Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Philadelphia 36-Month Follow Up Data Collection

Appendix A: HTE Philadelphia 36-Month Survey

HTE PHILADELPHIA 36-MONTH SURVEY

HumRRO, Draft

CATI: PLEASE HAVE PROGRAM AUTOMATICALLY RECORD THE START TIME AT THE BEGINNING OF EACH SECTION.

1X. INTERVIEWER: IS THIS A TRACKER-BASED INTERVIEW?

1 YES, TRACKER-BASED (GO TO TRACKER INTRODUCTION)

2 NO, RESPONDENT CALLED IN (GO TO CALL-IN INTRODUCTION)

3 NO, CALL INITIATED BY PHONE CENTER (GO TO MAIN INTRODUCTION)

2X. INTERVIEWER: ENTER THE TRACKER’S 4-DIGIT ID NUMBER ____ ____ ____ ____

TRACKER INTRODUCTION

Hello, my name is ______________________. Before we can begin I just have to make sure that I've pulled up the right questionnaire on the computer.

CATI: GO TO SCREENER

CALL-IN INTRODUCTION

As you know, we are doing a survey on behalf of the U.S. Department of Health and Human Services (HHS) about people’s job search, employment, and training experiences. HHS wants to find out what types of assistance work best to find people jobs and help them hold on to those jobs.

This interview should only take about 45 minutes of your time. Participation is completely voluntary. Your name will not be connected with any information you give me. What you say will not affect your ability to get benefits now or in the future and you may refuse to answer any question. In appreciation for your help, we will give you a gift of $___ for completing the interview. If you are ready, we can begin.

1 CONTINUE (GO TO SCREENER)

8 REFUSED – ENTER DISPOSITION CODE AND CALL NOTE DESCRIBING SITUATION IN THE CALL RECORD TEXT BOX

MAIN INTRODUCTION

Hello, this is ______________________. I’m calling for a U.S. Department of Health and Human Services study. May I please speak to (RESPONDENT)?

INTERVIEWER: IF NECESSARY, READ: “(RESPONDENT) has been selected to help with a study on employment and employment issues in Philadelphia.

1 RESPONDENT AVAILABLE – CONTINUE

2 RESPONDENT NOT AVAILABLE – ARRANGE CALLBACK AND ENTER CALL NOTE

8 REFUSED – ENTER DISPOSITION CODE AND CALL NOTE DESCRIBING SITUATION IN THE CALL RECORD TEXT BOX

Recently we sent you a letter saying we would be calling to talk to you about your job search and employment experiences. Did you receive that letter?

1 YES (DISPLAY SECOND TEXT CHOICE IN PARENTHESES BELOW)

2 NO (DISPLAY FIRST TEXT CHOICE IN PARENTHESES BELOW)

7 DON’T KNOW (DISPLAY FIRST TEXT CHOICE IN PARENTHESES BELOW)

8 REFUSED (DISPLAY FIRST TEXT CHOICE IN PARENTHESES BELOW)

(The letter explained that/Good! As we mentioned in the letter,) we are doing a survey on behalf of the U.S. Department of Health and Human Services (HHS). HHS wants to find out what types of assistance work best to find people jobs and help them hold on to those jobs.

This interview should only take about 45 minutes of your time. Participation is completely voluntary. Your name will not be connected with any information you give me. What you say will not affect your ability to get benefits now or in the future and you may refuse to answer any question. In appreciation for your help, we will give you a gift of $____ for completing the interview. If you are ready, we can begin.

1 CONTINUE

8 REFUSED – ENTER DISPOSITION CODE AND CALL NOTE DESCRIBING SITUATION IN THE CALL RECORD TEXT BOX

SCREENER

First I must make sure that I've pulled up the right questionnaire on the computer.

1a. When were you born?

INTERVIEWER: ENTER DATE USING FORMAT BELOW

___ ___/___ ___/ ___ ___ ___ ___ [RANGE MM = 1 – 12, 97, 98] [DD = 1 – 31, 97, 98]

M M D D Y Y Y Y [RANGE YYYY = 1920 – 1987, 9997, 9998]

CATI: COMPARE RESPONSE GIVEN IN 1A TO THE BIRTH DATE ON SAMPLE FILE. IF IT AGREES WITH THE BIRTH DATE ON THE FILE, BEGIN QUESTIONNAIRE. ELSE, CONTINUE.

2a. What are the last 4 digits of your Social Security Number? ___ ___ ___ ___ [RANGE 0001 – 9999]

CATI: COMPARE RESPONSE GIVEN IN 2A TO LAST FOUR DIGITS OF SSN ON SAMPLE FILE. IF THE 4 DIGITS GIVEN BY R AGREE WITH THE NUMBER ON THE FILE, BEGIN QUESTIONNAIRE. IF THEY DO NOT AGREE AFTER SECOND VALIDATION ATTEMPT, DISCONTINUE THE INTERVIEW.

CATI: IF INTERVIEW DISCONTINUED: I’m sorry. I was unable to pull up the correct questionnaire. I will need to check with my supervisor to look into the problem. I will recontact you when the problem is resolved. Thank you for your time.

CATI: IF TRACKER-BASED INTERVIEW DISCONTINUED (1X = 1): I’m sorry. I’m having a little problem pulling up the correct questionnaire. Would you please put our field staff person back on the phone for a minute?

CATI: IF INTERVIEW DISCONTINUED ALLOW INTERVIEWER TO ASSIGN A DISPOSITION CODE AND ENTER A CALL NOTE IN THE CALL RECORD TEXT BOX.

SECTION A: PARTICIPATION IN EMPLOYMENT AND EDUCATION ACTIVITIES

CATI: RECORD START TIME

CATI: INSERT RANDOM ASSIGNMENT DATE [RAD] FROM SAMPLE FILE WHEREVER [RAD] APPEARS.

CATI: INSERT DATE USING CURRENT MONTH AND LAST YEAR WHEREVER [THIS MONTH LAST YEAR] APPEARS.

During this interview I will be asking about the experiences you’ve had and services you may have received during the past 12 months. I will also ask you a few questions about experiences you’ve had and services you received since [RAD]. This is the date that this research study began. Let’s begin.

JOB SEARCH

A1a. During the past 12 months, that is, since [THIS MONTH LAST YEAR], have you participated in classes or group meetings that try to teach people how to look for a job or prepare a resume sometimes called “Job Club” or “Job Readiness Training?”

1 YES

2 NO (GO TO A1c)

7 DON’T KNOW (GO TO A1c)

8 REFUSED (GO TO A2a)

A1b. During the past 12 months, that is, since [THIS MONTH LAST YEAR], about how many weeks did you go to a Job Club? INTERVIEWER: IF LESS THAN ONE WEEK, ENTER ONE WEEK. IF LESS THAN WHOLE WEEK, ROUND UP.

_____ NUMBER OF WEEKS [RANGE 1-52]

97 DON’T KNOW

98 REFUSED

CATI: IF A1a=1 THEN A1C = 1 AND GO TO A2a.

A1c. Since [RAD], have you participated in Job Club?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

ESL

A2a. During the past 12 months, that is, since [THIS MONTH LAST YEAR], have you ever taken part in ESL classes, that is English as a Second Language?

1 YES

2 NO (GO TO A2d)

7 DON’T KNOW (GO TO A2d)

8 REFUSED (GO TO A3a)

A2b. During the past 12 months, that is, since [THIS MONTH LAST YEAR], about how many weeks did you take ESL classes? INTERVIEWER: IF LESS THAN ONE WEEK, ENTER ONE WEEK. IF LESS THAN WHOLE WEEK, ROUND UP.

_____ NUMBER OF WEEKS [RANGE 1-52]

97 DON’T KNOW

98 REFUSED

A2c. Question Deleted.

CATI: IF A2a=1 THEN A2d=1 AND GO TO A3a.

A2d. Since [RAD], have you ever taken part in ESL classes?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

ABE/GED/Regular HS

A3a. During the past 12 months, that is, since [THIS MONTH LAST YEAR], have you ever taken part in any Adult Basic Education (ABE) classes, GED classes, or classes to prepare for a regular high school diploma? IF NECESSARY, READ: “Adult Basic Education (ABE) classes are for improving your basic reading and math skills. GED classes help prepare for the GED test.” IF NECESSARY, READ: “A GED is a General Education Diploma, an equivalency degree similar to a high school diploma. GED classes help prepare for the GED test.”

1 YES

2 NO (GO TO A3d)

7 DON’T KNOW (GO TO A3d)

8 REFUSED (GO TO A4a)

A3b. During the past 12 months, that is, since [THIS MONTH LAST YEAR], about how many weeks did you take ABE, GED, or high school classes? INTERVIEWER: IF LESS THAN ONE WEEK, ENTER ONE WEEK. IF LESS THAN WHOLE WEEK, ROUND UP.

_____ NUMBER OF WEEKS [RANGE 1-52]

97 DON’T KNOW

98 REFUSED

A3c. Question Deleted.

CATI: IF A3a=1 THEN A3d=1 AND GO TO A4a.

A3d. Since [RAD], have you participated in ABE, GED, or high school classes?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

COLLEGE COURSES

A4a. During the past 12 months, that is, since [THIS MONTH LAST YEAR], have you ever taken any college courses for credit? This would include courses at community, two-year, and four-year colleges.

