Form 1 MLP + Quantitative Semi-Annual Report

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Overview

PRA Statement
Direct Services Overview
Legal Case Work
Social Service Referrals
Partners
Events
Outcomes
Individual Characteristics
Household Characteristics

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Sheet 1: PRA Statement

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Sheet 2: Direct Services Overview

Direct Services
Report Information
Grant Recipient Name
Start Date for Reporting Period
End Date for Reporting Period
Please report the following information for all individuals referred to or screened by the MLP for legal/social needs.
	# of unduplicated individuals this reporting period	# of unduplicated individuals since the start of the grant	Notes
Total number of individuals referred for MLP+ services (Enter the total number of individuals who were referred by health care or other partners for MLP services)
Total number of individuals receiving at least one intake interview for MLP legal or social services (Enter the total number of individuals who met with any MLP staff for an intake interview)
Total number of individuals receiving intake interviews who did not receive MLP services (Enter total number of individuals who did not receive any legal or social services from the MLP after intake)			List primary reasons individuals did not receive MLP services:
Individuals Served
	# of unduplicated individuals this reporting period	# of unduplicated individuals since the start of the grant	Notes
Total number of individuals receiving case services who received any level of legal services (Enter the total number of low-income individuals who received brief or extended legal services)
Total number of individuals receiving any level of social services including brief (e.g., social service consultation, assistance filling out a form, assistance with a referral for wraparound services etc.) and intensive services (e.g., case management/service navigation/other services that provide ongoing, individualized assistance to comprehensively address an individual's or family's unique needs) (Enter the number of low-income individuals that received brief or intensive social services during the requested reporting period)

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Sheet 3: Legal Case Work

Direct Services - Legal Cases
Case Services
For case services, please track open, ongoing, and closed cases, which represent the provision of MLP+ services to low-income individuals to address a legal problem. For each case that closed this reporting period, please report the type of legal services provided and the type of problem addressed. Additionally, please provide the type of legal problem that is being addressed in each case that remains open at the end of the reporting period.
In column B, please report the following information for services provided by the MLP this reporting period. In column C, please report the following information for the services provided by MLP+ funding this reporting period. Information provided in column C must include services and activities supported only with MLP+ funds either through a direct count for services funded only with MLP+ funds or based on a proportional analysis for services supplemented with MLP+ funds and also funded through other sources.
Cases	# of cases for the MLP	# of MLP+ funded cases	Notes
Total number of new cases opened this reporting period
Total number of ongoing cases continuing from last reporting period
Total number of cases closed this reporting period
Legal service types for closed cases (report each case only once for highest level of service)	# of closed cases for the MLP	# of closed MLP+ funded cases	Notes
