NYTD COMPLIANCE STANDARDS

** DRAFT (Rev. 6/30/08) **


NYTD: Youth Outcome Survey Questionnaire

No. Survey Question Your Response
37 Currently are you employed full-time?
38 Currently are you employed part-time?
39 In the past year, did you complete an apprenticeship, internship, or other on-the-job training, either paid or unpaid?
40 Currently are you receiving social security payments (Supplemental Security Income (SSI, Social Security Disability Insurance (SSDI)
41 Currently are you using a scholarship, grant, stipend, student loan, voucher, or other type of educational financial aid to cover any educational expenses?
42 Currently are you receiving ongoing welfare payments from the government to support your basic needs?
43 Currently are you receiving public food assistance?
44 Currently are you receiving any sort of housing assistance from the government, such as living in public housing or receiving a housing voucher?
45 Currently are you receiving any periodic and/or significant financial resources or support from another source not previously indicated and excluding paid employment?
46 What is the highest educational degree or certification that you have received?
47 Currently are you enrolled in and attending high school, GED classes, post-high school vocational training, or college?
48 Currently is there at least one adult in your life, other than your caseworker, to whom you can go for advice or emotional support?
49 Have you ever been homeless? OR In the past two years, were you homeless at any time?
50 Have you ever referred yourself or has someone else referred you for an alcohol or drug abuse assessment or counseling? OR In the past two years, did you refer yourself, or had someone else referred you for an alcohol or drug abuse assessment or counseling?
51 Have you ever been confined in a jail, prison, correctional facility, or juvenile or community detention facility, in connection with allegedly committing a crime? OR In the past two years, were you confined in a jail, prison, correctional facility, or juvenile or community detention facility, in connection with allegedly committing a crime?
52 Have you ever given birth or fathered any children that were born? OR In the past two years, did you give birth to or father any children that were born?
53 If you responded yes to the previous question, were you married to the child’s other parent at the time each child was born?
54 Currently are you on Medicaid?
55 Currently do you have health insurance, other than Medicaid?
56 Does your health insurance include coverage for medical services?
57 Does your health insurance include coverage for mental health services?
58 Does your health insurance include coverage for prescription drugs?