1 YES

2 NO (GO TO A4e)

7 DON’T KNOW (GO TO A4e)

8 REFUSED (GO TO A5a)

A4b. Did any of these classes earn you credits towards an associate’s or bachelor’s degree?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

A4c. During the past 12 months, that is, since [THIS MONTH LAST YEAR], about how many weeks did you take these college courses? INTERVIEWER: IF LESS THAN ONE WEEK, ENTER ONE WEEK. IF LESS THAN WHOLE WEEK, ROUND UP.

_____ NUMBER OF WEEKS [RANGE 1-52]

97 DON’T KNOW

98 REFUSED

A4d. Question Deleted.

CATI: IF A4a=1 THEN A4e=1 AND GO TO A5a.

A4e. Since [RAD], have you participated in college courses for credit?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

VOCATIONAL TRAINING

A5a. During the past 12 months, that is, since [THIS MONTH LAST YEAR], did you get vocational training for a specific job, trade, or occupation [CATI: IF A4A = 1 (YES)] INSERT “other than the college courses you just mentioned”]? Please don't include on-the-job training or unpaid work experience.

1 YES

2 NO (GO TO A5F)

7 DON’T KNOW (GO TO A5F)

8 REFUSED (GO TO B1)

A5b. During the past 12 months, that is, since [THIS MONTH LAST YEAR], about how many weeks did you take vocational training classes? INTERVIEWER: IF LESS THAN ONE WEEK, ENTER ONE WEEK. IF LESS THAN WHOLE WEEK, ROUND UP.

_____ NUMBER OF WEEKS [RANGE 1-52]

97 DON’T KNOW

98 REFUSED

A5c. What kind of occupation or type of job was this training for?

INTERVIEWER: RECORD VERBATIM RESPONSE

97 DON’T KNOW

98 REFUSED

A5d. Question Deleted.

A5e. Did these vocational training classes earn you credits that you could use towards an associate’s or bachelor’s degree?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF A5a=1 THEN A5f=1 AND GO TO B1.

A5f. Since [RAD], have you participated in vocational training at any other time?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: RECORD END TIME

SECTION B. EDUCATIONAL ATTAINMENT

CATI: RECORD START TIME

The next few questions concern your education.

B1. What is the highest grade or year of school that you have already completed?

INTERVIEWER, IF THE SAMPLE MEMBER ANSWERS “GED,” ASK: Before you received your GED, what was the highest grade of school you completed?

[AA/AS OR ASSOCIATE DEGREE = 14, BA/BS DEGREE = 16, MA OR MASTERS = 18, PH.D. OR DOCTORATE = 20]

___ ___ [RANGE 00 – 20]

97 DON’T KNOW

98 REFUSED

CATI: FOR ALL DATES (EX. B3a, B6, ETC), USE ‘97’ FOR DON’T KNOW MONTH AND ‘9997’ FOR DON’T KNOW YEAR. USE ‘98’ FOR REFUSED MONTH AND ‘9998’ FOR REFUSED YEAR.

B2. Do you have any type of trade license or training certification?

1 YES

2 NO (GO TO B5)

7 DON’T KNOW (GO TO B5)

8 REFUSED (GO TO B5)

B3. How many trade licenses or training certifications have you obtained?

____ (RANGE 1 – 10)

97 DON’T KNOW (GO TO B5)

98 REFUSED (GO TO B5)

B3a. CATI: IF B3 = 1, ASK: When did you receive it? CATI: IF B3 = 2 - 10, ASK: When did you receive the most recent one?

_____ / _____ [RANGE MM = 1 – 12, 97, 98]

MM YYYY [RANGE YYYY = 1960 – CURRENT YEAR, 9997, 9998]

B4. CATI: IF B3=1, ASK: What type of license or certification did you receive? (PROBE: What type of trade or work does it qualify you to do?) CATI: IF B3 = 2-10, ASK: What was the (next) most recent license or certification received? (PROBE: What type of trade or work does it qualify you to do?) CATI: LOOP 5 TIMES; USE “NEXT” AFTER FIRST LOOP.

97 DON’T KNOW

98 REFUSED

B5. Do you have a GED certificate?

B6. When did you receive it?

_____ / _____

MM YYYY

GO TO B7

1 YES

2 NO (GO TO INSTRUCTION BEFORE B7)

7 DON’T KNOW (GO TO INSTRUCTION BEFORE B7)

8 REFUSED (GO TO INSTRUCTION BEFORE B7)

CATI: IF B1 < 12 AND B5 IS NOT EQUAL TO 1 (YES), GO TO C1. [RANGE MM = 1 – 12, 97, 98]

[RANGE YYYY = 1960 –

CURRENT YEAR, 9997, 9998]

B7. Do you have a high school diploma?

B8. When did you receive it?

_____ / _____

MM YYYY

GO TO B9

1 YES

2 NO (GO TO INSTRUCTION BEFORE B9)

7 DON’T KNOW (GO TO INSTRUCTION BEFORE B9)

8 REFUSED (GO TO INSTRUCTION BEFORE B9)

[RANGE MM = 1 – 12, 97, 98]

[RANGE YYYY = 1960 –

CURRENT YEAR, 9997, 9998]

CATI: IF B5=2 AND B7=2, GO TO C1.

B9. An associates degree?

B10. When did you receive it?

_____ / _____

MM YYYY

GO TO B11

1 YES

2 NO (GO TO B11)

7 DON’T KNOW (GO TO B11)

8 REFUSED (GO TO B11)

[RANGE MM = 1 – 12, 97, 98]

[RANGE YYYY = 1960 –

CURRENT YEAR, 9997, 9998]

B11. A bachelor’s degree?

B12. When did you receive it?

_____ / _____

MM YYYY

GO TO B13

1 YES

2 NO (GO TO C1)

7 DON’T KNOW (GO TO C1)

8 REFUSED (GO TO C1)

[RANGE MM = 1 – 12, 97, 98]

[RANGE YYYY = 1960 –

CURRENT YEAR, 9997, 9998]

B13. A graduate degree?

B14. When did you receive it?

_____ / _____

MM YYYY

GO TO C1

1 YES

2 NO (GO TO C1)

7 DON’T KNOW (GO TO C1)

8 REFUSED (GO TO C1)

[RANGE MM = 1 – 12, 97, 98]

[RANGE YYYY = 1960 –

CURRENT YEAR, 9997, 9998]

CATI: RECORD END TIME

SECTION C: EMPLOYMENT HISTORY

CATI: RECORD START TIME

The next questions are about all paid jobs you currently have or have had. This includes self-employment, such as paid baby-sitting, construction, housekeeping jobs, maintenance, yard work, or any other jobs you've had. It may also include transitional or subsidized jobs, which are jobs where people often get their paycheck from an employment program rather than from the company or employer where they work. Again, I would like to remind you that your answers will remain entirely confidential.

C1. Are you currently working for pay?

1 YES (GO TO C1a )

2 YES, CURRENTLY ON LEAVE (GO TO C1a )

3 NO (GO TO C3)

4 LAID OFF (GO TO C4)

7 DON’T KNOW (GO TO C3)

8 REFUSED (GO TO C3)

C1a. How many jobs do you currently have? (SELF-EMPLOYMENT OR TEMPORARY OR "TEMP" WORK IN THE SAME FIELD COUNTS AS ONE JOB.)

________ [RANGE = 1 – 15]

NUMBER

97 DON’T KNOW

98 REFUSED

CATI: IF C1a= 1, 97, 98, GO TO C4.

C2. For whom do you usually work the most hours? PROBE: What is your employer’s name?

IF HOURS THE SAME: Who have you worked for the longest?

__________________________________________

EMPLOYER’S NAME

96 SELF-EMPLOYED

97 DON’T KNOW

98 REFUSED

CATI: IF “96” (SELF-EMPLOYED), CREATE TEXT BOX FOR INTERVIEWER TO INSERT JOB NAME FOR USE AS C2/C4 TEXT FILL IN SUBSEQUENT QUESTIONS.

CATI: IF C1a > 1, GO TO C5a.

CATI: IF C1 = 4. FILL WITH CODE “1.”

C3. Have you ever worked for pay at all? Please don't count unpaid experience.

1 YES (GO TO C4)

2 NO (GO TO C3a)

7 DON’T KNOW (GO TO C3a)

8 REFUSED (GO TO C3a)

C3a. A lot of people have irregular, odd, or side jobs, or do extra work to make ends meet. Have you ever done any work like that for pay?

1 YES (GO TO C4)

2 NO (GO TO D1)

7 DON’T KNOW (GO TO D1)

8 REFUSED (GO TO D1)

CATI: FOR TEXT FILLS IN REMAINDER OF THIS SECTION, USE FIRST CHOICE IF R IS STILL EMPLOYED (C1 = 1 OR 2). USE SECOND CHOICE IF R IS NOT CURRENTLY EMPLOYED (C1 = 3, 4, 7, OR 8).

C4. I'd like to ask you some questions about your (current/most recent) job. Please tell me where you (work/worked). PROBE: What (is/was) your employer's name?

__________________________________________

EMPLOYER’S NAME

96 SELF-EMPLOYED

97 DON’T KNOW

98 REFUSED

CATI: IF “96” (SELF-EMPLOYED), CREATE TEXT BOX FOR INTERVIEWER TO INSERT JOB NAME FOR USE AS C2/C4 TEXT FILL IN SUBSEQUENT QUESTIONS.

C5b. Question Deleted.

