funding from the American Rescue Plan. As indicated in our email, the American Institutes
for Research is working to understand how [states, local administrators, providers, behavioral health
advocates] like you(rs) implemented American Rescue Plan funds and how the funds were used to
advance equitable access to behavioral health crisis response. We are not evaluating you or your
organization, nor are we conducting a compliance review; rather, we are seeking to understand your
experiences related to the provisions of behavioral health crisis care and your organizations use of ARP
funds.
Before we schedule an interview, we ask that you complete this brief screening form so that we can
better understand your connection to ARP-funded behavioral health crisis programs in [geographic
area]. We will use this information to ensure you are a good fit for the study, and to tailor interview
questions to your role and experience. This form also asks one demographic question (race/ethnicity)
which we will use when analyzing our interview results. We do not use the demographic information to
select individuals for interviews.
The information you provide in this form is confidential and will be stored on a secure server that is
only accessible to members of our research team. We will retain this information only for the duration
of the study and will destroy it within 5 years after the study ends.
Questions
Please make sure to click “Submit” at the bottom of the page before you click out of the form.
1. Please provide your full name ____________
2. Are you currently working in a role related to behavioral health care? (Please include paid or
unpaid, full time or part time work)
a.

Yes

No → Skip to Question 5

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the General Services
Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a systematic look at the
contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and delivery across the Federal
Government. The time required to complete the screener is an estimated 0.17 hours per response, including the time to review instructions, search
existing data resources, gather the data needed, to review and complete the information collection. This information collection is voluntary and
respondents will be informed of all planned uses of the data and that their information will be kept private to the extent permitted by law. If you have
comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: arp.national.evaluation@gsa.gov,
Attention: Information Collections Clearance Officer.

Patient Focus Group Recruitment Screener

3. What is the name of the agency/organization that you work for? ____________
4. How long have you been working in this role?
a.

Less than one year

1-3 years

4-5 years

More than 5 years

5. Which best describes your role in behavioral health care? (Select all that apply)
I work for an organization that provides behavioral health care services
Specify role/job title:
I work for a state or local behavioral health agency
Specify role/job title:
I work for a different state or local agency
Specify role/job title:
dvocate for behavioral health funding or for people who use behavioral health services as
par
Specify role/job title:
I advocate for behavioral health funding or for people who use behavioral health services as
a volunteer
I use or have used mental health or substance use services
I am a caregiver for someone who uses or has used mental health or substance use services
Other ____________
6. Please indicate your agreement with this statement: I am familiar with federal funding for
behavioral health that was available through the American Rescue Plan Act (or ARPA),
including...

Substance Abuse and Mental Health
Services Administration (SAMHSA) grants
Medicaid Mobile Crisis Planning Grants

Strongly
disagree

Disagree

Neither agree nor
disagree

Agree

Strongly
agree

Medicaid Mobile Crisis Enhanced Federal
Medical Assistance Percentage (FMAP)
State and Local Funding for Coronavirus
Response
Other funding _________________

Behavioral Health Key Informant Interview Screener
May 2024

7. What is your race and/or ethnicity? Select all that apply.
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian and Pacific Islander
White
Other race not listed here ____________
Prefer not to say

8. We are in the process of scheduling interviews, which will take about 60 minutes. We will
conduct the interview using Zoom videoconference, but it will have a dial-in option for
participants who cannot access the internet or do not wish to be on video. If you wish to
participate in the videoconference, you will need a computer, tablet or phone that can access the
Internet. Do you have access to the Internet through a computer, tablet or phone?
Yes
No
I plan to dial into the interview
Message After Form is Submitted:
Thank you for submitting the form! We will review the information to confirm that you are a good fit
for the study. If so, we will reach out to schedule an interview time. If you have any questions about
the study, please email us at: STUDYEMAIL@air.org.

Behavioral Health Key Informant Interview Screener
May 2024

OMB Control #: 3090-0332
Expiration Date: 05/31/2027
B

Appendix C: Key Informant Interview Instruments
This appendix includes questions for state and local administrators (Exhibit C1), behavioral
health providers who have knowledge of, or were responsible for administering, ARP funding
(Exhibit C2), and behavioral health consumer advocates (Exhibit C3). Because we expect to
interview a wide range of individuals, each interview will be tailored to fit the specific role and
expertise of key informants. To do this, we have structured the interview questions in a table
that shows the main (stem) question with a number of potential probes that interviewers may
draw from based on answers provided during the discussion. Some key informants may not
have knowledge of, or exposure to, every area that is covered in the questionnaire. In those
cases, we will skip any questions that are not relevant for the key informant.
Exhibit C1. Administrator Questions and Probes
Stem Question

Potential Probe Topics

Adoption by intended staff, settings, systems, communities
Thanks for sharing more about yourself with me. To start, we want to ask you about the process of
applying and planning for behavioral health crisis funding that was available under the American
Rescue Plan. [Note to interviewer: tailor introduction of this question based on the type of funding
and the respondent's role]
Your [state/agency] received American
Probe for each funding type received:
Rescue Plan funding through [SAMHSA
• SAMSHA grants
grants, Medicaid SPA/planning grant,
• Medicaid SPA/Planning Grant
SLFRF].
• SLFRF
1. Can you talk about what led your
agency to seek ARP funding from
these sources?
2. How easy was it to understand the
• The provision of support, training, or technical
guidelines for this funding? Why or
assistance on how this funding could be used, and
why not?
examples if applicable.
• Who provided support or technical assistance.
• Extent to which technical assistance provided the
clarity needed to understand the guidelines for ARP
funding, and examples if applicable.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the interview is an estimated 1 hour per response, including the time
to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Officer.

Stem Question

Potential Probe Topics

3. Can you tell me about the decisionmaking process for how to use these
funds?

•

How the crisis care needs of the community were
assessed, including formal or informal coordination
with other [state/local/program] administrators.
[Interviewer will tailor this question to clarify
“community” and the geographic area of the case
study.]

• How the crisis care needs of the community were

prioritized, including criteria used to define “high
priority” needs or populations.
• How equity was integrated into plans for using the
funds. For example: assessing and addressing
disparities in access to services or outcomes by race,
ethnicity, language, rurality, and/or other intersecting
identities.

4. If your agency was able to blend ARP
funding types together or with other
funding for behavioral health crisis
care, tell me how that went?

• Unique opportunities created by the combination of
funding.
• Lessons about what works well when combining
funds, including any policies that made it easier to
combine the funds.
• [If able OR unable to blend funding]: Challenges
faced, including any policies that made it harder to
combine these funds.

Implementation consistency, costs, and adaptations made during delivery
I’d like to transition to some questions
about the process of receiving and using
ARP funds.
5. If your agency experienced any
challenges related to receiving or how
you planned to use ARP funds, can you
tell me about that?

6. If the availability of ARP funding
impacted the way your agency
collaborates or collaborated with
other agencies or organizations, could
you tell me about...

• For example: receiving it in a timely manner,
constraints on how you could use the funds, or
reporting on the use of funds.
• [If they distributed SAMHSA funds to subgrantees]:
Challenges in disbursing funds to subgrantees.
• How challenges modified original plans to use funds,
including any modifications to plans for addressing
disparities.
• Strategies used to overcome challenges in the
process of receiving or using ARP funds.
• [If no challenges]: Factors or strategies that
prevented challenges to receiving or using ARP funds.
• How this collaboration differed from the ways in
which (and/or with whom) agency has collaborated in
the past.
• Opportunities presented through this collaboration.
• Challenges of collaboration with other organizations.

Stem Question

Potential Probe Topics

Effectiveness or efficacy
Next, I’d like to talk about your views
regarding the uses of this funding.
7. How did you/your agency use the
funding to provide or administer
behavioral health crisis care in
[geographical area]?

• Sustainment or expansion of existing programs or
services. (Specify services)
• Implementation of new programs or services, and
examples if applicable.
• Administrative processes or quality improvement
efforts, and examples if applicable.
• Workforce enhancements such as training, incentives,
and other programs.
• Equitable distribution of any changes in behavioral
health crisis care, and examples such as reduction of
disparities in access by race, ethnicity, language,
rurality, and/or other intersecting identities.
• Extent to which ARP funding met behavioral health
crisis program and service needs in [geographical
area].

Reach the intended population
Now I’d like to talk about the availability
of behavioral health crisis care for people
in your agency’s [geographical area].
8. If you are aware of strategies that
were used to increase access to
services for people with behavioral
health needs in your [geographical
area], can you tell me about those
strategies?
9. Can you tell me about the populations
that sought services provided by ARP
funding? For example, geographic
areas, socioeconomic or demographic
factors, certain behavioral health
needs. How have these populations
differed from who has been served in
the past?

