Instrument sheet · holistic review
Colorado Family Support Assessment 2.0 — Part A
All 14 domains in form order, with their definitions and every scoring anchor from 5
down to 1. Every domain uses the same 5-point ordinal scale, scored 5 (strongest) down to 1 (most acute), with a Prevention Line drawn between 3 and 2. Scores of 1 and 2 fall below the Prevention Line.
Anchors are written as behavioral criteria rather than questions. This is an interview-administered rubric: the advocate assigns the score, the family does not self-select an option.
Economic Self-Sufficiency
8 domains 01 Income
Assesses family income adequacy using Federal Poverty Level (FPL) guidelines.
Definition: - Income does not include noncash such as CCAP, Medicaid, and SNAP, but it does include TANF, SSI, or other cash benefits.
5 Family income is greater than 300% of poverty adjusted for family size.
4 Family income is between 251%–300% of poverty adjusted for family size.
3 Family income is between 201%–250% of poverty adjusted for family size.
Prevention Line
2 Family income is between 101%–200% adjusted for family size.
1 Family income is between 0–100% of poverty adjusted for family size.
N/I Not enough information at this time
Implementation note. These are 2021 figures. Any digital version should compute the FPL percentage from current-year guidelines rather than hard-coding this table.
02 Employment
Assesses the status and stability of employment.
Definitions: - Adult = individuals responsible for children in the family.
- Employable = 1) does not have a disability (not receiving SSI/SSD), 2) is over the age of 16, 3) is not retired, and/or 4) desires or needs employment.
- Stable employment = in a permanent (regular/dependable) position for 3 months or longer.
- Benefits = earned vacation/sick/holiday pay; retirement plans; and/or health insurance.
- Full-time = at least 30 hours per week.
5 At least one adult has full-time stable employment AND access to employer-based benefits
4 At least one adult has full-time stable employment
3 At least one adult in the family is employed full-time AND no adult has stable employment
Prevention Line
2 At least one adult in the family has temporary or part-time employment AND no adult has full-time employment
1 All employable adults in the family are not employed
N/I Not enough information at this time
N/A All adults are not employable
03 Housing
Assesses the ability of the family to obtain appropriate housing of choice based on their circumstances.
Definitions: - Housing-cost burden = monthly rent/mortgage ÷ monthly before-tax income (e.g. $1,000 rent ÷ $2,000 monthly gross pay = 50% of income).
- Substandard = any home that is not safe and adequate (i.e., dry, clean, pest-free, contaminant-free, well ventilated, and well maintained).
5 Without subsidies, owning or renting without cost burden (monthly mortgage/rent below 30% monthly pretax income) AND living in a neighborhood of choice
4 Without subsidies, owning or renting without cost burden (monthly mortgage/rent below 30% monthly pretax income)
3 Any of the following: living in steady subsidized or transitional housing that is safe and adequate; monthly rent/mortgage is 30–49.9% of monthly pretax income (moderate cost burden)
Prevention Line
2 Any of the following: living in substandard housing; receiving short-term rental assistance; facing threatened eviction or foreclosure; monthly rent/mortgage is 50% or more of monthly pretax income (severe cost burden)
1 Any of the following: homeless; "couch surfing"; living in a shelter; doubling up with others (do not include voluntary roommate situations); eviction notice; forced displacement (fire; flood; discharge from institution with no housing)
N/I Not enough information at this time
04 Transportation
Assesses the degree to which family transportation needs are met.
5 All family members always have transportation needs met through public transportation, a car, or a regular ride (100% of the time)
4 All family members have transportation needs met at least most of the time through public transportation, a car, or a regular ride (about 3 out of 4 times / 75–99% of the time)
3 All family members can find a way to meet basic transportation needs some of the time through public transportation, a car, or a regular ride (about 2 out of 4 times / 50–74% of the time)
Prevention Line
2 At least one family member's transportation needs are inconsistently met through public transportation, a car, or a regular ride (about 1 out of 4 times / 25–49% of the time)
1 Any family member rarely has transportation needs met through public transportation, a car, or a regular ride (less than 25% of the time)
N/I Not enough information at this time
05 Food Security
Assesses a family's level of food security based on USDA definitions.
Definitions and scoring rules: - USDA: food insecurity is limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.
- Families receiving public assistance for food will score 1 or 2 when they meet the conditions of very low or low food security, respectively.
- Families receiving public assistance for food should not score higher than a 3.
- Public assistance for food = food bank access within past month, or enrolled in SNAP, WIC, food stamps, and/or free/reduced school lunch.