C5c. Would you describe this job as:

C5c_1. Seasonal work, meaning you were hired for only a few weeks or months?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C5c_2. Work for a “temp” agency?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C5c_3. An occasional odd job, meaning you were hired for only a few hours or days?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF C1 = 1 OR 2, INSERT END DATE OF “77 / 7777” TO DESIGNATE STILL WORKING.

C6. What month and year did you start (CATI: IF C1 = 3, 4,7, OR 8 INSERT “and end”) this job?

START: ___ ___/___ ___ ___ ___ [RANGE MONTH = 1 – 12, 77, 97, 98]

MONTH YEAR

END: ___ ___/___ ___ ___ ___ [RANGE YEAR = 1980 – CURRENT YEAR,

MONTH YEAR 7777, 9997, 9998]

97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR

98 REFUSED MONTH 9998 REFUSED YEAR

CATI: IF END DATE EARLIER THAN RAD, THEN SKIP TO D1.

C7. What kind of work (do/did) you do on this job?

INTERVIEWER: ENTER VERBATIM RESPONSE. PROBE AS NEEDED.

97 DON’T KNOW

98 REFUSED

C8. What do they make or what service do they provide? INTERVIEWER: ENTER VERBATIM RESPONSE. PROBE AS NEEDED.

97 DON’T KNOW

98 REFUSED

C9. Including yourself, about how many people (work/worked) at your (current/most recent) place of employment, including managers, supervisors, and part-time employees?

01 1-4

02 5-9

03 10-19

04 20-49

05 50-99

06 100-249

07 250-499

08 500+

97 DON’T KNOW

98 REFUSED

C10. (Now/Just before you left), including overtime, how many hours per week (do/did) you usually work on this job at [C2/C4 EMPLOYER NAME]? INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

[RANGE = 1 – 90]

HOURS/WEEK

97 DON’T KNOW

98 REFUSED

C11. (Does/Did) the number of hours you work(ed) from week to week change:

1 a lot,

2 a fair amount,

3 a little, or

4 hardly at all?

7 DON’T KNOW

8 REFUSED

C11a. How many days per week (do/did) you usually work?

[RANGE 1 – 7]

DAYS/WEEK

97 DON’T KNOW

98 REFUSED

CATI: IF C5c_3 = 1 (R WORKS AN OCCASIONAL ODD JOB), GO TO C14.

C12. Which of the following best describes your usual weekly work schedule at your job during the last month you worked? Did you work a:

1. regular daytime shift,

2. regular evening shift,

03 regular night shift,

04 rotating shift (one that changes regularly from days to evenings to nights),

05 split shift (one consisting of two distinct periods each day),

06 an irregular schedule (one that changes from day to day), or

95 something else (SPECIFY)?_______________________________________________

97 DON’T KNOW

98 REFUSED

C12a. Did your usual shift include working on a weekend day—Saturday or Sunday?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF R IS CURRENTLY WORKING (C1=1 OR 2) ASK C13. ELSE GO TO C14.

C13. During the past four weeks, how many days did you miss more than half of the day from your job because of personal or family reasons, including vacation? (RANGE 0-28 DAYS MISSED)

__________

97 DON’T KNOW

98 REFUSED

CATI: IF C13 = “0,” GO TO C14.

I’m going to read you a list of reasons why people miss work. Please tell me which of these applied to you in the last four weeks.

C13a. Did you miss work because:

	YES	NO	DON’T KNOW	REFUSED
a. you were on vacation?	1	2	7	8
b. you were sick?	1	2	7	8
c. you were caring for a sick family member?	1	2	7	8
d. you had problems with child care?	1	2	7	8
e. you had problems with transportation?	1	2	7	8
f. you had some other reason? (SPECIFY) ___________________________________	1	2	7	8

C14. What (are/were) your earnings (now/just before you left) before taxes? Please include tips, commissions, and regular overtime pay. INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.

$ ___ ___ ___ ,___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]

AMOUNT

999999.97 DON’T KNOW

999999.98 REFUSED

CATI: IF C14 IS 999999.97 (DON’T KNOW) OR 999999.98 (REFUSED), GO TO INSTRUCTION BEFORE C17.

C15. (Is/Was) that:

(INTERVIEWER: READ AS NECESSARY.)

01 per hour,

02 per week,

03 every 2 weeks,

04 twice a month,

05 once a month,

06 per year,

07 per day, or

95 some other way (GO TO C15a)?

97 DON’T KNOW

98 REFUSED

CATI: IF C15 NOT EQUAL 95 THEN GO TO C16.

C15a Please estimate what you (make/made) in a typical week. INTERVIEWER: Round to the nearest whole dollar.

$ ___ ___ ___ ___ [RANGE 1 – 9995]

9997 DON’T KNOW

9998 REFUSED

C16. (Is/Was) that before or after taxes?

1 BEFORE

2 AFTER

7 DON’T KNOW

8 REFUSED

CATI: IF C5c_3 = 1 (R WORKS AN OCCASIONAL ODD JOB), GO TO C24. IF C2 OR C4 = 96 (SELF EMPLOYED) AND C5c_3 IS NOT EQUAL TO 1 (R WORKS AN OCCASIONAL ODD JOB), GO TO C20.

C17. Which of the following benefits (are/were) available to you on your job, even if you (are/were) not receiving them?

INTERVIEWER: SELECT “YES” IF R WILL EVENTUALLY BE OFFERED BENEFITS.

	YES	NO	DON’T KNOW	REFUSED
a. Sick days with full pay?	1	2	7	8
b. Paid vacation?	1	2	7	8
c. Paid holidays?	1	2	7	8
d. Dental benefits, including any offered at a cost to you?	1	2	7	8
e. A retirement or 401K plan?	1	2	7	8
f. A health plan or medical insurance, including any offered at a cost to you?	1	2	7	8

CATI: IF C17f = 1 (YES), THEN ASK C18. ELSE GO TO C20.

C18. (Are/Were) you enrolled in the health or medical insurance plan offered by your employer?

1 YES (GO TO C20)

2 NO (GO TO C19)

7 DON’T KNOW (GO TO C20)

8 REFUSED (GO TO C20)

C19. What is the main reason you didn’t enroll in your employer’s health insurance plan? Was it that:

(MARK ONE)

1 you were covered by Medicaid or (CATI: INSERT APPROPRIATE STATE INSURANCE PROGRAM NAME),

2 you were covered by another insurance plan,

3 the cost was too expensive,

4 you hadn’t worked long enough, or

5 some other reason ? (SPECIFY)____________________________

7 DON’T KNOW

8 REFUSED

C20. Did you have a change in your earnings since you started this job?

1. YES

2. NO

7 DON’T KNOW

8 REFUSED

C20a. Did you have a change in the number of hours since you started this job?

1. YES

2. NO

7 DON’T KNOW

8 REFUSED

CATI: IF C20=1, ASK C21; ELSE GO TO INSTRUCTIONS BEFORE C22.

C21. What were your starting earnings for this job—that is, how much were your earnings when you started this job? Please include tips, commissions, regular overtime pay and earnings, before taxes. IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MADE IN A TYPICAL WEEK.

$ ___ ___ ___ ,___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]

AMOUNT

999999.97 DON’T KNOW

999999.98 REFUSED

CATI: IF C21 IS 999999.97 (DON’T KNOW) OR 999999.98 (REFUSED), GO TO INSTRUCTIONS BEFORE C22.

C21a. Was that:

(INTERVIEWER: READ AS NECESSARY.)

01 per hour,

02 per week,

03 every 2 weeks,

04 twice a month,

05 once a month,

06 per year,

07 per day, or

95 some other way? (Go to C21b)

97 DON’T KNOW

98 REFUSED

CATI: IF C21a NOT EQUAL 95, THEN GO TO C21c.

C21b. Please estimate what you made in a typical week. INTERVIEWER: Round to the nearest whole dollar.

$ ___ ___ ___ ___ [RANGE 1 – 9995]

9997 DON’T KNOW

9998 REFUSED

C21c. Was that before or after taxes?

1 BEFORE

2 AFTER

7 DON’T KNOW

8 REFUSED

CATI: IF C20a =1 ASK C22; ELSE SKIP TO C23a.

C22. Including overtime, how many hours per week did you work when you began this job? INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

__________________ [RANGE = 1 = 90]

HOURS/WEEK

97. DON’T KNOW

98. REFUSED

C22a. How many days per week did you usually work when you began this job?

[RANGE 1 – 7]

DAYS/WEEK

97 DON’T KNOW

98 REFUSED

CATI: IF C2 OR C4 = 96 (SELF EMPLOYED) OR IF C5c_3 = 1 (OCCASIONAL ODD JOB), GO TO C24.

CATI: END RECORD TIME

C23a. (Have you received/did you receive) a promotion while working for [C2/C4 EMPLOYER NAME], meaning that you moved to a higher position or job title?

1 YES (GO TO C24)

2 NO

7 DON’T KNOW

8 REFUSED

C23b. (Is/Was) your job one in which there (is/was) a possibility that you could move up or be promoted?