• For example: outreach to underserved populations,
expanding provider licensure, partnerships between
providers and community organizations, no wrong
door programs.
• [If not aware]: Whether and to what extent your or
another organization collects data on patient access,
including strategies to increase access.

• Individuals with greater behavioral health crisis needs
or those with historically limited access.
Examples of individuals with greater service or access
needs: By race, ethnicity, language, rurality, and/or
other intersecting identities, type and degree of
behavioral health services needed.

Stem Question

Potential Probe Topics

10. What data have you seen or are you
aware of related to service use?

• Service use data examples: client demographics or
service needs, geographic access, timeliness of
access, client volume, volume of services provided,
types of services used, service access and use along
the continuum of care.
• [If service use details are unknown but data exists]:
Sharing or directing AIR to the data.
• Service use data gaps for agency or region.

11. To what extent was your agency able
to develop new partnerships for your
behavioral health crisis work?

• [If new partnership(s)]: Ways in which new partners
supported availability of services to populations with
higher needs or limited access. Examples: race,
ethnicity, language, rurality, and/or other intersecting
identities, type and degree of behavioral health
services needed.
• [If new partnership(s)]: Factors that helped facilitate
new partnership.
• [If no new partnership]: Organizations you would
have liked to partner with.
• [If no new partnership]: Barriers to establishing new
partnership.

12. What do you see as remaining gaps in
the availability of behavioral health
crisis care in [geographical area]?

• Different gaps for different populations or
communities in [geographical area], for example, by
race, ethnicity, language, rurality, and/or other
intersecting identities, type and degree of behavioral
health services needed.

Maintenance and sustainment of intervention effects
Finally, we’d like you to reflect on the
sustainability of any of the changes in
behavioral health crisis care that we
just talked about.
13. How is your agency or team planning
to sustain or expand ARP-funded
changes to behavioral health crisis
care after this funding is no longer
available (in 2025)?

• Other persistent changes beyond those they planned
or prioritized
• Changes that are priorities to sustain or expand.
• Other funding sources identified by agency in
anticipation of ARP funds ending in 2025.
• Ways in which new organizational structures or
partnerships can/will facilitate maintenance of
changes in behavioral health crisis care.
• Specific concerns about the expiration of this
funding.

Exhibit C2. Provider Questions and Probes
Stem Question

Potential Probe Topics

Adoption by intended staff, settings, systems, communities
Thanks for sharing more about yourself with me. To start, we want to ask you about funding for
behavioral health crisis services that became available under the American Rescue Plan. [Note to
interviewer: tailor introduction of this question based on the type of funding and the respondent's
role]
1. Can you tell me about the decisionmaking process for how to use the ARP
funds? How did you carry out this
decision?

• Ways in which the crisis care needs of the
community were assessed, including formal or
informal coordination with other
[state/local/program] administrators. [Interviewer
will tailor this question to clarify “community” and
the geographic area of the case study.]
• Ways in which the crisis care needs of the
community were prioritized, including criteria used
to define “high priority” needs or populations.
• Ways in which equity was integrated into plans for
using the funds. For example: assessing and
addressing disparities in access to services or
outcomes by race, ethnicity, language, rurality,
and/or other intersecting identities.
• Ways in which existing behavioral health crisis
system strengths informed planning. (Examples:
previous programmatic or service success,
supportive leadership, strong workforce)

2. If your agency was able to combine ARP
funding with other funding sources, can
you elaborate on how that process went?

• Unique opportunities created by the combination
of funding.
• Lessons about what works well when combining
funds, including any policies that made it easier to
combine the funds.
• [If able OR unable to blend funding]: Constraints or
challenges faced, including any policies that made
it harder to combine these funds.

Stem Question

Potential Probe Topics

Implementation consistency, costs, and adaptions made during delivery
I’d like to transition to some questions about
the process of receiving and using ARP
funds.
3. If your organization experienced any
challenges with receiving ARP funding or
how you planned to use ARP funds, can
you tell me about that?

4. If ARP funding changed the way your
organization collaborates or collaborated
with other organizations or agencies
could you tell me…

• For example: receiving it in a timely manner,
constraints on how you could use the funds, or
reporting on the use of funds.
• Prompt respondent to think back about challenges.
How those challenges modified their original plans
to use funds, including any modifications to plans
for addressing disparities.
• Strategies used to overcome challenges in the
process of receiving or using ARP funds.
• [If no challenges]: Factors and strategies that
prevented challenges to receiving or using ARP
funds.
• Ways in which this collaboration differed from the
ways (and/or with whom) organization has
collaborated in the past.
• Opportunities presented through this
collaboration.
• Challenges of collaborating with other
organizations.

Effectiveness or efficacy
Next, I’d like to talk about your views
regarding the uses of this funding.
5. How did you/your organization use the
funding to provide behavioral health crisis
services for people in your [geographical
area]?

• Sustainment or expansion of existing programs or
services, and examples if applicable.
• Implementation of new programs or services, and
examples if applicable.
• Administrative processes or quality improvement
efforts, and examples if applicable.
• Workforce capacity. For example: Hiring more
staff. Hiring more diverse staff. Increased
compensation for existing staff. Improve staff
retention. Examples if applicable.
• Mobile crisis services, and examples if applicable.
• Equitable distribution of any changes in behavioral
health crisis care. For example, reduction of
disparities in access by race, ethnicity, language,
rurality, and/or other intersecting identities.
• Extent to which funding met behavioral health
crisis program and service needs in [geographical
area].

Stem Question

Potential Probe Topics

Reach the intended population
Now I’d like to talk about the availability of
behavioral health crisis care for people in
your organization’s [geographical area].
6. What strategies did your organization use
to increase access to services for people
with behavioral health needs in
[geographical area]?
7. Can you tell me about the populations
that sought services provided by ARP
funding? For example, populations in
certain geographic areas, socioeconomic
or demographic factors, certain
behavioral health needs. How have these
populations differed from who has been
served in the past?

• For example: outreach to underserved
populations, offering new services, hiring
more/certain types of providers, partnerships with
community organizations.
• [If strategies used OR no strategies used]:
Awareness of strategies to increase access used by
other service provider organizations.
• Individuals with greater behavioral health crisis
needs or those with historically limited access. For
example: By race, ethnicity, language, rurality,
and/or other intersecting identities, type and
degree of behavioral health services needed.

8. Thinking back to 2020 and up until now,
what changes, if any, have you observed
in the utilization of behavioral health
crisis services?

• For example: changes in behavioral health needs,
types of services available, types of services used,
geographic changes, timeliness of service use,
volume of services available, use across the
continuum of care.

9. What do you see as remaining gaps in the
availability of behavioral health crisis care
in [geographical area]?

• How gaps vary for different populations or
communities in [geographical area]. For example:
by race, ethnicity, language, rurality, and/or other
intersecting identities, type and degree of
behavioral health services needed.

Maintenance and sustainment of intervention effects
Finally, we’d like you to reflect on the
sustainability of any changes in behavioral
health crisis care that we just talked about.
10. How is your organization or team
planning to sustain or expand ARPfunded changes to behavioral health
crisis care after this funding is no longer
available (in 2025)?

• Other persistent changes beyond those they
planned or prioritized
• Changes that are priorities to sustain or expand.
• How new organizational structures or partnerships
can/will facilitate maintenance of changes in
behavioral health crisis care.
• Specific concerns about the expiration of this
funding.
• Awareness of other funding sources identified in
anticipation of ARP funds ending in 2025.

Exhibit C3. Behavioral Health Consumer Advocate Questions and Probes
Stem Question

Potential Probe Topics

Adoption by intended staff, settings, systems, communities
Thanks for sharing more about yourself with me. To start, we want to ask you about funding for
behavioral health crisis services. In March of 2021, the American Rescue Plan was enacted, which
provided funding to address the public health and economic impacts of the COVID-19 pandemic. Some
of the funding that became available under the American Rescue Plan was specifically for behavioral
health crisis services.

1. Can you reflect on what you knew

• Types of funding aware of: COVID-19 recovery
legislation broadly, ARP funding broadly, specific ARP
funding, ARP behavioral health funding.
• Depth of knowledge about funding types: COVID-19
recovery legislation broadly, ARP funding broadly,
specific ARP funding, ARP behavioral health funding.
• Awareness that funding intended to address historical
inequities and disparities.
• Information channels that informed awareness. For
example: mass media, professional networks,
legislation tracking, social media, personal networks.