5 High food security: family members have no problems, or anxiety about, accessing enough quality food with variety
4 Marginal food security without reliance on public assistance for food: family members have anxiety about accessing food, but the quantity, quality, and variety of their food intake are not reduced AND family does not rely on public assistance for food
3 Reliance on public assistance for food: the quantity, quality, and variety of food intake are not reduced AND the family relies on public assistance for food
Prevention Line
2 Low food security (disruption in quality and variety of food intake): family has enough food AND any of the following — they rely on a few types of low-cost foods; they can't afford to eat balanced meals
1 Very low food security (disruption in quantity of food intake): food intake reduced for one or more family members because the household lacks money or other resources for food
N/I Not enough information at this time
08 Adult Education
Assesses adult(s) academic, institution-based achievements.
Definitions: - Adult = individual(s) responsible for children in the family; include emancipated minors.
- Teen parents: if living with adult caregivers, consider the teen parent's education in the Child Education domain; if living as a stand-alone family unit, consider it here.
5 All adults in the family have a high school diploma or GED and have obtained any of the following: a professional certification or training; an Associate's degree; a Bachelor's degree or higher
4 At least one adult in the family has a high school diploma or GED and has obtained any of the following: a professional certification or training; an Associate's degree; a Bachelor's degree or higher
3 At least one adult in the family has a high school diploma or GED and is enrolled in post-secondary education or specialized training (professional certificate program, Associate's, Bachelor's)
Prevention Line
2 At least one adult in the family has a high school diploma or GED and is not pursuing further education
1 No adult in the family has a GED or high school diploma
N/I Not enough information at this time
09 Cash Savings
Assesses the degree to which a family is building liquid assets via cash savings.
Definition: - Cash savings refer to assets that are or can be quickly converted to cash without penalty. Examples include cash, checking, savings, money market, government-issued bonds.
5 Three months or more of monthly income saved
4 One to three months of monthly income saved
3 Some but less than one month of monthly income of cash savings
Prevention Line
2 No cash savings and has plan or has just begun to implement cash savings
1 No cash savings and no desire/ability to set savings goals
N/I Not enough information at this time
11 Health Coverage
Assesses the degree to which family members have adequate medical health insurance.
Definition: - Underinsured = unable to pay out-of-pocket medical expenses (family does not seek care because of out-of-pocket payments; family unable to pay current medical expenses).
5 All family members have basic primary health insurance (other than Medicaid, CHP+, or CCIP) AND all family members have dental insurance
4 All family members have basic primary health insurance (other than Medicaid, CHP+, or CCIP)
3 All family members have basic primary health insurance AND at least one family member receives coverage through Medicaid, CHP+, or CCIP
Prevention Line
2 Any of the following: some family members are uninsured; family is underinsured
1 All family members are uninsured
N/I Not enough information at this time
Local note. CHP+ and CCIP are Colorado programs. Virginia equivalents: FAMIS and Cardinal Care.
Health
2 domains 12 Physical Health
Assesses degree to which **any** family member's physical health concerns interfere with life activities.
Definitions: - Important life activities include work, school, caring for children, managing a household (shopping, preparing meals, cleaning, etc.), or reaching developmental milestones for young children.
- Consider the impact of a family member's physical health concerns on other family members as well as themselves.
5 Family member(s) have no known ongoing physical health problems
4 Physical health concerns typically do not interfere with important life activities — in past month, health concerns taken care of without work/school absences
3 Physical health concerns only occasionally interfere with important life activities. Any of the following: missed work/school 1 time last month due to illness/treatments; was late to work/school/scheduled appts, but not more than 1 time in the past month due to illness/treatments
Prevention Line
2 Physical health concerns considerably interfere with important life activities. Any of the following: missed work/school 2 or more times in past month due to illness/treatments; late to work/school/scheduled appts 2 or more times in past month due to illness/treatments; work opportunities limited due to health concerns; physical health concerns create considerable stress and/or disrupt family functioning
1 Family member(s) physical health concerns prohibit important life activities
N/I Not enough information at this time
13 Mental Health
Assesses degree to which **any** family member's mental health issues interfere with life activities.
Definitions: - Important life activities include work, school, caring for children, managing a household (shopping, preparing meals, cleaning, etc.), or reaching developmental milestones for young children.
- Consider the impact of family members' mental health issues on other family members as well as themselves.
- Mental health issues can include symptoms of illnesses (e.g., anxiety, depression) without diagnosis.