1 YES

2 NO (GO TO C24)

7 DON’T KNOW

8 REFUSED

C23c. (Do/Did) you think you (are/were) likely to move up or be promoted while you (are/were) working at this job?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C24. Think about your (current/most recent) job. How often (does/did) it require you to:

	DAILY (1)	WEEKLY (2)	MONTHLY (3)	NEVER (4)
a. Talk with customers or clients face to face – daily, weekly, monthly, or never?
b. Talk over the phone with customers or clients– daily, weekly, monthly, or never?
c. Read instructions or reports– daily, weekly, monthly, or never?
d. Write letters or memos – (daily, weekly, monthly, or never)?
e. Work with a computer, such as word processing or data entry?
f. Work with another electronic machine such as a cash register, bar code scanner, or calculator?
g. Do arithmetic, including making change?
h. Fill out forms?
i. Keep a close watch over gauges, dials, or instruments of any kind?
j. Supervise other people who report to you?

CATI: FOR C24a THROUGH C24j, DON’T KNOW = 7, REFUSED = 8.

C25. (Are/Were) you a member of a labor union or an employee association like a union at this job?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C25a How did you find this job?

01 TWC OR STEP

01 OTHER EMPLOYMENT PROGRAM

02 ONE STOP

03 SCHOOL PLACEMENT OFFICE/JOB COUNSELOR

04 PRIVATE EMPLOYMENT AGENCY

05 TEMP AGENCY

06 NEWSPAPER WANT AD

07 FRIEND OR RELATIVE

08 INTERNET

09 SAW HELP WANTED SIGN

95 OTHER (SPECIFY) ______________

97 DON’T KNOW

98 REFUSED

C26. Question Deleted.

C27. For each of the following statements about your experiences at work, please indicate whether you agree or disagree?

a. You (have/had) a lot of responsibility in your job. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

b. Your job (is/was) physically demanding, meaning it (requires /required) you to move or carry heavy objects, such as boxes or equipment, or move or carry people, such as patients. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

c. You (risk/risked) your health or safety doing this work. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

CATI: IF C2 OR C4 = 96 (SELF EMPLOYED), GO TO C27f.

d. You (receive/received) the respect you (deserve/deserved) from your superiors. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

e. You (receive/received) the respect you (deserve/deserved) from your colleagues or co-workers. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

f. You (have/had) been provided with the right equipment that you (need/needed) to do your job well. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

CATI: IF C2 OR C4 = 96 (SELF EMPLOYED), GO TO C27h.

g. You (are/were) allowed to contribute ideas as to how your job should be performed. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

h. You (cannot/could not) count on keeping this job. Do you:

1 Agree, or

2 Disagree?

7 DON’T KNOW

8 REFUSED

C28. Now, I’d like to ask you some questions about transportation to and from your (current/most recent) job.

How (do/did) you usually get to your job at [C2/C4 EMPLOYEER NAME]? (Do/Did) you: (INTERVIEWER: SELECT ALL THAT APPLY.) Any other way?

1 drive your own car,

2 walk,

3 get a ride with someone,

4 ride a bus, a subway, or other transportation, or

5 get there some other way? SPECIFY: ____________

6 R WORKS AT HOME (GO TO C31a)

7 DON’T KNOW

8 REFUSED

C29. How many minutes (does/did) it usually take you to get to this job? That is, how long (does/did) it

take you to travel to your work, one way?

__ __ __MINUTES (RANGE 1-240)

997 DON’T KNOW

998 REFUSED

C30. Question Deleted.

C30a. Question Deleted.

CATI: RECORD END TIME

CATI: IF C1a = 1, GO TO C39a. IF C1a IS GREATER THAN 1, THEN DISPLAY C31a.

CATI: IF C3 = 1 OR C3a = 1, GO TO C39a.

C31a. I’d like to ask you questions about the other jobs you currently have. Let’s start with the name of your other current employer.

CATI: AFTER NAME OF SECOND CURRENT JOB ENTERED IN C32, ASK “What other job do you currently have?” RECORD THE NAME(S) OF UP TO TWO JOBS IN C32. USE ‘96’ TO INDICATE NO OTHER CURRENT JOBS. WHEN NO MORE JOBS, GO TO C33 FOR FIRST JOB. LOOP THROUGH C33-C39 FOR EACH JOB IN C32 SEPARATELY. DISPLAY C32 JOB NAME FOR EACH C33-C39 LOOP.

CATI: FOR C32, C36 AND C39, DON’T KNOW = ‘97’ AND REFUSED = ’98.’ FOR C33, DON’T KNOW MONTH = ’97,’ DON’T KNOW YEAR = ‘9997’; REFUSED MONTH = ‘98’ AND REFUSED YEAR = ‘9998.’ FOR C37, AND C38 DON’T KNOW = ‘7’ AND REFUSED = ‘8.’

CATI: IF C35 IS 99999.97 (DON’T KNOW) OR 99999.98 (REFUSED), GO TO C38.

	SECOND CURRENT JOB	THIRD CURRENT JOB
C32. What other jobs do you currently have? CATI: RECORD ALL JOBS, THEN CONTINUE WITH C33.	[ ] 96 NO OTHER CURRENT JOB CATI: IF C32=96, GO TO C39a	[ ] 96 NO OTHER CURRENT JOB CATI: ALL GO TO C33 FOR SECOND CURRENT JOB.
CATI: LOOP THROUGH C33-C39 FOR EACH JOB SEPARATELY.
C33. When did you start this job? INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.	START: ___ ___/___ ___ ___ ___ MM YYYY [RANGE MM = 1 – 12] [YYYY = 1968 – CURRENT YEAR]	START: ___ ___/___ ___ ___ ___ MM YYYY [RANGE MM = 1 – 12] [YYYY = 1968 – CURRENT YEAR]
C34. Including overtime, how many hours per week do you work on this job currently? INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER AS HOURS PER WEEK.	______ _____ HOURS/WEEK [RANGE = 1 – 90] 97 DON’T KNOW 98 REFUSED	______ _____ HOURS/WEEK [RANGE = 1 – 90] 97 DON’T KNOW 98 REFUSED
C35. What are your earnings now, before taxes? Please include tips, commissions, and regular overtime pay. INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.	$___ ___ , ___ ___ ___.___ ___ [RANGE = 1 – 99999.95] 99999.96 MINIMUM WAGE 99999.97 DON’T KNOW 99999.98 REFUSED	$___ ___ , ___ ___ ___.___ ___ [RANGE = 1 – 99999.95] 99999.96 MINIMUM WAGE 99999.97 DON’T KNOW 99999.98 REFUSED
C36. Is that: (INTERVIEWER: READ AS NECESSARY.)	per hour, 01 per week, 02 every 2 weeks, 03 twice a month, 04 once a month, 05 per year, 06 per day, or 07 something else? (SPECIFY) 95 ___________________	per hour, 01 per week, 02 every 2 weeks, 03 twice a month, 04 once a month, 05 per year, 06 per day, or 07 something else? (SPECIFY) 95 ___________________
C37. Is that before or after taxes?	BEFORE 1 AFTER 2	BEFORE 1 AFTER 2
C38. Does your employer make available a health plan or medical insurance, even if you are not receiving it?	YES 1 NO 2	YES 1 NO 2
C39. How many days in a typical week do you usually work?	___________ DAYS/WEEK [RANGE = 1 – 7] CATI: IF “96” IN THIRD CURRENT JOB, GO TO C39a; ELSE GO TO C33 FOR THIRD CURRENT JOB.	___________ DAYS/WEEK [RANGE = 1 – 7]

C39a. Now, I would like to ask you a few questions about the job you had before [this job (if C1a = 1) or (C3=1 OR C3a=1/ these current jobs (if C1a = 2 – 10)].

C39b. Did you have a job before [this job (if C1a = 1 or C3 = 1or C3a = 1/ these current jobs (if C1a = 2 – 10)]?

1 YES

2 NO (GO TO D1)

7 DON’T KNOW (GO TO D1)

8 REFUSED (GO TO D1)

C40. How long did you work in that job?

_________ [ ] MONTHS [RANGE = 1 - 480]

NUMBER [ ] YEARS [RANGE = 1 - 40]

997 DON’T KNOW

998 REFUSED

C41. Including overtime, how many hours per week were you usually working before you left that job? INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.

_____ _____ [RANGE = 1 - 90]

HOURS/WEEK

97 DON’T KNOW

98 REFUSED

C42. What were your earnings, before taxes, when you left that job?

$ ___ ___ , ___ ___ ___ . ___ ___ [RANGE = 1 – 99999.95]

AMOUNT

99999.96 MINIMUM WAGE (GO TO C44)

99999.97 DON’T KNOW (GO TO C44)

99999.98 REFUSED (GO TO C44)

C43. Was that:

(INTERVIEWER: READ AS NECESSARY.)

01 per hour,

02 per week,

03 every 2 weeks,

04 twice a month,

05 once a month,

06 per year,

07 per day, or

95 something else? (SPECIFY)________

97 DON’T KNOW

98 REFUSED

C44. How many days per week did you usually work before you left that job?

____ ____ [RANGE: 1 – 7]

DAYS/WEEK

97 DON’T KNOW

98 REFUSED

C45. Did the employer make available a health plan or medical insurance, even if you were not receiving it?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C46. How much time were you out of work before finding your next job?

_________ [ ] MONTHS [RANGE = 1 - 120]

NUMBER [ ] YEARS [RANGE = 1 - 10]

997 DON’T KNOW

998 REFUSED

CATI: RECORD END TIME

C47. Now please think about all the jobs you have had since (RAD), even the ones you just told me about. Altogether, how many jobs have you had since (RAD)?

IF NECESSARY: Transitional or subsidized jobs are jobs where people often get their paycheck from an employment program rather than from the company or employer where they work. Please count multiple episodes of day labor or temporary work in one field, for example, construction or office work, as one job.