2. If you were involved in advocating for
ARP funding to be used in [geographic
area or their area of advocacy], can you
tell me about your experience?

• Types of funding advocated for: Medicaid SPA,
Medicaid planning grant, SAMSHA grants, State and
Local Fiscal Recovery Funds.
• Specific outcomes advocated for? For example:— your
state/city/county to receive funding, how to spend
funding, specific services needed or wanted, services
for specific populations or communities.
• Agencies or groups the advocacy was directed at and
their responsiveness.
• Continued involvement in this advocacy.

about this funding at the time?

Implementation consistency, costs, and adaptations made during delivery

I’d like to transition to some questions
about the roll out of or expansion of
behavioral health crisis services in
[geographic area or state].
3. If you were engaged [by local/state
agency(ies)] as a partner in the
implementation or expansion of crisis
care programs or services funded
through ARP, what was your or your
organization’s role?

• [If engaged by local/state agency(ies)]: Examples of
potential roles as an implementation partner: subject
matter expert, lived experience, awareness raising
among community.
• [If not engaged by local/state agency(ies)]: How would
you have wanted to be engaged as an implementation
partner?

Stem Question

Potential Probe Topics

4. If the availability of ARP funding
changed the way you or your
organization collaborates or
collaborated with other partners, could
you tell me...[reference probes]?

• How this collaboration differed from the ways in
which (and/or with whom) advocate has collaborated
in the past.
• Opportunities presented through this collaboration.
• Challenges of collaboration with other organizations
or groups.

Effectiveness or efficacy
5. Thinking back to 2020 and up until now,
what changes, if any, have you
observed or experienced in the
availability of behavioral health crisis
care?

• For example: changes in behavioral health needs,
types of services available, types of services used,
geographic availability, timeliness of service
availability, volume of services available, availability
across the continuum of care.
• Equitable availability of services. For example:
differences in availability for people based on race,
ethnicity, language, rurality, other intersecting
identities and/or stigmatized populations (e.g., people
who use substances, unstably housed people, people
with co-occurring behavioral health needs).

Reach the intended population
Now I’d like to talk about the availability of
behavioral health crisis care for the
[community/population/geographical
area]?
6. If you/your organization partnered with
[local/state agency] to increase access
to behavioral health crisis services,
which strategies did you use to increase
access?
7. Can you tell me about what behavioral
health crisis services were available
before ARP funding? [For example, only
in certain geographic areas, limited to
911 response, specific behavioral
health needs]. Can you tell me about
how that changed after ARP funding, if
at all?

•

8. What do you see as remaining gaps in
the availability of behavioral health
crisis care for the
[community/population/geographical
area] you represent?

• How gaps vary for different populations or
communities in [geographical area]. For example: by
race, ethnicity, language, rurality, and/or other
intersecting identities, type and degree of behavioral
health services needed.

For example: outreach, mobile or otherwise, to
underserved population, technical assistance,
facilitating partnerships between providers and
community organizations.

• Individuals with greater behavioral health crisis needs
or those with historically limited access? For example:
By race, ethnicity, language, rurality, and/or other
intersecting identities, type and degree of behavioral
health services needed.

Stem Question

Potential Probe Topics

Maintenance and sustainment of intervention effects
Finally, we’d like you to reflect on the
sustainability of any of the changes in
behavioral health services that we just
talked about for
[community/population/geographical
area] you represent.
9. As you may know, the additional
funding that ARP provided will expire in
2025. Which behavioral health crisis
programs or services, since 2021 or
generally, do you think are essential to
maintain or expand after ARP funding
ends in 2025?
10. If you or your organization plan to
engage in advocacy for additional
funding or services in anticipation of
the expiration of this funding, can you
tell me about...[reference probes]?

•

For example: changes in behavioral health needs,
types of services available, types of services used,
geographic availability, timeliness of service
availability, volume of services available, availability
across the continuum of care.

• Equitable availability of services. For example:
differences in availability for people based on race,
ethnicity, language, rurality, other intersecting
identities and/or stigmatized populations (e.g., people
who use substances, unstably housed people, people
with co-occurring behavioral health needs).

• [If yes]: Engagement strategies.
• [If yes]: Agencies or groups advocacy directed at.
• [If yes]: Organizations/other partners engaged in
advocacy.
• [If no]: Why not?

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix D: Homelessness Programs Survey Outreach
Materials
Attachment 1: HUD SNAPS ListServ email to CoCs

This fall, CoCs will receive two survey requests related to two separate federal evaluation studies. One
survey is related to CoC’s American Rescue Plan Experience and second related to CoC role in Emergency
Housing Voucher program. Please visit HUD page for additional information on both studies. Both
surveys are voluntary and will be used for research purposes only and will NOT be used for compliance
monitoring. Information that you share will be deidentified and will not be associated with a CoC,
community, or individual.

About the American Rescue Plan National Evaluation
How was your CoC engaged by local government agencies to participate in American Rescue Plan
programs that served people at risk of experiencing or currently experiencing homelessness?
A national evaluation of the American Rescue Plan is underway and you are invited to share your CoC’s
experience. The U.S. General Services Administration (GSA) has engaged the American Institutes for
Research (AIR) in partnership with Abt Global and Decision Information Resources (DIR) to study how
American Rescue Plan (ARP) housing programs were implemented to equitably support people
experiencing, or at risk of homelessness. We have invited you to participate in this survey to help
understand whether and how CoCs were engaged by local government agencies or other partners to
provide input and implement ARP housing-related programs. You can find out more about the study
here [link to webpage with detailed information sheet and survey PDF].
You can share your CoC’s experience by answering an online survey from Abt Global and DIR that will be
sent to your CoC’s Collaborative Applicant contact in October 2024. The survey will ask about
• CoC’s involvement in different ARP programs
• CoC’s role in determining participant eligibility, prioritization, funding allocations, and in service
delivery to increase equitable access
• Different types of homeless services funded through ARP program
• CoC’s overall ARP experience
The survey should take from 10 – 45 minutes depending on how involved your CoC was in implementing
ARP programs in your community. Based on survey responses, 8-10 communities will be selected for
deeper study. Findings from this study are expected to be available in 2027.
About the Emergency Housing Voucher Study
[Study description from EHV project team]

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the outreach email is an estimated 0.08 hours per response, including
the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Officer.

Attachment 2: Survey Details and Study Information Sheet
About the Study
A national evaluation of the American Rescue Plan is underway and you are invited to share your CoC’s
experience. The U.S. General Services Administration (GSA) has engaged the American Institutes for
Research (AIR) in partnership with Abt Global and Decision Information Resources (DIR) to study how
American Rescue Plan (ARP) housing programs were implemented to equitably support people
experiencing, or at risk of homelessness. We have invited you to participate in this survey to help
understand whether and how CoCs were engaged by local agencies to provide input and implement ARP
housing-related programs.
Survey Procedure
The Abt and DIR study team will administer an online survey to collect information on the level of each
CoC’s involvement in ARP housing programs that will be crucial to answer the study’s key research
questions. The survey is being sent to the primary contact at all the 388 CoCs. We anticipate the survey
will take about 10 - 45 minutes to complete, depending on a CoC’s level of involvement in ARP
programs. CoC primary contacts can share their unique survey link with other staff at their agency or
forward the survey to other CoC partner organizations.
Who should complete the survey?
We expect that CoC Collaborative Applicant Executive Director, a staff person, or CoC Board Member
who has been involved in your CoC since ARP programs started in 2021, can best answer the questions
on this survey. If you do not know the answers to all questions on the survey, you can forward this
custom link for your CoC to your colleagues or a contact person in another CoC organization, including a
previous CoC Collaborative Applicant to fill in the unanswered questions. If you do not know who to
share this survey link with or have any other questions, please contact us at
arpcocsurvey@abtglobal.com.
What information is needed for this survey?
Please see the PDF here for a full list of questions on the survey. ARP funding
became available in early 2021. Some of these programs have ended, some are ending soon, and some
others have a longer timeframe. You will not need to collect or report any specific data on this survey.
Staff who have been most involved in ARP programs since the start in 2021 will be in the best position to
answer these questions. This survey mainly aims to capture your CoC’s overall experience and
involvement in different ARP programs. For a list of different ARP programs that may be relevant in
addressing the needs of people experiencing homelessness refer this resource.
Privacy
Your participation is completely voluntary, and you may choose to skip questions or discontinue
participation at any time. Whether or not you decide to participate will not affect your organization’s
relationship with HUD or any of the federal entities administering the ARP programs. Your responses are
also private, meaning our team will only use this information for research and evaluation purposes. The
reports prepared for this study will summarize findings across the CoCs presenting results in the
deidentified form, and will not associate responses with a CoC, community, or individual.