Brief service (cases involving only limited services, e.g., counsel/advice, communicating with third party by phone or letter, simple legal document preparation) (Enter the number of closed cases that only received brief services)
Extended service (cases requiring longer-term/more in-depth services, e.g., negotiated settlements, court appearances, preparation of highly complex documents) (Enter the number of closed cases that received extended services)
Legal problems for closed cases	Total # of closed cases for MLP	Total # of closed cases with MLP+ funding	Notes
Income maintenance (TANF; Social Security; food stamps; SSDI; SSI, unemployment compensation; veterans’ benefits; state and local income maintenance)
Housing Federally subsidized housing; homeownership/real property; private landlord/tenant; public housing; mobile homes; housing discrimination; mortgage foreclosure; mortgage predatory lending practices
Education Discipline; special education/learning disabilities; access; vocational education; student financial aid
Employment Employment discrimination; wage claims and other FLSA issues; EITC and taxes, employment rights, agricultural worker issues (not wage claims/FLSA issues)
Family and Children Adoption; custody/visitation; divorce/separation/annulment; adult guardian/conservatorship; parental rights termination; paternity; domestic abuse; support; delinquent juveniles; neglected/abused dependent; emancipation; minor guardianship
Individual rights Immigration/naturalization ; mental health, disability rights, civil rights, human trafficking, criminal record expungement
Consumer/financial Bankruptcy/debtor relief; collection; contracts/warranties; collection practices; predatory lending; loans/installment purchase; public utilities; unfair and deceptive sales and practices
Health Medicaid; Medicare; CHIP; home and community based care; private health insurance; long-term health care facilities; state and local health
Other Tribal law; licenses; wills/estates; advance directives/powers of attorney; torts
Legal problems for open cases	Total # of open cases for MLP	Total # of open cases with MLP+ funding	Notes
Income maintenance (TANF; Social Security; food stamps; SSDI; SSI, unemployment compensation; veterans’ benefits; state and local income maintenance)
Housing Federally subsidized housing; homeownership/real property; private landlord/tenant; public housing; mobile homes; housing discrimination; mortgage foreclosure; mortgage predatory lending practices
Education Discipline; special education/learning disabilities; access; vocational education; student financial aid
Employment Employment discrimination; wage claims and other FLSA issues; EITC and taxes, employment rights, agricultural worker issues (not wage claims/FLSA issues)
Family and Children Adoption; custody/visitation; divorce/separation/annulment; adult guardian/conservatorship; parental rights termination; paternity; domestic abuse; support; delinquent juveniles; neglected/abused dependent; emancipation; minor guardianship
Individual rights Immigration/naturalization ; mental health, disability rights, civil rights, human trafficking, criminal record expungement
Consumer/financial Bankruptcy/debtor relief; collection; contracts/warranties; collection practices; predatory lending; loans/installment purchase; public utilities; unfair and deceptive sales and practices
Health Medicaid; Medicare; CHIP; home and community based care; private health insurance; long-term health care facilities; state and local health
Other Tribal law; licenses; wills/estates; advance directives/powers of attorney; torts

