Youth Vulnerability Index (VI)

CHICAGO COORDINATED ENTRY SYSTEM – YOUTH VULNERABILITY INDEX

Youth Vulnerability Index

Introduction

Different housing programs in Chicago offer different types of supports. This screening will help determine which housing program will best fit your needs. I will ask questions about things like your health experiences, any children you may have, and any involvement in foster care. Some of the questions are personal in nature and may be difficult to answer. If you do not feel comfortable answering a question, please just ask me to skip it. The information you provide will be used to assess eligibility for housing programs and level of service intervention required.
If any of the questions are confusing or you don’t know how to answer, feel free to ask and I will be happy to clarify for you.
I know that we have only been talking for a short time and some answers you may not want to share with someone you just met. It’s up to you how honest you are in this survey, but the more truthful you are, the better we can match you to the right program and support you in finding stable housing. If you need a break at any point, please feel free to let me know.

PLEASE DO NOT PRINT THIS PAGE.  IF YOU NEED A PRINTED COPY, PLEASE PRINT THE ATTACHED PDF.

VI Questions

 Disability
1. This question asks about a disabling condition, which means any condition that limits your ability to work or perform daily activities. Some examples include a substance abuse disorder, serious mental illness, developmental disability, or chronic physical disabilities. Have you been diagnosed with a disabling condition?
Yes ___
No ___
Client doesn’t know ___
Client refused ___
Data not collected ___ 

Foster Care
2. Have you ever been in foster care? By foster care, I mean a foster home, group, home, or the home of a relative that you were placed in by court.
Yes ___
No ___
Client doesn’t know ___
Client refused ___
Data not collected ___

 

If yes, please answer 2a, 2b, and 2c. If any other response, please continue on to question 3.

 

2a. If yes, how old were you when you entered foster care? ________

2b. If yes, how old were you when you left foster care? ________

2c. Where did you go when you left?

Returned to parent’s home ________ Aged out/Emancipated ________

Adopted ________ Other ________

 

Pregnant

3. Have you ever been pregnant or gotten someone else pregnant?

Yes  ___

No  ___

Client doesn’t know    ___

Client refused   ___

Data not collected    ___

Healthcare

4. How many times have you been to the emergency room in the past three months? It’s okay to estimate if you aren’t exactly sure. ____

5. How many times have you been hospitalized as an inpatient in the past year? ____

6. If you have tried marijuana, how old were you when you first tried it? ____

Never tried it   ___

Client doesn’t know    ___

Client refused     ___

Data not collected   ___

Jail or Detention

7. Before your 18^th birthday, did you spend any time in jail or detention?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

Children

8. Do you have any children under age 18 who are currently not living with you?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

If yes, please answer 8a – 8e. If any other response, please continue on to question 9.

 

8a. If yes, where are these children staying?

-Foster care ____

-Group home____

-With family____

-With friends____

-Other (please specify): ______________________________________________

8b. If yes, are they living apart from you because you are homeless (i.e. you couldn’t bring them to the shelter)?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

Child Welfare

8c. Have you ever had an open case with the child welfare system for any of your children (including children who are living with you and those who are not)?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

8d. Are you currently receiving any services as a result of a child abuse/neglect investigation?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

8e. Have you ever had one of your children placed in foster or adoptive care?

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

Emotional Well Being

9. Are you currently or have you ever received treatment for mental health issues? This could mean that you saw a counselor, or participated in a mental health program. It could also mean that you were admitted to a hospital or treated by a doctor or other health professional.

Yes                              ___

No                               ___

Client doesn’t know    ___

Client refused             ___

Data not collected       ___

Observer Response (do not ask this question out loud)

9a. Skilled Assessor observed mental health issues:

Yes                              ___

No                               ___