Survey Risk and Benefit
Responses to this survey will only be used for research purposes only and will NOT be used for
compliance monitoring. We do not expect any risks associated with your participation in the survey.
While there is no expected direct benefit for your organization, the findings will help federal agencies
learn about the implementation of housing-related ARP programs.
Participation in this study is voluntary. Whether or not you decide to participate will not affect your
organization’s relationship with HUD or any of the federal entities administering the ARP programs.
Future information use
The study team may store the data you provide for this study after removing your name and any
identifying information. This information may be used for future studies without additional informed
consent from you.
Who to contact if you have questions
For any questions related to the study, contact the study director, Dr. Naganika Sanga at
naganika.sanga@abtglobal.com or +1 301-347-5027. If you have questions about the survey, please
email arpcocsurvey@abtglobal.com. If you have concerns or questions about your rights as a
participant, contact the Chair of AIR’s Institutional Review Board at IRBChair@air.org, by phone toll-free
at 1-800-634-0797 or c/o AIR, 1400 Crystal Drive, 10th floor, Arlington, VA 22202-3289.
This survey was approved by the Office of Management and Budget, as required by the Paperwork
Reduction Act of 1995, under OMB control number 3090-0332, with expiration date of May 31, 2027.

About the Study
Why is this study being conducted?
The American Rescue Plan (ARP) Act of 2021 made significant investments available for U.S.
communities. Multiple ARP programs provided resources to communities with the goal of
improving housing stability and reducing homelessness. Some of these programs also included
waivers or recommendations to improve equitable access to housing resources for people with a
disproportionate risk of experiencing homelessness. To date, no study examines how ARP housing
programs with equitable implementation features were used by communities to serve people at
risk of or currently experiencing homelessness or how these innovative strategies were used to
improve access for people with a disproportionate risk of experiencing homelessness.
The U.S. General Services Administration (GSA) has engaged the American Institutes for Research
(AIR) in partnership with Abt Global and Decision Information Resources (DIR) to study these
questions. Through this study, we will describe how the homeless service sector (via CoC lead
agencies) was engaged in ARP housing programs aimed at reducing housing instability and
homelessness and the program features they put in place to improve access for people that
experience a disproportionate risk of homelessness. The study will help GSA and other federal
agencies like the US Department of Housing and Urban Development (HUD) identify strategies that
can help in structuring future programs.
We are studying CoC organizations because they are responsible for a community’s strategic plan
to reduce homelessness and have the most comprehensive understanding of a community’s needs,
past and ongoing efforts. We expect that communities where CoCs played an active role in ARP
planning and implementation will have important lessons to offer about strategies that best
support people at risk of or experiencing homelessness. Likewise, we expect communities where
CoCs were not actively engaged in these programs will help understand alternative approaches
adopted by ARP agencies in the absence of CoC involvement and identify barriers to effective
coordination.
What is this study about?
The purpose of this study is to better understand how ARP Housing Programs were used to serve people
at risk of or currently experiencing homelessness and which implementation features were put in places
to improve access for people with a disproportionate risk of experiencing homelessness.

The study team will focus on answering three primary research questions:

The study is composed of three parts: 1) a survey of all CoC lead collaborative applicants, 2) a deeper
analysis of eight to ten communities that includes interviews with CoC and ARP partner staff and limited
document review, and 3) a cross-site analysis that uses localized data to identify trends.

Which ARP programs were related to homelessness?
Some of the key ARP programs that may be related to people experiencing or at-risk of experiencing
homelessness are:
A detailed list of ARP programs that may be relevant in addressing the needs of people experiencing
homelessness are available here.
What will be done with the study when it is completed?

The study findings will be presented to GSA and other federal agencies and made publicly available at
the end of the study in 2027.
How is this study different from other ongoing studies of CoCs?
There are currently other studies examining the ARP housing programs like EHV and ERA. Our study as
part of the ARP National Evaluation looks beyond individual programs such as ERA and EHV, to focus on
a broader set of ARP programs that were used by localities and their CoCs to various degrees to serve
people experiencing or at-risk of experiencing homelessness. It focuses on local priorities and
partnerships, populations served through ARP programs, lessons learned, and innovative approaches
established through ARP programs. This study is designed to complement other studies being
conducted. Some of these other studies are:
•
•

Three HUD-sponsored studies are investigating the impact of ERA spending on evictions and
housing instability and the role local program characteristics played in this relationship.
Another HUD-sponsored study, Emergency Housing Voucher (EHV) National Evaluation Study
program is examining who received EHVs and how waivers helped reach households with
disproportionate risk of experiencing homelessness. The HUD-EHV evaluation is also
administering a national survey to all CoCs to capture how the CoCs used EHVs, their criteria for
determining eligibility, the services they offered to EHV participants, and the CoC coordination
mechanisms with Public Housing Agencies(PHAs) in implementing EHVs.

How can I find out more about this study?
For any questions related to the study, contact the study director, Dr. Naganika Sanga at
naganika.sanga@abtglobal.com or +1 301-347-5027. If you have questions about the survey, please
email arpcocsurvey@abtglobal.com. If you have concerns or questions about your rights as a
participant, contact the Chair of AIR’s Institutional Review Board at IRBChair@air.org, by phone toll-free
at 1-800-634-0797 or c/o AIR, 1400 Crystal Drive, 10th floor, Arlington, VA 22202-3289.
This survey was approved by the Office of Management and Budget, as required by the Paperwork
Reduction Act of 1995, under OMB control number 3090-0332, with expiration date of May 31, 2027.

Attachment 3: Emails from study team
Initial email with survey link
Email Subject: You Are Invited to Share your CoC’s American Rescue Plan Experience in a National

Study
Dear [name],
Your organization is invited to share your CoC’s American Rescue Plan (ARP) experience. Participate in
this survey to help us understand whether and how CoCs were engaged by local agencies to provide
input and implement ARP housing-related to equitably support people experiencing, or at risk of
homelessness.
This survey is part of the ARP National Evaluation being conducted on behalf of the U.S. General Services
Administration (GSA) by the American Institutes for Research (AIR), Abt Global, and Decision
Information Resources (DIR). The study will help federal agencies identify strategies to help reach people
who experience disproportionately high rates of homelessness. The survey is voluntary and will not be
used for compliance purposes.
You are being contacted as the primary contact for the [CoC name]. The survey link below is a custom
link for your CoC that you can share with other staff on your team or another agency participating in
your CoC. We expect that the CoC Executive Director, a staff person, or CoC Board Member who has
been involved in your CoC since ARP programs started in 2021, can best answer the questions on this
survey.
Survey responses will be used to answer questions about
•
•
•
•

CoC’s involvement in different ARP programs
CoC’s role in determining participant eligibility, prioritization, funding allocations, and in service
delivery to increase equitable access
Different types of homeless services funded through ARP program
CoC’s overall ARP experience

The survey should take from 10 – 45 minutes depending on how involved your CoC was in implementing
ARP programs in your community. Based on survey responses, 8-10 communities will be selected for
deeper study. Findings from this study are expected to be available in 2027.
You can help us answer these questions and share your CoC’s experience by clicking this unique link or
forwarding to someone in your CoC best positioned to complete the survey. [CoC Name from mail
merge] : [insert survey/questionnaire ]
You can find out more about the study and survey on this webpage and in the attachments that include
a study information sheet [link] and a full list of the survey questions [link].