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Sheet 4: Social Service Referrals

Social Services Referrals (OPTIONAL)
Please complete the table below for referrals made for individuals or families receiving services supported by MLP+ during the reporting period . In column A, list the service type for referrals; In column B, specify the total number of referrals for that service. In column C, select the category that most closely aligns with the service types. Provide notes in column D about what kind of services were provided, if needed. The first two lines are examples and should be deleted before completion.
Service type	Number of referrals made this reporting period	Category of Referral (select one:)	Notes		Definitions: Employment services: include the provision of skills training and job readiness opportunities for youth and adults (including vocational training, apprenticeships, and self-employment), the distribution of employment supplies (such as uniforms, work boots, and equipment), and services aimed at supporting employment retention and growth (such as referrals, employer interactions, and career pathways). Education and development services for youth: include Early Head Start services for individuals aged 0-3, Head Start services for individuals aged 3-5, childcare subsidies or payments, early childhood education for ages 0-5 outside of Head Start, K-12 support services (e.g., English, literacy), young adult literacy classes, and college/post-secondary readiness support (e.g., applications, scholarships). Additionally, they encompass the provision of school supplies, participation in before and after-school activities, summer youth programs, life skills coaching, and home visiting programs, as well as adult education programs such as literacy, English language, high school equivalency, and applied technology classes." Education and development services for adults: include adult literacy classes, English language instruction, basic education (e.g., financial literacy), high school equivalency programs, and applied technology courses. These services also include life skills coaching, access to employment readiness support, and participation in social programs such as childcare subsidies, housing assistance, and workforce development initiatives. Additionally, services may provide resources for post-secondary education readiness (e.g., applications, scholarships, and textbooks) and evidence-based home visiting programs to support family stability and growth. Income and asset building services: include training and counseling to support income management and asset growth, such as credit repair, financial literacy, budgeting, homebuying, and foreclosure prevention, as well as business and entrepreneurial financial services like micro-loans, business development loans, and entrepreneurial support. Additionally, these services offer benefit coordination and advocacy for programs like child support, health insurance, SSI, Veterans benefits, TANF, and SNAP. Transportation services that facilitate access to income and asset-building opportunities, such as bus vouchers or passes to attend training, are also included. Housing services: include rental payment assistance (e.g., emergency rental payments and deposits) and housing payment assistance for down payments or emergency mortgage payments. These services also provide eviction prevention through counseling, landlord/tenant mediation, and utility payment assistance. Housing placement and rapid re-housing services support individuals in securing temporary, transitional, or permanent housing. Additionally, services include housing maintenance and improvements (e.g., structural repairs, accessibility upgrades, emergency home repairs) and weatherization services to enhance energy efficiency and safety in households. Health services: include immunizations, health screenings (e.g., physicals and chronic health assessments), and developmental delay screenings. These services also provide healthcare payment assistance for seniors (e.g., prescription and doctor visit payments) and health insurance counseling. Additionally, they cover maternal and child health services (e.g., breastfeeding support and postpartum care), reproductive health services (e.g., family planning and STI prevention), general wellness services (e.g., fitness, mindfulness, and medication management), home visits for older adults, participation in senior centers, mental and behavioral health services (e.g., substance use counseling, mental health support, domestic violence prevention), and dental services for both adults and children (e.g., screenings, exams, and procedures). Nutrition services: include food and nutrition skills classes (e.g., cooking and healthy eating), the distribution of prepared meals (e.g., Meals on Wheels, congregate sites), and food distribution services (e.g., groceries and food share programs). These services also support community gardening activities and provide emergency hygiene and clothing assistance, including hygiene kits, diapers, and access to hygiene facilities (e.g., showers and laundry). Transportation services: include public transportation vouchers or passes, gas cards, and non-medical transportation assistance. Additionally, these services offer medical transportation for healthcare-related needs and rideshare or taxi vouchers to ensure access to essential appointments and services.
		o Employment services
		o Education and development services for youth
		o Education and development services for adults
		o Income and asset building services
		o Housing services
		o Health services
		o Nutrition services
		o Transportation services
		o Other services (please specify in Notes column)
Example: Food pantry	72	Nutrition services
Example: Head Start	25	Education and development services for youth

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Sheet 5: Partners

Partnerships for MLP+ Grant Program
Use this form to report information about partners involved in the MLP+ program this reporting period. Partnerships may be formal or informal partnerships that support delivery of services for this grant.
Partner name	Was the partnership established prior to the start of the MLP+ grant project?	Partnership Start Date (MM/YYYY) for new partners (you may enter N/A for partnerships started prior to the start of the grant)	Types of Services Partner Will Provide to MLP+ Participants [Select all that apply: legal, employment, education and development for youth, education and development for adults, income and asset building, , housing, health, nutrition, transportation,, other (please describe in "Other Notes" section)]	How does the MLP+ project support the activities and objectives of the partner	How does this partnership support the activities and objectives of the MLP+ project?	Other Notes

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Sheet 6: Events

Events
Use this form to report information about events your organization has hosted or co-hosted this reporting period with support from the MLP+ grant funding.
Event Date (MM/DD/YYYY)	Was this event a training?	Title of Event	Description of Event	Purpose (e.g., training, community education, patient outreach, community collaboration)	Target Audience (e.g., medical providers, social service providers, patients, community organizations)	# of Attendees	Is this event part of a series? If yes, please list the series name.	Other Notes