________ [RANGE = 1 - 40]

NUMBER

97 DON’T KNOW (GO TO C48_1)

98 REFUSED (GO TO C48_1)

C47a. Were any of these jobs transitional or subsidized jobs? Transitional or subsidized jobs are jobs where people often get their paycheck from an employment program rather than from the company or employer where they work.

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

C47_1. CATI: IF “1” JOB IN C47, ASK: Have you worked at this job since (THIS MONTH LAST YEAR)?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: GO TO NEXT SECTION.

C47_2 CATI: IF 2 - 40 IN C47, ASK: Of the (CATI: INSERT # OF JOBS IN C47) jobs since (RAD), how many did you work at since (THIS MONTH LAST YEAR)?

________ [RANGE = 0 - 40]

NUMBER

97 DON’T KNOW

98 REFUSED

CATI: ASK IF C47 = 2 - 40. ELSE GO TO NEXT SECTION.

C48_1. How much have you worked during the past 12 months?

1 All 12 months,

2 More than 6 months but less than 12 months, or

3 6 months or less

7 DON’T KNOW

8 REFUSED

C49 – C52. Questions Deleted.

C53. Since [RAD], how many times has this happened to you?

C53a. You received a raise in pay at your job. Was it:

1. Never,

2. Once, or

3. More than once?

7 DON’T KNOW

8 REFUSED

C53b. You received a promotion at your job. Was it:

1 Never,

2 Once, or

3 More than once?

7 DON’T KNOW

8 REFUSED

C53c. You found another job while you were working. Was it:

1 Never,

2 Once, or

3 More than once?

7 DON’T KNOW

8 REFUSED

C53d. You left a job to go immediately into a higher-paying one. Was it:

1 Never,

2 Once, or

3 More than once?

7 DON’T KNOW

8 REFUSED

C53e. You worked for an employer for at least six months. Was it:

1 Never,

2 Once, or

3 More than once?

7 DON’T KNOW

8 REFUSED

C54. Please think about how your (current/most recent) job compares to other jobs you’ve had since [RAD]. [Is (items a, b, c, e, f, g, h)/ Are (item d)] the [INSERT ITEM] in your (current/most recent) job better, about the same, or worse than in those other jobs? CATI: REPEAT QUESTION USING NEXT ITEM IN LIST.

	BETTER	ABOUT THE SAME	WORSE	DON’T KNOW	REFUSED
a. Number of hours of work	1	2	3	7	8
b. Start and end of the workday	1	2	3	7	8
c. Money earned for a typical week of work	1	2	3	7	8
d. Benefits	1	2	3	7	8
e. Travel to and from home and work	1	2	3	7	8
f. Work enjoyment	1	2	3	7	8
g. Job security	1	2	3	7	8
h. Opportunity to advance on the job	1	2	3	7	8

CATI: RECORD END TIME

SECTION D: MARRIAGE, HOUSEHOLD COMPOSITION, AND CHILD CARE

CATI: RECORD START TIME

Now I’d like to ask some questions about you and your family.

D1. First, I’m required to ask your gender. Are you male or female?

1 MALE

2 FEMALE

8 REFUSED (AND INTERVIEWER UNABLE TO TELL)

D1a. Have you ever been married?

1 YES

2 NO (GO TO D3)

7 DON’T KNOW (GO TO D3)

8 REFUSED (GO TO D3)

D2. Are you currently:

1 married and living with your spouse,

2 separated or living apart from your spouse,

3 divorced, or

4 widowed?

7 DON’T KNOW

8 REFUSED

CATI: IF D2 = 1 (CURRENTLY MARRIED AND LIVING WITH SPOUSE), GO TO D4a.

D3. Are you currently living with a partner as a couple?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

Now I’m going to ask you about the people who lived in your household at least two nights a week last month.

D4a. Including you (CATI: IF D2 = 1, INSERT “and your spouse”. IF D3 = 1, INSERT “and your partner”) and any other adults and children, how many people lived together in your household at least two nights a week during (PRIOR MONTH)?

_________ [RANGE 01-20 PEOPLE]

97 DON’T KNOW

98 REFUSED

CATI: IF D4a = 01 OR 97 OR 98 OR [D4a = 2 AND [D2 = 1 OR D3 = 1]], GO TO E1.

D4b. Of these people you just mentioned, how many were children of your own who are under age 18? Please include biological, adopted, step, and foster children.

_________ BIOLOGICAL/ADOPTED/STEP/FOSTER CHILDREN [RANGE 0-12]

97 DON’T KNOW

98 REFUSED

CATI: IF D4b = 0 OR 97 OR 98, GO TO D10.

D4c. Question Deleted.

D4d. What are the ages of each of the children who are under age 18. Let’s start with the oldest. What is the age of the next oldest?

_________ [ ] MONTHS [RANGE = 00 - 23]

NUMBER [ ] YEARS [RANGE = 1 - 17]

97 DON’T KNOW

98 REFUSED

CATI: IF ANY CHILDREN 12 YEARS OLD OR YOUNGER, CONTINUE. ELSE GO TO SECTION E.

D5. Now I’m going to ask you about child care. Child care includes day care centers or nursery schools, Head Start, before- or after-school care centers, a babysitter, including brothers or sisters, the child’s other parent if that parent does not live with you, or other relatives, and summer camps. Please don’t count kindergarten, first grade, or higher. Were any of your children under age 13 cared for in a child care arrangement last month?

INTERVIEWER: REGULAR CUSTODY ARRANGEMENTS DO NOT COUNT AS CHILD CARE.

1 YES

2 NO (GO TO D10)

7 DON’T KNOW (GO TO D10)

8 REFUSED (GO TO D10)

D6. How many children were in a regular child care arrangement? By ‘regular’ I mean at least 10 hours per week last month.

INTERVIEWER: REGULAR CUSTODY ARRANGEMENTS DO NOT COUNT AS CHILD CARE.

_________ [RANGE 0-12]

97 DON’T KNOW (GO TO D10)

98 REFUSED (GO TO D10)

CATI: IF “0,” GO TO D10.

D7. Did you or anyone in your household pay anything for any of this child care used last month even if you were paid back?

1 YES

2 NO (GO TO D7b)

7 DON’T KNOW (GO TO D7b)

8 REFUSED (GO TO D7b)

D7a. Last month, about how much money did you or anyone in your household spend on child care? Only include payments for your children under age 13. Include costs for which you were paid back or expect to be paid back by the government or by someone else. INTERVIEWER: ROUND TO THE NEAREST WHOLE DOLLAR.

$ ___ ___ ___ CHILD CARE EXPENDITURE

997 DON’T KNOW [RANGE = 1 – 995]

998 REFUSED

D7b. Did anyone else pay for part or all of the costs of this child care used last month? By this I mean a government agency, your employer, or someone else outside your household?

1 YES

2 NO (GO TO D9)

7 DON’T KNOW (GO TO D9)

8 REFUSED (GO TO D9)

D7b_1. Who paid these child care costs?

1 Pennsylvania Department of Public Welfare (DPW) or other government agency

2 Employer

3 Someone else

4 SOME OR ALL OF THE ABOVE

7 DON’T KNOW

8 REFUSED

D7c. Did or will [IF D7b_1 = 1, 2, OR, 3, THEN INSERT THAT RESPONSE; IF D7b_1 = 4, 7, OR 8, THEN SAY: “the government, your employer, or someone else”] pay any money directly to the child care provider for the child care used last month?

1 YES

2 NO (GO TO D8a)

7 DON’T KNOW (GO TO D8a)

8 REFUSED (GO TO D8a)

D8. How much did they or will they pay directly to the child care provider for the child care you used last month?

$ ___ ___ ___ CHILD CARE REIMBURSEMENT

997 DON’T KNOW [RANGE = 1 – 995]

998 REFUSED

If D8 = DON’T KNOW or REFUSED, go to D8a. Else, go to D8b.

D8a. Did they or will they pay:

1. Less than $100

2. Between $100 and $300

3. Between $301 and $500

4. Between $501 and $800

5. More than $801

997. DON’T KNOW

998. REFUSED

D8b. Did or will [IF D7b_1 = 1, 2, OR, 3, THEN INSERT THAT RESPONSE; IF D7b_1 = 4, 7, OR 8, THEN SAY: “the government, your employer, or someone else”] pay you back for the child care you used last month?

1 YES

2 NO (GO TO D9)

7 DON’T KNOW (GO TO D9)

8 REFUSED (GO TO D9)

D8c. How much did they or will they pay you back for the child care you used last month?

$ ___ ___ ___ CHILD CARE REIMBURSEMENT

997 DON’T KNOW [RANGE = 1 – 995]

998 REFUSED

If D8c = DON’T KNOW or REFUSED, go to D8b. Else, go to D9.

D8db. Did they or will they pay you back:

1. Less than $100

2. Between $100 and $300

3. Between $301 and $500

4. Between $501 and $800

5. More than $801

997 DON’T KNOW

998 REFUSED

D9. During the past month, have you had a child care arrangement where the amount you paid depended on how much your income was?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

D10. During the past year, that is, since [THIS MONTH LAST YEAR], did you have to quit a job, quit school, or a training activity because you had problems arranging child care or keeping a child care arrangement?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

D11. During the past year, that is, since [THIS MONTH LAST YEAR], did you refuse a job offer or decide not to enroll in school or a training activity because you had problems arranging child care or keeping a child care arrangement?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: RECORD END TIME

SECTION E: HOUSING

CATI: RECORD START TIME

These questions are in regard to your housing. INTERVIEWER: READ ALL OPTIONS EVEN IF R INTERRUPTS WITH ANSWER.