If you have any questions or need assistance taking the survey, please contact our study team at
arpcocsurvey@abtglobal.com. We know you are busy and appreciate your time to help us learn more
about the important work your CoC is doing.
Thank you!
Sincerely,
[Name]

Follow up email with survey link
Email Subject: Don’t Miss Out! You Are Invited to Share your CoC’s American Rescue Plan Experience in
a National Study
Dear [name],
Your organization was recently invited to share your CoC’s American Rescue Plan (ARP) through a web
survey. We hope you will consider participating in this opportunity! If you have any questions or would
like assistance completing the survey, please do not hesitate to reach out to our team at
arpcocsurvey@abtglobal.com.
The study will help GSA and other federal agencies like the US Department of Housing and Urban
Development (HUD) identify strategies to help reach people who experience disproportionately high
rates of homelessness. The survey is voluntary and will not be used for compliance purposes. You can
find more details about the study and this survey and download a copy of the survey questions by
clicking the link below.
You are being contacted as the primary contact for the [CoC name]. The survey link below is a custom
link for your CoC that you can share with other staff on your team or another agency participating in
your CoC. We expect that CoC Executive Director, a staff person, or CoC Board Member who has been
involved in your CoC since ARP programs started in 2021, can best answer the questions on this survey.
Survey responses will be used to answer questions about
•
•
•
•

The survey should take from 10 – 45 minutes depending on how involved your CoC was in implementing
ARP programs in your community. Based on survey responses, 8-10 communities will be selected for
deeper study. Findings from this study are expected to be available in 2027.
You can help us answer these questions and share your CoC’s experience by clicking this unique link or
forwarding it to someone in your CoC best positioned to complete the survey. [CoC Name from mail
merge] : [insert survey/questionnaire ].
You can find out more about the study and survey on this webpage and in the attachments that include
a study information sheet [link] and a full list of the survey questions [link].
We know you are busy and appreciate your time to help us learn more about the important work your
CoC is doing.
Thank you!
Sincerely,
[Name]

Phone follow-ups, telephone walk through
Hello,
I am calling on behalf of the American Rescue Plan (ARP) National Evaluation. The study is being led by
Abt Global and Decision Information Resources (DIR) in partnership with AIR, under contract with the
U.S. General Services Administration (GSA).
You might have received an email from HUD informing you about a survey related to your and a followup email from our study team with the survey link and additional information. I wanted to tell you more
about the survey and see if you are interested in participating. This survey will help us understand
whether and how CoCs were engaged by local agencies to provide input and implement housing-related
ARP programs. We believe CoCs will have valuable insights to share about strategies that can improve
access for people with a disproportionate risk of experiencing homelessness. Findings from the study
will help GSA and other federal agencies like the US Department of Housing and Urban Development
(HUD) identify strategies that can help in structuring future programs.
The survey is voluntary and will not be used for compliance purposes. You can find more details about
the study and this survey and download a copy of the survey questions in the email we sent previously.
One or more individuals from your CoC can use the same link to complete the survey.
Would you be willing to participate in the survey?
a) I am happy to go over the questionnaire during our call and fill out based on your responses.
b) Alternatively, I can resend the email with the link to the survey if you prefer to fill the survey
online on your own or share it with someone from your CoC.
If a) read the consent page and go over the survey questions over the call. Reiterate the email address
and invite them to contact in case they have any questions.
If b) send the email and refer to place where the survey contact information is noted in the email.
Reiterate the email address and invite them to contact in case they have any questions.
If neither a or b,
Would you recommend we contact someone else at your local CoC to help answer this survey?
If yes, will you please share this person’s name, role, and contact details? We will reach out to
them directly.
Thank you for your time. In case you have any further questions, please contact us at
arpcocsurvey@abtglobal.com.

APPENDIX E: Survey Consent and Instrument

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

SURVEY CONSENT
CoC Experiences with American Rescue Plan Programs
The U.S. General Services Administration (GSA) has engaged the American Institutes for
Research (AIR) in partnership with Abt Global and Decision Information Resources (DIR) to
study how American Rescue Plan (ARP) housing programs were implemented to equitably
support people experiencing, or at risk of homelessness.
We are inviting you to participate in this survey to help understand whether and how CoCs
were engaged by local agencies to provide input and implement ARP housing-related programs.
Survey responses will be used to identify 8-10 CoCs for follow-up interviews.
You can download a copy of the survey questions to preview or share with your staff here [link
to survey pdf]. We anticipate this survey will take about 10 - 45 minutes based on the extent of
your CoC’s involvement in ARP programs.
Staff who have been most involved in ARP programs since the start in 2021 will be in the best
position to answer these questions. You may share this custom survey link with multiple staff at your agency to complete these questions or you may
forward this link to colleagues in another CoC organization, including a previous CoC
Collaborative Applicant contact. If you do not know who to share this survey link with, please
contact us arpcocsurvey@abtglobal.com.
Freedom to withdraw. This survey is voluntary. You can decide not to participate or discontinue
participation at any time without any penalty.
Confidentiality. Your responses are also private, meaning our team will only use this
information for research and evaluation purposes. The survey results will be presented
deidentified form, and will not associate responses with any specific CoC, community, or
individual.
Risks and benefits. There are no known risks for participating in this survey. Whether or not
you decide to participate will not affect your organization’s relationship with HUD or any of the
federal entities administering the ARP programs. Responses to this survey will only be used for
research purposes only and will NOT be used for compliance monitoring. While there is no
expected direct benefit for your organization, the findings will help federal agencies learn about
the implementation of housing-related ARP programs.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the consent and survey is an estimated 0.42 hours per response,
including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information
collection. This information collection is voluntary and respondents will be informed of all planned uses of the data and that their information
will be kept private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for
improving this form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Officer.

APPENDIX E: Survey Consent and Instrument
Future information use. The study team may store the data you provide for this study after
removing your name and any identifying information. This information may be used for future
studies without additional informed consent from you.
This survey was approved by the Office of Management and Budget, as required by the
Paperwork Reduction Act of 1995, under OMB control number 3090-0332, with expiration date
of May 31, 2027.
If you have questions about the survey, please email arpcocsurvey@abtglobal.com. For any
questions related to the study, contact the study director, Dr. Naganika Sanga at
naganika.sanga@abtglobal.com or +1 301-347-5027. If you have concerns or questions about
your rights as a participant, contact the Chair of AIR’s Institutional Review Board at
IRBChair@air.org, by phone toll-free at 1-800-634-0797 or c/o AIR, 1400 Crystal Drive, 10th
floor, Arlington, VA 22202-3289.
By clicking the next button and completing the survey you indicate that you have consented to
participate in this research. You may choose to skip any question or discontinue participation at
any time. If you do not want to participate, please close the browser.

APPENDIX E: Survey Consent and Instrument

SURVEY INSTRUMENT
[Display name of the CoC based on the individualized survey link]
1. Is your CoC’s Collaborative Applicant part of the government or a separate entity? Select the option
that best describes your CoC’s Collaborative Applicant from the list below.
[check boxes with the following options]
a) Local Government
b) Public Housing Agency
c) State Government
d) US Territories Government
e) Tribes/Tribally Designated Housing Entities
f) Separate, non-governmental entity
g) Not sure
h) Other, please specify ______________________________ [text box]
1A. [If the respondent selects a) under Q1] Your CoC is part of the local government. Please
select the option that best describes your CoC.
o CoC is created as a separate chartered government entity
o CoC is an integrated arm of the local government
o Unsure
2. What are the top housing and homelessness issues in your CoC’s jurisdiction at present? Select up
to three issues from the list below that represent the biggest challenges in serving people
experiencing homelessness or at-risk of experiencing homelessness.
[check boxes with the following options]
o Low rental vacancy rates
o Shortage of units with affordable rents for low-income households
o Shortage of affordable units with transit connectivity
o Inadequate subsidized housing
o Insufficient street outreach
o Insufficient shelter capacity
o Insufficient short-term rental assistance (e.g., rapid re-housing, etc.)
o Insufficient housing wrap-around or support services
o Insufficient permanent supportive housing
o Poor coordination between different homelessness and housing provider agencies
o Landlord barriers (e.g., requiring high credit scores, security deposits)
o Other, please specify __________________ [text box]
The following questions are related to the American Rescue Plan (ARP) grants distributed to your locality.
To the extent possible, consider the overall duration of ARP funding in your responses (ARP started in
2021). Otherwise, you may choose your answers that best represent your most recent experience.
3

APPENDIX E: Survey Consent and Instrument
3. Please select all the ARP programs in which your CoC participated (for example: received funding,
provided input on how the program is designed, provided referrals). In your responses, please also
consider state and local initiatives your CoC participated in that were funded though ARP funds.
Newly created time-limited
ARP program
o ERA - Emergency Rental
Assistance (Both ERA1 and
ERA2)

ARP added funding to pre-existing
program
o LIHEAP – Low Income Home Energy
Assistance Program

o EHV - Emergency Housing
Vouchers

o Housing Assistance and Supportive
Services Programs for Native
Americans and Native Hawaiians
o Emergency Assistance for Rural
Housing

o HAF - Homeowners
Assistance Fund
o SLFRF – Coronavirus State
and Local Fiscal Recovery
Funds
o LIWAP – Low Income Home
Water Assistance Program

Others
Others
(please
specify)
____________
[text box]
o

NONE
o CoC did not
participate in any
way in any ARP
programs

o HOME-ARP - HOME American
Rescue Plan
o SAMHSA - CCBHS - Substance
Abuse Prevention and Treatment
Block Grant, Expansion of the
Certified Community Behavioral
Health Clinics
o ESSER Elementary and Secondary
School Emergency Relief –
Homeless Children and Youth (ARPHCY)
o CACFP - Child and Adult Care Food
Program

[If the respondent selects the option under “None” under Q3 then exit the survey and display “Thank you
for participating in the survey. If you think someone else in your CoC may know whether your CoC
participated in any of the ARP programs, you can forward this link to them to complete the survey on behalf of your CoC]

APPENDIX E: Survey Consent and Instrument
[Questions below asked only to CoCs who indicate they were involved in one or more of the above ARP
programs]
4. Considering your overall participation in all the ARP programs you were involved in, rate the extent
of your CoC’s involvement (e.g., design, service delivery, referrals) in your locality’s ARP-funded
initiatives [rank from 1 - minimal involvement to 5 – fully involved in design and implementation].