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Sheet 7: Outcomes

Outcomes (OPTIONAL)
Use this form to report your organization’s administrative data on outcomes for cases closing during the reporting period that received extended services and were supported by MLP+ grant funding
General Outcomes
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Provided knowledge of how to address the legal problem
Assistance provided improved client or household member health
OTHER (Please describe in Notes column)
Income Maintenance
TANF; Social Security; food stamps; SSDI; SSI, unemployment compensation; veterans benefits; state and local income maintenance
Detailed Outcomes for Income Maintenance
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Obtained, preserved, or increased income benefits (TANF, SSI, SSDI, SNAP, Unemployment, Workers Comp, Veteran, etc.)
Overcame denial of emergency assistance
Obtained assistance with business start/development
Reduced or waived overpayment or debt
Stopped financial exploitation of client by payee or other familiar
Obtained favorable payment schedule
Obtained other monetary relief
OTHER (Please describe in Notes column)
Summary Outcomes for Income Maintenance
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Housing
Federally subsidized housing; homeownership/real property; private landlord/tenant; public housing; mobile homes; housing discrimination; mortgage foreclosure; mortgage predatory lending practices
Detailed Outcomes for Housing
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Prevented eviction from public housing
Prevented eviction from private housing
Delayed eviction providing time to seek alternative housing
Avoid or delay foreclosure or other loss of home
Obtained access to housing
Obtained or retained participation in subsidized housing
Obtained favorable payment schedule
Obtained modification of a loan
Obtained monetary relief
Avoided, or obtained redress for, charges by landlord
Avoided motion for attorney fees award against client
Improved housing stability
Remedied unsafe housing
Obtained repairs, improved housing conditions, or otherwise enforced rights to decent habitable housing
Preserved or restored access to personal property
Enforced tenant rights
OTHER (Please describe in Notes column)
Summary Outcomes for Housing
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Education Outcomes
Discipline; special education/learning disabilities; access; vocational education; student financial aid
Detailed Outcomes for Education
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Returned or kept student in school
Overcame barrier to enrollment in school
Avoided or delayed or reduced length of suspension
Obtained individualized education program and/or appropriate services
Obtained correction of school records
Avoided inappropriate special education classification
Protected confidential information
Protected student safety
Obtained or increased education programming
Avoided motion for attorney’s fees for client
OTHER (Please describe in Notes column)
Summary Outcomes for Education
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Employment Outcomes
Employment discrimination; wage claims and other FLSA issues; EITC and taxes, employment rights, agricultural worker issues (not wage claims/FLSA issues)
Detailed Outcomes for Employment
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Increased or maintained wages or back pay
Delayed discharge
Overcame, or obtained redress for, job discrimination
Prevented, avoided, or obtained redress for wrongful discharge
Secured damages for illegal job action
Reduced or avoided garnishment or attachment
Obtained or enrolled in training/education
Resolved on-the-job issues (e.g., safety/grievance)
Avoided motion for attorney’s fees for client
OTHER (Please describe in Notes column)
Summary Outcomes for Employment
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Family and Child Outcomes
Adoption; custody/visitation; divorce/separation/annulment; adult guardian/conservatorship; parental rights termination; paternity; domestic abuse; support; delinquent juvenile, neglected/abused dependent; emancipation; minor guardian/conservatorship
Detailed Outcomes for Family and Child
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Improved client safety or safety of household members
Eliminated or reduced risk to children
Improved family stability
Obtained order of protection
Obtained order for financial responsibilities
Obtained divorce, separation, or annulment
Addressed abuse or neglect an elder
Prevented guardianship/conservatorship for adult
Obtained guardianship/conservatorship for adult
Obtained/modified parenting plan
Preserved/obtained parental rights
Obtained/preserved right of visitation
Avoided protective order/removal of children
Obtained guardianship or retained guardianship for a child
Prevented or ended guardianship for a child
Obtained adoption
Obtained permanent living situation for a child
Avoided or reversed findings of child abuse/neglect
Obtained foster care services
Improved terms of foster care plan
Obtained emancipation
Avoided motion for attorney’s fees for client
OTHER (Please describe in Notes column)
Summary Outcomes for Family and Child