5 Family member(s) have no known ongoing mental health problems
4 Mental health concerns typically do not interfere with important life activities — in past month, mental health concerns taken care of without work/school absences
3 Mental health concerns only occasionally interfere with important life activities. Any of the following: missed work/school 1 time last month due to illness/treatments; was late to work/school/scheduled appts, but not more than 1 time in the past month due to illness/treatments
Prevention Line
2 Mental health concerns considerably interfere with important life activities. Any of the following: missed work/school 2 or more times in past month due to illness/treatments; late to work/school/scheduled appts 2 or more times in past month due to illness/treatments; work opportunities limited due to health concerns; mental health concerns create considerable stress and/or disrupt family functioning
1 Family member(s) mental health concerns prohibit important life activities
N/I Not enough information at this time
Standalone
4 domains 06 Child Care
Assesses the family's ability to obtain reliable, affordable, and quality childcare.
Definitions: - Unreliable = provider can't be counted on for pre-arranged care or inconvenient hours.
- Quality = low provider/child ratios; developmentally appropriate toys; safe inside and outside play and sleep areas; adequate supervision; little or no TV time; healthy food; caring and trained staff.
- Low quality = parent has concern about quality (e.g., high provider/child ratios; concerned that provider is unable to meet child's needs).
- Unaffordable = other basic needs are sacrificed to pay for child care.
- Subsidies = Colorado Child Care Assistance Program (CCAP) or other public assistance programs that cover child care expenses.
- For school-aged children under 12, consider out-of-school child care needs (e.g., summer, before/after school).
5 All of the following: child care is reliable; affordable without subsidies; quality; reliable back-up child care options are available when needed
4 All of the following: child care is reliable; affordable without subsidies; quality
3 All of the following: child care is reliable; affordable with subsidies; quality
Prevention Line
2 Any of the following (with or without CCAP or public assistance programs): child care is unreliable; child care is low quality; child care is unaffordable
1 Any of the following: needs child care, but none is available/accessible; child is unsupervised and may be unsafe
N/I Not enough information at this time
N/A No children under 12, children are in someone else's care (e.g. foster care), or family is able to adequately care for children and does not need child care
Local note. The CCAP reference is Colorado-specific. Virginia's equivalent is the Child Care Subsidy Program, administered locally through DSS.
07 Child Education
Assesses school-aged children's access to and engagement in educational institutions.
Definitions: - Home-schooled children are enrolled in school if state homeschool requirements are met.
- Consider teenagers, even if parents, as children unless they are emancipated minors or living as a stand-alone family unit.
- School-aged = grades 1–12.
- Truancy = 4 unexcused absences from public school in the past month.
5 No child in the family has truancy/disciplinary actions at school AND all children are meeting academic achievement expectations AND any child is exceeding academic achievement expectations
4 No child in the family has truancy/disciplinary actions at school AND all children are meeting academic achievement expectations
3 No child in the family has truancy/disciplinary actions at school AND any child in the family is not meeting academic achievement expectations and is receiving academic support services
Prevention Line
2 Any child in the family is experiencing any of the following: truancy or disciplinary actions at school; not meeting academic achievement expectations and is not receiving academic support services
1 Any child in the family is not enrolled in school
N/I Not enough information at this time
N/A All children are not school-aged or have earned GED
10 Debt Management
Assesses the degree to which a family is managing debt.
Definition: - Debt-free = free from owing any money (i.e. mortgage, student/car/personal loans) to any individual or a company, including overdue rent/utilities, credit card balances, etc.
5 Family is debt-free
4 Income pays towards debt and debt reducing (pays more than minimum monthly payments and is not adding to debt)
3 Income pays towards debt and debt stabilized (pays minimum monthly payments and is not adding to debt)
Prevention Line
2 Income pays towards debt but debt increasing (pays minimum monthly payments and is adding to debt)
1 Inability or limited ability to pay down debt (may be making payments but cannot meet minimum required payments)
N/I Not enough information at this time
14 Substance Abuse
Assesses degree to which **any** family member's substance abuse interferes with important life activities.
Definitions: - Important life activities include work, school, caring for children, managing a household (shopping, preparing meals, cleaning, etc.).
- Consider the impact of family members' substance use on other family members as well as themselves.
5 Any of the following: abstains from substances; may use prescription drugs as prescribed or alcohol/marijuana (aged 21+) without negative consequences; continued sobriety for one year or longer
4 Continued sobriety for at least 6 months but less than one year
3 Any of the following: family member(s) occasionally experience negative consequences from substances, but does not interfere with life activities; continued sobriety for at least 3 months but less than 6 months
Prevention Line
2 Any of the following: misses or is late to work/school due to substance use; substance abuse creates considerable stress and/or disrupts family functioning; continued sobriety for less than 3 months; use of substances by underage youth during past month but does not prohibit important life activities or create an unsafe environment
1 Any of the following: abuse of substances by a family member prohibits important life activities; abuse of substances by a family member creates an unsafe environment
N/I Not enough information at this time
Implementation flag. This domain records substance use information. Where it is stored and who can access it needs to be settled against 42 CFR Part 2 before this is fielded in any new platform.