5. For the ARP programs your CoC was involved in, did the CoC receive funds through the program
(either directly as grantee or as a subgrantee)?

5A. [If respondent checks ‘yes’ for one or more programs under Q5] Select the programs for
which your CoC was a direct grantee.

6. For the ARP programs your CoC was involved in, did the CoC play a role in local program design
decisions (e.g., participant eligibility, prioritization, funding allocations)?

7. For the ARP programs your CoC was involved in, did the CoC deliver services to people experiencing
or at-risk of homelessness (either through ARP or non-ARP resources)?

7A. [If respondent reports they delivered services under more programs than they received
funding for i.e., ‘yes’ responses for Q7>Q5] Please confirm that your CoC provided services
related to the following ARP programs using non-ARP resources.

o
o

Yes
No, please explain_____________________ [text box]

Answer the following questions based on your overall experience from participating in different ARP
programs.
8. [If respondent checks ‘yes’ for one or more programs under Q6] What types of input did your CoC
provide related to decisions on how the local ARP programs you were involved with were designed?
Select all that apply.
o
o
o
o
o

Determining how to use funds
Deciding who should receive highest priority to receive program support
Developing method to prioritize applicants
Deciding how to change/streamline application process
Providing informal guidance / support to a non-CoC entity that planned and
implemented the program
5

APPENDIX E: Survey Consent and Instrument
Involving CoC lived expert advisory board on program design decisions
Providing guidance materials developed by the CoC on strategies to address
homelessness
Other, please specify: _____________________ [text box; add another option]

o
o
o

9. [If respondent checks ‘yes’ for one or more programs under Q7] What types of services did your CoC
provide to your clients as part of ARP program implementation? Select all that apply.
a)
b)
c)
d)
e)
f)

Case management support
Landlord or other service provider communication and negotiations
Moving assistance
Financial and legal counselling services
Assist in program application enrollment and processing
Redirect potential applicants to other ARP program administrating agencies
Other, please specify: _____________________ [text box; add another option]

9A. [If respondent selects option (e under Q9] What types of activities did your CoC participate
in to assist local ARP program application enrollment and processing? Select all that apply.
Using existing coordinated entry system (CES)
Using Homeless Management Information System (HMIS) to identify potential
applicants
Information dissemination to eligible applicants
Enrolling program participants
Training other agency staff in administering programs geared toward people
experiencing homelessness
Other, please specify: _____________________ [text box; add another option]

o
o
o
o
o

9A.i. [If the respondent selects first option under Q9A] How did you use your coordinated
entry system to support ARP implementation? Select all that apply.
o
o
o

Applied existing coordinated entry system (CES) for assessment
Applied existing coordinated entry system (CES) to prioritize applicants
Applied existing coordinated entry system (CES) to provide referrals

10. [If respondent selects one or more programs under Q5] How long did it take for your CoC to start
deploying ARP funds?
o
o
o
o
o
o

Within 2 months of receiving ARP funds
Within 2 - 6 months of receiving ARP funds
Within 6 months - 1 year of receiving ARP funds
Within 1 - 2 years of receiving ARP funds
More than 2 years after receiving ARP funds
Don’t know

APPENDIX E: Survey Consent and Instrument
11. We are interested in the services provided through ARP funding in your locality, either to create new
initiatives or to supplement existing initiatives to improve service capacity. For each service below,
check the box(es) that apply. If your locality does not provide the service through ARP, check the
option under the third column.
[table with check boxes with the following options]
New service
funded through
ARP resources
Homeless prevention services
Rental cash assistance

Supplemental
service provided
through ARP
funding

◻

Housing vouchers
Utility payments (water, sewer, internet, etc.)

◻

Services for people experiencing unsheltered
homelessness (e.g., street outreach,
encampment cleanings, housing navigation)
Decommissioning of homeless encampments

◻

Other: _____________________

◻

Permanent supportive housing

◻

Rapid re-housing

◻

Emergency shelter and other temporary
housing
Non congregate shelters (e.g., motels and
hotels)

Service not
provided
through ARP
funding

◻

For the following questions, please select your level of agreement with each statement that best reflects
your CoC’s experience planning and implementing ARP Housing programs.

12. Our CoC used different ARP and non-ARP programs in ways that helped optimize our community’s
homeless response system during the COVID pandemic
Agree

Somewhat
Agree

Somewhat
Disagree

Disagree

Unsure

APPENDIX E: Survey Consent and Instrument
13. Our CoC leveraged pre-existing infrastructure and collaborations to deepen the effectiveness and
reach of ARP funding.
Agree

Somewhat
Agree

Somewhat
Disagree

Disagree

Unsure

14. Our CoC developed innovative approaches (e.g., program outreach, application, and eligibility
determination) to increase ARP program enrollment.
Agree

Somewhat
Agree

Somewhat
Disagree

Disagree

Unsure

[If the respondent selects “Agree” or “Somewhat Agree” under Q14 move to Q14A, else move
to Q15]

14A. [If the respondent selects “Agree” or “Somewhat Agree” under Q14] Which of the
following practices did the CoC and your partners use to increase ARP program enrollment?
Please check all that apply from the list below. (estimated time: 1-2 minutes)
[check boxes with the following options]
o
o
o
o
o
o
o
o
o
o
o
o

Built a separate website/added a section to your website
Texted or called potentially eligible applicants
Shared information material with community partners
Mobile-based application forms
Established or expanded a call center for people experiencing homelessness
Auto-enrollment (e.g., no need to apply if met certain criteria)
Common application for multiple programs
Common application for neighboring local jurisdictions
Self-certification
Categorical eligibility (e.g., eligible if already eligible for another program)
Document waivers
Removing entry barriers to those with a history of drug use, mental health
needs, justice involvement, or other

Other, please specify _______________ [text box]

APPENDIX E: Survey Consent and Instrument
14B. [If the respondent selects more than 3 under Q14A] Of the practices you listed that the
CoC and its partners used in , which three do you think were most effective in
increasing ARP program enrollment?

14C. Of the practices you listed that the CoC and its partners used in , which
ones will you continue moving forward after ARP?

15. My CoC used ARP funds to expand services to specific subpopulations that were not served or were
underserved before the pandemic
Agree

Somewhat
Agree

Somewhat
Disagree

Disagree

Unsure

[If the respondent selects “Agree” or “Somewhat Agree” under Q15– go to 15A, else go to 16]
15A. [If the respondent selects “Agree” or “Somewhat Agree” under Q15, else to 16] Which
subpopulations were expected to be better served by expanded services funded by ARP?
Please check all that apply from the list below.
[check boxes with the following options]
o People exiting prison or jails
o Survivors of domestic violence, dating violence, sexual assault, stalking, or human
trafficking
o Older adults
o Veterans
o Unaccompanied youth
o Families with children
o Members of racial or ethnic groups with high rates of homelessness
o People with disabilities
o People experiencing unsheltered homelessness
o People experiencing sheltered homelessness
o People who were not experiencing homelessness but were housing insecure
o People with low-moderate income
o Other: _____________________ [text box]