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Individual Rights
Immigration/naturalization; mental health, disability rights, civil rights, human trafficking, criminal record expungement
Detailed Outcomes for Individual Rights
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Secured safety (e.g., for crime, human trafficking survivor)
Obtained, preserved, or improved rights of disabled persons
Obtained, preserved, or improved rights of institutionalized persons
Improved access for people with disabilities
Obtained tort relief under civil rights claim
Obtained relief, or redress from, constitutional violation
Obtained administrative relief from misconduct
Obtained citizenship
OTHER (Please describe in Notes column)
Summary Outcomes for Individual Rights
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Consumer/Financial
Bankruptcy/debtor relief; collection; contracts/warranties; collection practices; predatory lending; loans/installment purchase; public utilities; unfair and deceptive sales and practices
Detailed Outcomes for Consumer/Financial
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Reduced or avoided debt, dispute, garnishment, attachment, or loss of personal property
Recovered money or item owed to a client
Protected client from illegal creditor harassment
Overcame fraudulent sales practices
Overcame predatory lending practices
Obtained or restored utilities or avoided or delayed termination of utilities
Obtained federal bankruptcy protection
Obtained insurance (other than health or disability)
Obtained positive change to client’s credit report
Obtained favorable payment schedule
Improved client financial stability
Avoided motion for attorney’s fees for client
OTHER (Please describe in Notes column)
Summary Outcomes for Consumer/Financial
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Health
Medicaid; Medicare; CHIP; home and community based care; private health insurance; long-term health care facilities; state and local health
Detailed Outcomes for Health
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Obtained, preserved or increased Medicaid, CHIP, or Medicare
Obtained, preserved, or increased other health coverage
Obtained, preserved, or increased individual access to health care
Protected confidential health information
Improved institutional care
Obtained discharge from nursing home, assisted living facility, or mental health treatment
Stopped, or obtained redress for, harmful medical treatment
Obtained order for financial responsibilities
Avoided motion for attorney’s fees for client
OTHER (Please describe in Notes column)
Summary Outcomes for Health
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome
Other Outcomes
Tribal law; licenses; wills/estates; advance directives/powers of attorney; torts
Detailed Outcomes for Other
Outcome	Successful	Unsuccessful	Partially Successful	Not raised	Raised, but outcome unknown	Notes
Obtained a will
Obtained living will and/or health proxy or power of attorney
Settled estate
Obtained other monetary relief
Avoided or reduced tort liability or judgment
Solved a tax problem
Overcame taking of, or restriction of, driver’s license
Corrected criminal history records
OTHER (Please describe in Notes column)
Summary Outcomes for Other
TOTAL cases achieving a successful outcome in this category
TOTAL cases achieving a successful or partially successful outcome in this category
TOTAL cases that sought to achieve an outcome in this category that are known to not have achieved a successful or partially successful outcome
TOTAL cases that sought to achieve an outcome in this category without a known outcome

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Sheet 8: Individual Characteristics

Individual Characteristics (OPTIONAL)

Please use your administrative data to report the following information for focal clients in a case (e.g., a named client for a legal case, benefits applicant, etc.). For cases involving multiple clients, please choose a focal client considering who will benefit from the case or who your program will work with most frequently. Please report these data for clients involved in MLP+ cases closing October 1, 2025 – March 31, 2025

Individual characteristics

Item

Number

Notes

Total number of focal clients for MLP+ cases closing October 1, 2025 – March 31, 2025

Sex

Male

Female

Unknown

Disability status

Disabled

Non-disabled

Unknown

Veteran status

Veteran

Non-veteran

Unknown

Race/ethnicity

Asian

Black or African American

Hispanic or Latino

American Indian or Alaska Native

Middle Eastern or North African

White

Another racial/ethnic identity

Unknown

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Sheet 9: Household Characteristics

Individual Characteristics (OPTIONAL)
Please use administrative data to provide the following household characteristics for MLP+ clients with closed cases between October 1, 2025 and March 31, 2026. You may use numbers identified at the time of enrollment in services. Provide the information you have if you have cases with incomplete information. Each case should have at least one individual reported for the household.
Item	Number	Notes
Total households
Total number of adults in households
Total number of children in households