E1. Currently do you:

01 own your own home,

02 rent your home or apartment,

03 live with family or friends and pay part of the rent or mortgage payment,

04 live with family or friends and not pay rent,

05 live in a group shelter, or

06 live in some other arrangement?

[INTERVIEWER: DO NOT READ: CODE IF APPROPRIATE.

07 HOMELESS AND LIVING ON THE STREET

08 JAIL

09 ALONE AND RENT-FREE

97 DON’T KNOW

98 REFUSED

CATI: RECORD END TIME

SECTION F: HEALTH COVERAGE

CATI: RECORD START TIME

CATI: FOR PRIOR MONTH, INSERT CALENDAR MONTH BEFORE INTERVIEW MONTH.

The next few questions are about health coverage for you and your family.

F1. In [PRIOR CALENDAR MONTH] were you covered by Medicaid, Healthy Beginnings, or AdultBasic? Medicaid is administered through managed care by three providers—Americhoice, Health Partners, and Keystone Mercy.

PROBE: Did you have a valid Medicaid, Healthy Beginnings, or AdultBasic card?

1 YES (GO TO INSTRUCTION AFTER F1a)

2 NO

7 DON’T KNOW

8 REFUSED

F1a. In (PRIOR MONTH) were you covered by any other health insurance plan?

1. YES

2. NO

7 DON’T KNOW

8 REFUSED

CATI: IF D2 = 1, 2 (SPOUSE) OR D3 = 1 (PARTNER), GO TO F2. ELSE GO TO INSTRUCTION AFTER F2a.

F2. In (PRIOR MONTH) was your (CATI: IF D2 = 1 OR 2, INSERT “spouse.”  IF D3 = 1, INSERT “live-in partner.”  IF D2 = 2 AND D3 = 1, INSERT “live-in partner.”) covered by a public health insurance program like Medicaid, Healthy Beginnings, or AdultBasic? Medicaid is administered through managed care by three providers—Americhoice, Health Partners, and Keystone Mercy.

PROBE: Did he or she have a valid Medicaid, Healthy Beginnings, or AdultBasic card?

1 YES (GO TO INSTRUCTION AFTER F2a)

2 NO

7 DON’T KNOW

8 REFUSED

F2a. In (PRIOR MONTH) was he or she covered by any other health insurance plan?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF D4b = 1, GO TO F4. IF D4b > 1, GO TO F3_1. IF D4b = 0, 97, 98, GO TO G1. IF D4b IS BLANK, GO TO G1.

F

42-43

3_1. How many of your (# OF CHILDREN FROM D4b) children under age 18 who lived with you in (PRIOR MONTH) were covered by Medicaid, CHIP, or Healthy Beginnings? These programs may be administered through managed care by three providers–—Americhoice, Health Partners, and Keystone Mercy.

INTERVIEWER: IF R INDICATES THAT THE LISTED STATE CHILDREN’S HEALTH INSURANCE PROGRAM IS NOT APPLICABLE BECAUSE THEY HAVE MOVED, FOLLOW UP WITH: How many of your (# OF CHILDREN FROM D4b) children under age 18 were covered by Medicaid, CHIP, or the State Children’s Health Insurance Program in the state where you now live?

_________ [RANGE = 0 - 12]

NUMBER

97 DON’T KNOW (GO TO G1)

98 REFUSED (GO TO G1)

CATI: IF D4b AND F3_1 ARE EQUAL, GO TO G1.

CATI: ASK IF THE DIFFERENCE BETWEEN D4b AND F3_1 IS “1.”

F3a_1. Is the one child who was not covered by Medicaid, CHIP, or Healthy Beginnings covered by another health insurance plan?

INTERVIEWER: IF R INDICATED IN F3_1 THAT THE LISTED STATE CHILDREN’S HEALTH INSURANCE PROGRAM IS NOT APPLICABLE BECAUSE THEY HAVE MOVED, FOLLOW UP WITH: Was that child covered by Medicaid, CHIP, or the State Children's Health Insurance Program in the state where you now live?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: ALL GO TO G1.

F3a_2. CATI: ASK IF DIFFERENCE BETWEEN D4b AND F3_1 IS 2 - 12. How many of the [DIFFERENCE BETWEEN D4b AND F3_1) children who were not covered by Medicaid, CHIP, or Healthy Beginnings were covered by another health insurance program?

INTERVIEWER: IF R INDICATED IN F3_1 THAT THE LISTED STATE CHILDREN’S HEALTH INSURANCE PROGRAM IS NOT APPLICABLE BECAUSE THEY HAVE MOVED, FOLLOW UP WITH: How many of the (DIFFERENCE BETWEEN D4b AND F3_1) children were covered by Medicaid”, CHIP, or the State Children’s Health Insurance Program in the state where you now live?

_________ [RANGE = 0 - 12]

NUMBER

97 DON’T KNOW

98 REFUSED

CATI: ALL GO TO G1.

F4. In (PRIOR MONTH) was your child covered by Medicaid, CHIP, or Healthy Beginnings?

INTERVIEWER: IF R INDICATES THAT THE LISTED STATE CHILDREN’S HEALTH INSURANCE PROGRAM IS NOT APPLICABLE BECAUSE THEY HAVE MOVED, FOLLOW UP WITH “Was your child covered by Medicaid, CHIP, or the State Children's Health Insurance Program in the state where you now live?”

1 YES (GO TO G1)

2 NO

7 DON’T KNOW

8 REFUSED

F4a. In (PRIOR MONTH) was your child covered by any other health insurance plan?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: RECORD END TIME

SECTION G: HOUSEHOLD INCOME

CATI: RECORD START TIME

CATI: FOR PRIOR MONTH, INSERT CALENDAR MONTH BEFORE INTERVIEW MONTH.

Now, I am going to ask you some questions about the income that came into your household for everyone who lived together in (PRIOR MONTH). Please include all income from all the people who lived together in your household at least two nights a week last month. Again, I want to assure you that none of your answers will be discussed with anyone.

During (PRIOR MONTH):

G1. Did you work for pay?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF D4a = 1, GO TO G2.

G1a. Did any other adult or children who live in your household work for pay?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

G2. In (PRIOR MONTH), did you (CATI: IF D4a > 1, INSERT “or anyone else in your household”) receive:

a. Food Stamps?

1 YES (GO TO G2c)

2 NO (GO TO G2b)

7 DON’T KNOW (GO TO G2b)

8 REFUSED (GO TO G2c)

b. The government has a program in which people receive a certain amount of money each month to help them pay for food. The government gives people a card, sometimes called an EBT card, which they can use at the store, but only for buying food. In (PRIOR MONTH) did you (CATI: IF D4a > 1, INSERT “or anyone else in your household”) use such a card when purchasing food?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: REINSERT STEM FROM G2a [IN (PRIOR MONTH)…..]

c. Child Support?

1. YES

2. NO

7 DON’T KNOW

8 REFUSED

d. (CATI: INSERT APPROPRIATE STATE TANF PROGRAM NAME) or any cash assistance not including child support money or child care payments?

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

e. SSI - Supplemental Security Income or Disability?

1. YES

2. NO (GO TO G2g)

7 DON’T KNOW (GO TO G2g)

8 REFUSED (GO TO G2g)

f. Who received SSI (Supplemental Security Income or Disability) in (PRIOR MONTH)? Was it you, someone else in your family, or both you and other family members?

1 RESPONDENT (GO TO G3a_1)

2 SOMEONE ELSE (GO TO G2g)

3 BOTH (GO TO G3a_1)

7 DON’T KNOW (GO TO G2g)

8 REFUSED (GO TO G3a_1)

g. Since [RAD] have you applied for SSI for yourself?

1 YES

2 NO

7 DON’T KNOW

8. REFUSED

G3a_1. Thinking about the income from all sources, including the ones you just mentioned, that is from [CATI: INSERT ALL YES CATEFORIES FROM G1 (your job), G1a (the jobs of other household members), G2a (Food Stamps), G2b (the government program to help you buy food), G2c (child support), G2d (TANF), G2e (SSI), what was the total income for everyone living together in your household in (PRIOR MONTH)? Please don’t include tax returns or EITC payments in your answer. PROBE: Your best estimate is fine.

$ ___ ___ ___ ,___ ___ ___. [RANGE = 0 – 999995]

AMOUNT

999997 DON’T KNOW

999998 REFUSED

CATI: IF G3a_1 = 999997 (DON’T KNOW), GO TO G3b. IF G3a_1 = 999998, GO TO G3f. IF G3a_1 = 0, GO TO G4.

G3a_2. Question Deleted.

CATI: IF AMOUNT GIVEN IN G3a_1, GO TO G3f.

G3b. Would you say it was more or less than $1,500?

1 MORE THAN $1,500

2 EXACTLY $1,500 (GO TO G3f)

3 LESS THAN $1,500 (GO TO G3d)

7 DON’T KNOW (GO TO G3f)

8 REFUSED (GO TO G3f)

G3c. Would you say it was:

1 more than $1,500 but less than $2,000,

2 at least $2000 but less than $2,500, or

3 $2,500 or more?