APPENDIX E: Survey Consent and Instrument
15B. [If the respondent selects “Agree” or “Somewhat Agree” under Q15] Did you employ
any of the following engagement approaches to increase participation of underserved
subpopulations in ARP programs? Please check all that apply from the list below.
[check boxes with the following options]
o Collaborated with community-based organizations who have worked closely
with underserved populations
o Facilitated peer support or peer advocates
o Targeted engagement to communities/groups known to be underserved by
current programs
o Targeted engagement in neighborhoods expected to have greater share of
population who need support
o Translation of materials into multiple languages
o Provided trainings for service provider staff to provide culturally responsive
services
o Other (please specify) ___________________ [text box]
16. What challenges did your CoC experience in implementing ARP programs? Please check all that
apply from the list below.
[check boxes with the following options]
o Lack of CoC staff capacity
o Lack of service provider staff capacity
o Not enough time to carefully plan and engage with community due to spending
timeframes
o Lack of sufficient information to support quick decision-making (data that can
help identify and prioritize individuals who need assistance)
o Disparate service delivery mechanisms and lack of coordination
o Local funding priorities that competed with funding homeless services
o Multiple local governments with differing visions
o Other, please specify _______________ [text box]

APPENDIX E: Survey Consent and Instrument
17. Select the option that best describes your CoCs partnerships with other organizations/agencies in
implementing ARP programs.
o
o
o
o

Our CoC created new partnerships
Our CoC strengthened existing partnerships
Our CoC created new partnerships and strengthened existing partnerships
Our CoC neither created new partnerships nor strengthened existing partnerships

17A. Please check the box for each of the types of agencies with which your CoC partnered
with in implementing ARP programs.

o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o

[check boxes with the following options]
Community-based organizations that serve particular racial/ethnic communities
Community-based organizations that provide housing support to low-income individuals
and families
Social service providers (such as health, behavioral health, substance use)
Community-based organizations that serve LGBTQIA+ community
Youth-serving organizations
Tenant and other housing related advocacy organizations
Community Action Agency
Public Housing Agency (PHA)
Local Government Agency
Tribal Government Agency
State Government Agency
State Housing Finance Agency
Schools, school districts
Banks and credit unions
Housing developers
Local businesses
Utility service providers
Other, please specify _____________________________ [text box]

18. Can you tell us about the most important changes in services and rules allowed by ARP that should
be retained?

Thank you for completing the survey. You can forward this link
to others in your CoC who can help you complete the survey

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix F. Key Informant Interview Outreach
Email to State Leaders
Initial outreach email
Dear [NAME],
My name is [NAME] and I am a [researcher] with the American Institutes for Research (AIR). We
are conducting a study focused on strategies that states have used to coordinate
implementation of multiple programs funded by the American Rescue Plan (ARP). The study
focuses specifically on coordination of ARP-funded programs designed to equitably serve
children and their families. This evaluation is led by AIR, a not-for-profit research organization.
The study is overseen in partnership by the Office of Management and Budget (OMB) and the
U.S. General Services Administration (GSA) (National Evaluation of the American Data Rescue
Plan Generic Clearance (OMB #: 3090-0332, expires 05/31/2027).
What to Expect
We would like to schedule a voluntary interview with you to understand your experience and
unique perspective on your [state or agency’s] approach to coordinating ARP-funded programs
for children in families with low incomes. The interview will last about 45 minutes and will take
place via Zoom, using phone or computer (your preference). We would like to schedule the
interview in the coming weeks. Please use this link to answer a few introductory questions and
view available times.
Consent and Conﬁdentiality
All participants will be given suﬃcient information about the study prior to the discussion and
before agreeing to participate. This includes information on the study purpose, conﬁdentiality,
and risks and beneﬁts. Participation is voluntary and you can decide not to participate or
discontinue participation at any time. If you choose to participate, everything that you say
during the conversation will be kept anonymous.
If you have any questions about this study, please contact the Deputy Project Director, Allyson
Pakstis, at apakstis@air.org, or the GSA team at arp.national.evaluation@gsa.gov. If you have
concerns or questions about your rights as a participant, contact the Chair of AIR’s Institutional
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the outreach email is an estimated 0.07 hours per response, including
the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Oﬃcer.

Review Board at IRBChair@air.org, by phone toll-free at 1-800-634-0797 or c/o AIR, 1400
Crystal Drive, 10th ﬂoor, Arlington, VA 22202-3289.
We look forward to hearing from you soon.
Sincerely,
NAME OF INTERVIEWER

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix G. Key Informant Interview Instrument
This appendix includes the state leader interview protocol for the landscape review phase of
the study. We will develop the protocols for the case studies in conjunction with the national
review data collection and they will be part of a second Paperwork Reduction Act submission.
State Leader Interview Protocol
As part of the landscape review, we will conduct key informant interviews with state ARP
administrators and other state leaders. Each interview will be tailored to ﬁt the speciﬁc role and
expertise of key informants. To do this, we have structured the interview questions in a table
that shows the main (stem) question with several potential probes that interviewers may draw
from based on answers provided during the discussion. Some key informants may not have
knowledge of, or exposure to, every area that is covered in the interview. In those cases, we
will skip any questions that are not relevant for the key informant.
National Review State Leader Interview Protocol
Stem

Probes

Thanks for sharing more about yourself with me. In our discussion, I am going to be asking you
questions focused on coordination among ARP-funded programs to equitably serve children and
their families. Broadly speaking, we define “coordination” as when groups make changes or align
their activities, primarily for the benefit of their respective work. Note to interviewer: tailor questions
based on respondent's role, including whether they oversee a specific ARP program or have a broader
role. The stem questions below include references to “[ARP programs].” These indicate where the
interviewer should reference a specific ARP program(s), if respondent is the administrator of the
program(s), or the interviewer should reference ARP programs in general, if the respondent can
provide a cross-program or agency perspective.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the interview is an estimated 1.35 hours per response, including the
time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Oﬃcer.

Stem

Probes

1. We are interested in how you would characterize
the level of coordination among state agencies,
departments, or programs in relation to serving
children and their families through the American
Rescue Plan. I am going to read a list of
“coordination levels” – which level best captures
ARP planning and implementation to serve children
and their families in your state? This information
will only be used for context for our team.
(Adoption, Implementation)
Beginning with networking - which might involve
sharing information among groups, cooperation –
such as providing informal support among groups,
coordination – groups making changes or aligning
their activities, primarily for the benefit of their
respective work, to full collaboration – formal
partnerships in which groups work together
towards a shared goal.

•

[Based on response] Why did you select
that level? Can you provide an example
that reﬂects that coordination level?

2. Can you remember a time you coordinated [ARP
program] with other programs across state
agencies, departments, or programs? If so, could
you walk me through it? (Adoption,
Implementation)

•

Thank you for sharing this example.
What agencies were primarily involved
in this [ARP program] coordination
eﬀorts?

•

Did agencies set common goals as part
of this coordination eﬀort?

•

What were the intended outcomes of
this ARP coordination?

•

To what extent were the coordination
eﬀorts successful? How do you know?

•

What, if anything, was not successful
about the coordination eﬀorts?

•

Beyond this example, was there other
eﬀorts at the state to intentionally
coordinate implementation of [ARP
program] with other programs for
children in families with low incomes? If
so, can you describe the approaches
that your state used?

•

What was successful about these
eﬀorts? What was not?

Stem

Probes

3. [Adapt based on responses to previous questions].
To what extent do the coordination approaches
you’ve described represent a change from how the
state typically has approached coordination and
collaboration? (Adoption, Implementation)
4. To what extent does the state have an established
cross-agency coordinating body, such as a
Children’s Cabinet or other similar group, that
supports state-level coordination of policies and
programs for children or families? (Adoption,
Implementation)

If yes…
•

What is the name of this group?

•

Was [name] in place prior to ARP?

•

What was the role of [name] in relation
to the planning and implementation of
[ARP program]? What beneﬁt, if any,
did [name] play with regards to ARP?

5. Did state agencies establish formal agreements to
work together on coordination of [ARP program]
with other programs? If so, what was the focus of
these agreements? (Adoption, Implementation)

•

What were the outcomes of these
agreements, if any? What beneﬁts, if
any, did formal agreements have in
regard to ARP?

6. Did state agencies establish shared operations to
implement [the ARP-funded program] with other
programs? For example, establish a joint office to
roll out and monitor the use of funds? If so, please
describe. (Adoption, Implementation)

•

What beneﬁt, if any, did shared
operations have in regard to ARP
implementation?

7. Did your state facilitate any vehicle for agencies to
learn from one another, as ARP was implemented?
If so, please describe. (Adoption, Implementation)

•

What beneﬁt, if any, did shared
learning have in regard to ARP
implementation?

•

When your state received ARP funding,
did it identify speciﬁc priority
populations for [ARP program]? If so,
what were they?

•

To what extent, if at all, did the [plan
you described] inﬂuence how your state
identiﬁed priorities for intended
beneﬁciaries for [ARP program]?

•

Did your state use any other process to
prioritize certain populations for [ARP
program], other than what you’ve
talked about? If so, please describe
them.

8. Did state agencies coordinate communication to
families about ARP-supported services? If so, what
did this look like? (Adoption, Implementation)
9. Prior to the ARP, did your state have any publicly
stated goals for [ARP program] that identified
priority populations for the program? For example,
this could include a strategic plan or other public
document that had a goal of prioritizing services for
families who are unhoused or for children without
health insurance. If so, can you describe the plan
and these priorities? (Adoption, Implementation)
Note to interviewer – use example most relevant to
the ARP of focus.

Stem

Probes

10. To what extent, and how, did your state engage
family members with low incomes in ARP planning,
if at all? (Adoption, Implementation)

•

What family engagement strategies
were used? (Probe for surveys, town
halls, parent advisory groups, other)

12. What was challenging about coordination of [ARP
program] with other programs, if anything? What
were the key “pain points”? (Adoption,
Implementation)

•

How did your state address these
challenges, if at all?

13. Did your state coordinate [ARP program] with local
communities? If so, how? (Adoption,
Implementation)

•

What strategies worked well? What
was challenging?

•

What was the outcome of coordination
with localities?

•

What strategies worked well? What
was challenging?

11. What worked well about coordination of [the ARP
program] with other programs, if anything?
(Adoption, Implementation)

14. Did your state coordinate with tribal nations such
as [names of tribes within state] in relation to [ARP
program]? If so, how? (Adoption, Implementation)
15. Is there anything else you’d like to share about
your state’s coordination of ARP funds?
16. Are there any documents that would be useful for
our study team to review, to better understand
your state’s approaches to ARP coordination?

OMB Control #: 3090-0332
Expiration Date: 05/31/2027

Appendix H. State Leader Interview Consent
Introduction
Thank you for participating in our conversation about your experience with the American
Rescue Plan - ARP. My name is ___________, and my colleague(s) ________ and I work for an
organization called American Institutes for Research (AIR). We are conducting a study to learn
about the strategies that states have used to coordinate implementation of multiple ARPfunded programs designed to equitably improve outcomes for children in families with low
incomes. We are not evaluating you or your agency, nor are we conducting a compliance
review; rather, we are seeking to understand your experiences related to the ways in which
your state coordinated ARP-funded programs to support families with low incomes.
[FOR ZOOM MEETINGS:] Before we get started, are you familiar with navigating Zoom? [If yes,
skip to next paragraph, if no, provide the following explanation:]
The mute and video button are at the bottom left side of the Zoom toolbar. We would like
everyone to turn their videos on during the meeting if you can and feel comfortable doing so.
Are there any questions about Zoom?
I’d like to go over some disclosures and information about informed consent before we
proceed.
CONFIDENTIALITY: First, I would like to assure you that everything that you say during this
conversation will be kept anonymous. Your name and the names of any individuals that you
mention will not appear on any report or other publications, and the recording of today’s
conversation, along with any notes, will be stored on a secure server that is only accessible to
members of our research team. The reports we produce will summarize the information
gathered and will never be associated with an identiﬁable individual. We will destroy the
interview recording from this study 5 years after the study ends.
PARTICIPANT RIGHTS: Taking part in this study is voluntary. If you choose not to participate,
there will be no repercussions to you or your position at your agency.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 3090-0332. This information collection, proposed by the
General Services Administration, is for three evaluation studies under the American Rescue Plan National Evaluation, which aims to provide a
systematic look at the contributions of selected ARP-funded programs toward achieving equitable outcomes to inform program design and
delivery across the Federal Government. The time required to complete the consent is an estimated 0.08 hours per response, including the time
to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and respondents will be informed of all planned uses of the data and that their information will be kept
private to the extent permitted by law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: arp.national.evaluation@gsa.gov, Attention: Information Collections Clearance Oﬃcer.

RISKS AND BENEFITS: This study involves minimal risk to participant privacy, breaches to data
conﬁdentiality, and exposure to discomfort or emotional stress. The beneﬁt of this study is that
ﬁndings will expand the knowledge base about the landscape of state-level coordination
strategies. This information may be used by policymakers to improve coordination for other
programs or policies.
VERBAL CONSENT: There are no right or wrong answers to the questions we will ask today, so
feel free to share your thoughts. You may choose not to answer every question, and we can
stop the discussion at any time. Your participation in this interview is voluntary and you do not
have to answer any questions you don’t want to. Do you consent to participate in this study?
Our discussion will take approximately 45 minutes. We would like to record the session for
note-taking accuracy. However, we will not record if there are any concerns about the
recording, and instead will take notes. Do you have any objection to being recorded? Do you
have any other questions about the study or your participation before we begin?
Wonderful, we are going to begin the recording and start the discussion.
Start recording if there were no objections.

Attachments:
• Notification of Exemption for B&P# 8D091.pdf

Institutional Review Board
IRB00000436 / FWA00003952

AIR IRB
To:
From:
Subject:
Date:

Exemption Notification
Wrandi Carter
IRB Administrator
B&P# 8D091
06/07/2024

B&P# 8D091 -American Rescue Plan Evaluation - Behavioral Health Study has been verified by Tom
Workman as Exempt on 06/07/2024.
On the basis of this review, the IRB has determined that the collection of key informant interviews, including those
of patient and/or family advocates, as described in the materials submitted, is exempt on the grounds that the
research is with adults and involves only the use of tests, surveys, interviews, or public observation as defined in
45 CFR §46.104 (d) (2). The participants’ responses, if inadvertently disclosed, would not place them at risk of
criminal or civil liability, nor would their financial standing, employability, educational advancement, or reputation be
damaged. Therefore, this data collection is not subject to IRB oversight. Data collection may proceed.
Please note that changes to your protocol may affect its exempt status. Please contact the IRB directly to discuss
any changes you may contemplate.

Thank you,
Erin Morrison
IRB Administrator
emorrison@air.org
Please be reminded that all projects must undergo IRB review before initiating any recruitment or data
collection/analyses. Material changes to project activities also must undergo review via the Amendments tab.

Attachments:
• Notification of Exemption for B&P# 8D091.pdf

Institutional Review Board
IRB00000436 / FWA00003952

AIR IRB
To:
From:
Subject:
Date:

Exemption Notification
Leah Brown
IRB Administrator
B&P# 8D091
07/22/2024

B&P# 8D091 -ARP Evaluation - Homelessness Survey has been verified by Tom Workman as Exempt on
07/22/2024.
On the basis of this review, the IRB has determined that the survey of personnel in organizations serving the
homeless, as described in the materials submitted, is exempt on the grounds that the research is with adults and
involves only the use of tests, surveys, interviews, or public observation as defined in 45 CFR §46.104 (d) (2). The
participants’ responses, if inadvertently disclosed, would not place them at risk of criminal or civil liability, nor would
their financial standing, employability, educational advancement, or reputation be damaged. Therefore, this data
collection is not subject to IRB oversight. Data collection may proceed.
Please note that changes to your protocol may affect its exempt status. Please contact the IRB directly to discuss
any changes you may contemplate.

Attachments:
• Notification of Exemption for B&P# 8D091.pdf

Institutional Review Board
IRB00000436 / FWA00003952

AIR IRB
To:
From:
Subject:
Date:

Exemption Notification
Leah Brown
IRB Administrator
B&P# 8D091
07/19/2024

B&P# 8D091 -American Rescue Plan Evaluation - Coordination KIIs has been verified by Tom Workman as
Exempt on 07/19/2024.
On the basis of this review, the IRB has determined that the secondary data analysis and interviews with program
staff to evaluate the implementation of multiple American Rescue Plan-funded programs, as described in the
materials submitted, is exempt on the grounds that the research is with adults and involves only the use of tests,
surveys, interviews, or public observation as defined in 45 CFR §46.104 (d) (2). The study does not collect any
identifiable sensitive information, and the participants’ responses, if inadvertently disclosed, would not place them
at risk of criminal or civil liability, nor would their financial standing, employability, educational advancement, or
reputation be damaged; Therefore, this data collection is not subject to IRB oversight. Data collection may
proceed.
Please note that changes to your protocol may affect its exempt status. Please contact the IRB directly to discuss
any changes you may contemplate.

File Type	application/pdf
Subject	Recruitment outreach, consent forms
Author	American Institutes for Research (AIR)
File Modified	2024-08-30
File Created	2024-08-30