7 DON’T KNOW

8 REFUSED

CATI: ALL GO TO G3f.

G3d. Would you say it was:

1 at least $1,200 but less than $1,500,

2 at least $800 but less than $1,200,

3 at least $500 but less than $800, or

4 less than $500?

7 DON’T KNOW

8 REFUSED

G3e. Question Deleted.

G3f. How much of that household income from (PRIOR MONTH) was your own income? Please include all sources including your earnings, public assistance, child support, etc. Please don’t include tax returns or EITC payments in your answer. PROBE: How much of the income came
in your name? INTERVIEWER: ROUND TO NEAREST WHOLE DOLLAR.

$ ___ ___ ___ , ___ ___ ___. [RANGE = 0 – 999995]

AMOUNT

999997 DON’T KNOW

999998 REFUSED

CATI: IF G3f=999997 THEN GO TO G3f_1. OTHERWISE GO TO G4.

G3f_1. Would you say it was more or less than $1,500?

1 MORE THAN $1,500

2 EXACTLY $1,500 (GO TO G4)

3 LESS THAN $1,500 (GO TO G3f_3)

7 DON’T KNOW (GO TO G4)

8 REFUSED (GO TO G4)

G3f_2. Would you say it was:

1 more than $1,500 but less than $2,000,

2 at least $2000 but less than $2,500, or

3 $2,500 or more?

7 DON’T KNOW

8 REFUSED

CATI: ALL GO TO G4

G3f_3. Would you say it was:

1 at least $1,200 but less than $1,500,

2 at least $800 but less than $1,200,

3 at least $500 but less than $800, or

4 less than $500?

7 DON’T KNOW

8 REFUSED

G4. Did or will you or someone else fill out a federal tax return for you for (CATI: INSERT PRIOR CALENDAR YEAR)? PROBE: This is the return you would file in April of this year.

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

G5. Question Deleted.

G6. Question Deleted.

CATI: FOR REMAINING QUESTIONS IN THIS SECTION, IF RESPONDENT LIVES WITH A SPOUSE (D2=1) THEN USE TEXT IN PARENTHESES AND INSERT ‘SPOUSE.’ IF RESPONDENT LIVES WITH A PARTNER (D3=1) THEN USE TEXT IN PARENTHESES AND INSERT ‘PARTNER.’

G7. Do you (or your [spouse/partner]) have any money or savings you keep in a safe place at home or elsewhere, such as money in a savings account? Remember that this information will be kept confidential and will only be used for the purpose of this study. (IF NECESSARY, READ: This would include money in a savings bond, money market fund, credit union, pension fund, stocks or bonds, or certificates of deposit.)

1 YES

2 NO (GO TO G9)

7 DON'T KNOW (GO TO G9)

8 REFUSED (GO TO G9)

G8. How much altogether do you (and your [spouse/partner]) have in savings? Your best estimate is fine. Remember that this information will be kept confidential and will only be used for the purpose of this study.

$ ___ ___ ___ ___ ___ SAVINGS AMOUNT [RANGE = 1-20,000]

99997 DON’T KNOW

99998 REFUSED

CATI: ASK IF G8=99997 (DON’T KNOW).

G8b. Would it be:

1 Less than $200,

2 $200 to $500,

3 $501 to $1000,

4 $1001 to $2000, or

5 More than $2000

7 DON'T KNOW

8 REFUSED

G9. Do you have a valid driver’s license?

1 YES

2 NO (GO TO G12)

7 DON'T KNOW (GO TO G12)

8 REFUSED (GO TO G12)

G9a. Do you have access to a car that you can use regularly?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

G9b_1 – G11b. Questions Deleted.

G12 Altogether, in (PRIOR MONTH), what did your household spend on rent or housing, including the mortgage payment, home insurance, and property taxes. (PROBE FOR BEST ESTIMATE IF R IS UNCERTAIN).

$ ___ ___ ___ ___ ___ HOUSING EXPENSES [RANGE = 1 - 2,000]

$0 NOTHING OR UNDER $1

9997 DON’T KNOW

9998 REFUSED

CATI: RECORD END TIME

SECTION H: SECTION DELETED

SECTION I: HEALTH STATUS

CATI: RECORD START TIME

Let me turn now to some questions about your health. I’d like to remind you, again, that all your answers to these questions are confidential.

I1. In general, how would you rate your overall health now? Is it:

1 Excellent,

2 Very good,

3 Good,

4 Fair, or

5 Poor

7 DON’T KNOW

8 REFUSED

I2. Question Deleted.

I3. Do you (“CATI: IF D4a > 1, INSERT “or does anyone in your family”) have a health problem or disability that prevents you from working or participating in training activities or that limits the kind or amount of work you can do?

INTERVIEWER: IF R ASKS, THE DEFINITION OF FAMILY IS LIMITED TO THOSE IN THEIR HOUSEHOLD.

1 YES

2 NO

7 DON’T KNOW

8 REFUSED

CATI: IF I3 = 2, 7, OR 8, GO TO I6.

CATI: ALLOW MULTIPLE RESPONSES FOR I4.

CATI: IF D4a = 1, FILL I4 WITH CODE “1” (RESPONDENT)

I4. Who has a health problem or disability - you, a child, or someone else in your family? Anyone else?

(INTERVIEWER: ENTER ALL THAT APPLY.)

1 RESPONDENT

2 CHILD

3 SOMEONE ELSE

7 DON’T KNOW

8 REFUSED

I5. Question Deleted.

I6. The next questions are about how you have been feeling during the past 30 days. About how often during the past 30 days did you feel nervous – would you say all of the time, most of the time, some of the time, a little of the time, or none of the time?

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

I7. During the past 30 days, about how often did you feel hopeless – all of the time, most of the time, some of the time, a little of the time, or none of the time?

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

I8. During the past 30 days, about how often did you feel restless or fidgety? (INTERVIEWER: IF NECESSARY, REPEAT: all, most, some, a little, or none of the time?)

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

I9. How often did you feel so depressed that nothing could cheer you up? (INTERVIEWER: IF NECESSARY, REPEAT: all, most, some, a little, or none of the time?)

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

I10. During the past 30 days, about how often did you feel that everything was an effort? (INTERVIEWER: IF NECESSARY, REPEAT: all, most, some, a little, or none of the time?)

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

I11. During the past 30 days, about how often did you feel worthless? (INTERVIEWER: IF NECESSARY, REPEAT: all, most, some, a little, or none of the time?)

1 ALL

2 MOST

3 SOME

4 A LITTLE

5 NONE

7 DON’T KNOW

8 REFUSED

CATI: RECORD END TIME

SECTION J: CHILD OUTCOMES

CATI: IF NO CHILD PROVIDED IN SAMPLE, THEN SKIP TO NEXT SECTION.

CATI: INSERT NAME, AGE, DOB VARIABLES FROM SAMPLE IN CHART BELOW FOR CHILD.

CATI: RECORD START TIME

J1. The rest of the interview will turn more toward topics like the family and raising children. From information recorded when the project began, we have randomly selected a school-age child. First, I have a few questions about that child.

CATI: DISPLAY CHART.

	NAME	DOB	RA AGE	AGE NOW	SEX		DECEASED
J1a. CHILD				[RANGE =5 – 19]	1 F	2 M	1 YES

[DOB RANGE: MONTH = 1 – 12

DAY = 1–31 YEAR = 1986 – 2000]

J1_1. The child who was selected is: INTERVIEWER: USE AGE, NAME, OR DOB TO IDENTIFY CHILD.

CATI: PRESENT FOLLOWING QUESTIONS FOR MISSING VARIABLES.

IF NAME MISSING: What is this child’s name?

INTERVIEWER: IF R REFUSES TO PROVIDE FULL NAME, SAY: Can you tell me at least the child’s first name or initial?

IF DOB MISSING: What is this child’s date of birth?

INTERVIEWER: IF R IS RELUCTANT TO PROVIDE THE CHILD’S DOB, ATTEMPT TO COLLECT AT LEAST THE MONTH AND THE YEAR.

CATI: What is the month and year of the child’s date of birth?

INTERVIEWER: IF R RELUCTANT TO GIVE CHILD’S DOB, SAY: Children develop so quickly. Because of that, it is important for us to capture the exact age of your child.

CATI: How old is this child now? CATI: ENTER THIS AGE IN “AGE NOW” COLUMN AND USE THIS FOR AGE QUALIFICATION.

CATI: Ask: Is this child male or female?

INTERVIEWER: RECORD MISSING INFORMATION IN CHART. DO NOT ASK ABOUT DECEASED STATUS. RECORD “YES” (1) IF R REPORTS THAT CHILD IS DECEASED.

INTERVIEWER: CAN RESPONDENT IDENTIFY CHILD, ALLOWING YOU TO PROCEED WITH QUESTIONS ABOUT THAT CHILD?

1. YES (CONTINUE)

2. NO (GO TO NEXT SECTION)

9 R CAN’T ANSWER QUESTIONS (NO CUSTODY/CONTACT) (GO TO NEXT SECTION)

CATI: ALLOW INTERVIEWER TO GO TO NEXT SECTION AT ANY REMAINING QUESTION IN THIS SECTION BECAUSE R CANNOT ANSWER QUESTIONS BECAUSE HE/SHE DOESN’T HAVE CUSTODY OF OR CONTACT WITH CHILD – SIMILAR TO CODE 9 ABOVE.

The following questions concern [CHILD]’s current school situation.

CATI: USE NAME OF CHILD FROM CHART FOR TEXT FILL.

J2_1. Is (CHILD) currently enrolled in and attending school? (INTERVIEWER: IF SUMMER ASK, Did (CHILD) attend school during the past school year?) (INTERVIEWER: IF CHILD IS OUT SICK, BUT WILL BE RETURNING, RECORD “1” FOR “YES.”)

1 YES (GO TO J4_1)

2 NO (GO TO J3_1)

7 DON’T KNOW (GO TO J4_1)

8 REFUSED (GO TO J4_1)

J3_1. Why is (CHILD) not attending school?

01 DROPPED OUT (GO TO J5)

02 HOME SCHOOLED (GO TO J4_1)

03 GRADUATED HIGH SCHOOL (GO TO J5)

04 ON VACATION OR BREAK (GO TO J4_1)

05 NOT STARTED SCHOOL YET (GO TO J9)

95 OTHER (SPECIFY): ___________________ (GO TO J4_1)

97 DON’T KNOW (GO TO J5)

98 REFUSED (GO TO J5)

J4_1. And what grade is (CHILD) in? (INTERVIEWER: IF SUMMER ASK: What grade did (CHILD) attend in the past school year? And what grade did (CHILD) just complete?)

_________ [RANGE = 0 – 13, 97, 98]

GRADE

KINDERGARTEN = 0

POST HIGH SCHOOL = 13

97 DON’T KNOW

98 REFUSED

J5. At any time since (RAD), has (CHILD) ever…

J5a_1. Received special education because of a physical, emotional, behavioral, or learning problem?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J5b_1. Repeated a grade, including kindergarten?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

IF CHILD NOT IN SCHOOL (J2_1=2) AND J3_1, NE 4, THEN SKIP TO J7.

The following questions are about how your child is doing in general.

J6a-J6a_4. Questions Deleted.

J6a_5. Based on your knowledge of (CHILD)’s school work, including the most recent report card, how is (CHILD) doing overall? (INTERVIEWER: IF SUMMER, ASK: How did (CHILD) do overall “during the last school year.”) Would you say:

1 Not well at all,

2 Below average,

3 Average,

4 Well, or

5 Very well?

7 DON’T KNOW

8 REFUSED

J7. I am going to read a list of situations that some children may experience. Not all of these may apply to younger children. At any time since (RAD), has (CHILD) ever had any of the following problems?

J7a_1. Being suspended from school?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J7b_1. Being expelled from school?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

CATI: IF CHILD IS NOT 12 OR OLDER IN “AGE NOW” COLUMN, GO TO Jf_1. ELSE ASK J7c_1.

J7c_1. Having to go to juvenile court?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J7d_1. Having a problem with alcohol or drugs?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J7e_1. Getting into trouble with the police?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J7f_1. Had any behavior that is hard to control?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

CATI: IF CHILD IS NOT 12 OR OLDER IN “AGE NOW” COLUMN, GO TO CATI INSTRUCTION BEFORE J9.

CATI: IF J3 _1 =1, MARK J7g_1 WITH A “1.”

J7g_1. Dropping out of school before graduating?

1 YES

2 NO

7 DON'T KNOW

8 REFUSED

J8 through J8b_3. Questions Deleted

CATI: CONTINUE IF CHILD 12 YEARS OR YOUNGER. ELSE GO TO NEXT SECTION.

J9. Now, I would like to ask you about child care arrangements for (CHILD).

J9a_1. Last month, did anyone besides you regularly take care of (CHILD) at least 10 hours a week, like a relative, sitter, child care center, or family day care home? Please don’t include any time spent in kindergarten, first grade, or higher during the regular school day.

1 YES

2 NO (GO TO NEXT SECTION)

7 DON'T KNOW (GO TO NEXT SECTION)

8 REFUSED (GO TO NEXT SECTION)

J9b_1. Who usually took care of (CHILD) at least once a week last month? PROBE: Who else?

RECORD ALL THAT APPLY.

02 CHILD’S OTHER BIOLOGICAL PARENT

03 CHILD’S STEPPARENT/R’S SPOUSE/ PARTNER

04 CHILD’S GRANDPARENT

05 CHILD’S SIBLING/HALF SIBLING

06 CHILD’S OTHER RELATIVE

07 BABYSITTER OR NON-RELATIVE IN CHILD’S HOME

08 FAMILY DAY CARE OR NON-RELATIVE IN ANOTHER HOME

09 PRESCHOOL, NURSERY SCHOOL, OR DAY CARE CENTER

10 HEAD START

11 EXTENDED BEFORE/AFTER SCHOOL PROGRAM

12 SUMMER CAMP

95 OTHER (SPECIFY): ___________________

97 DON’T KNOW

98 REFUSED

CATI: IF ONLY ONE ANSWER IN J9b_1, GO TO J9d_1.

CATI: ONLY PRESENT ANSWERS REPORTED IN J9b_1.

J9c_1. Of those you mentioned, who usually took care of (CHILD) for the most hours last month? Please exclude time spent in kindergarten, first grade, or higher during the regular school day.

02 CHILD’S OTHER BIOLOGICAL PARENT

03 CHILD’S STEPPARENT/R’S SPOUSE/ PARTNER

04 CHILD’S GRANDPARENT

05 CHILD’S SIBLING/HALF SIBLING

06 CHILD’S OTHER RELATIVE

07 BABYSITTER OR NON-RELATIVE IN CHILD’S HOME

08 FAMILY DAY CARE OR NON-RELATIVE IN ANOTHER HOME

09 PRESCHOOL, NURSERY SCHOOL, OR DAY CARE CENTER

10 HEAD START

11 EXTENDED BEFORE/AFTER SCHOOL PROGRAM

12 SUMMER CAMP

95 OTHER (SPECIFY): ___________________

97 DON’T KNOW

98 REFUSED

CATI: USE TEXT FILL IN PARENTHESES WHEN MORE THAN ONE ARRANGEMENT IN J9b_1.

J9d_1. During a typical week, how many hours altogether is (CHILD) being regularly taken care of in (all) the arrangement(s) you just mentioned? PROBE: Please exclude any time spent in kindergarten, first grade, or higher during the regular school day. Your best estimate is fine.

______ [RANGE = 1 – 90, 97, 98]

HOURS

CATI: RECORD END TIME

SECTION K: CONTACT INFORMATION

CATI: RECORD START TIME

Those are all the questions I have to ask you today. Thank you for the time you’ve spent talking with me and for your participation in this study. In order to send your gift, I need to confirm your name and address.

K1. I have your full name listed as (CATI: DISPLAY NAME) spelled as (INTERVIEWER: SPELL NAME). Is that correct? INTERVIEWER: IF R REFUSES, SAY: I will be unable to send your check.

1 YES

2 NO

8 REFUSED

CATI: IF K1 = 1, GO TO K2. IF K1 = 8, GO TO END. ELSE PROVIDE TEXT BOX FOR ENTRY OF CORRECTED NAME WHILE ORIGINAL NAME IS DISPLAYED FOR COMPARISON PURPOSES.

K1a. INTERVIEWER: ENTER CORRECTED NAME.

K2. Is this your current address? (CATI: DISPLAY ORIGINAL ADDRESS) INTERVIEWER: READ ADDRESS TO R, SPELLING EACH WORD.

1 YES

2 NO

8 REFUSED

CATI: IF K2 = 1 OR 8, GO TO K2b. ELSE PROVIDE TEXT BOX FOR ENTRY OF CORRECTED ADDRESS WHILE ORIGINAL ADDRESS IS DISPLAYED FOR COMPARISON PURPOSES.

K2a. INTERVIEWER: ENTER CORRECTED ADDRESS. READ BACK THE ADDRESS INFORMATION TO R, SPELLING THE WORDS.

K2b. INTERVIEWER: Is there another address you would like me to use to send your gift?

1 YES

2 NO

8 REFUSED

CATI: IF K2b = 2, 8, GO TO K3. ELSE PROVIDE TEXT BOX FOR ENTRY OF SUPPLEMENTAL ADDRESS WHILE ORIGINAL ADDRESS IS DISPLAYED FOR COMPARISON PURPOSES.

K3. I also need to confirm your phone number in case we have any questions about the interview. (CATI: DISPLAY ORIGINAL PHONE NUMBER) INTERVIEWER: READ THE PHONE NUMBER. Is this correct?

1 YES

2 NO

8 REFUSED

CATI: IF K3 = 1 OR 8, GO TO K4. ELSE PROVIDE TEXT BOX FOR ENTRY OF CORRECTED PHONE NUMBER. DISPLAY ORIGINAL PHONE NUMBER FOR COMPARISON PURPOSES.

K3a. INTERVIEWER: ENTER CORRECTED PHONE NUMBER. READ BACK TO R TO CONFIRM.

K4. Question Deleted.

Thank you very much for your time and assistance. [CATI: PHONE CENTER INITIATED CALL (1X = 3), INSERT “Your gift should be mailed out to you in the next two to three weeks.”]. If you have any questions about the study or your check, you can contact Vivian Loik of HumRRO, the company in charge of conducting this survey. Her toll-free number is 1-800-256-4170.

[CATI: IF TRACKER-BASED INTERVIEW (1X = 1), INSERT “Would you please put our field staff person back on the phone? Thank you!” ELSE, INSERT “Thank you! Have a nice day!”]

END

CATI: RECORD END TIME

38