Silicon Valley Guaranteed Income Project
Phase: NA
Conditions: Families Experiencing Homelessness and/or Housing Instability, Housing Stability
Sponsor: University of California, San Francisco

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 1 of 33 
Protocol Template Effective: 07 JAN 2015  
 
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 
Clinical Research Protocol 
SILICON VALLEY GUARANTEED INCOME PILOT PROTOCOL 
Protocol Number: 
V1.4 
Version Date: 
11/27/2022 
Investigational Product: 
N/A 
IND Number: 
N/A 
Development Phase: 
N/A 
Sponsor: 
 
 
Oanh Kieu Nguyen, MD, MAS 
1001 Potrero Ave, Box 0862 
San Francisco, CA 94110 
Funding Organization: 
UCSF Benioff Homelessness & Housing Initiative 
Principal Investigator: 
Name: Oanh Kieu Nguyen, MD, MAS 
 
Telephone: 
628-206-3755 
Fax: 
 
 
E-mail: 
oanh.nguyen@ucsf.edu 
Medical Monitor: 
N/A 
Coordinating Center: 
N/A 
 
Approval: 
 
 
 
PI or Sponsor Signature (Name and Title)  
 
Date 
This confidential information about an investigational product is provided for the exclusive use of 
investigators of this product and is participant to recall at any time.  The information in this 
document may not be disclosed unless federal or state law or regulations require such disclosure.  
Participant to the foregoing, this information may be disclosed only to those persons involved in the 
study who have a need to know, with the obligation not to further disseminate this information.   

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 2 of 33 
Protocol Template Effective: 07 JAN 2015  
PROTOCOL AGREEMENT 
 
I have read the protocol specified below. In my formal capacity as Investigator, my duties 
include ensuring the safety of the study participants enrolled under my supervision, as 
outlined in the protocol.  It is understood that all information pertaining to the study will 
be held strictly confidential and that this confidentiality requirement applies to all study 
staff at this site. Furthermore, on behalf of the study staff and myself, I agree to maintain 
the procedures required to carry out the study in accordance with accepted GCP principles 
and to abide by the terms of this protocol. 
 
Protocol Number:  v1.4 
 
Protocol Title:  SILICON VALLEY GUARANTEED INCOME PILOT PROTOCOL 
 
Protocol Date:  10/28/22 
 
 
 
 
Investigator Signature  
 
Date 
 
Print Name and Title 
Site # 
 
 
Site Name 
 
Address 
 
 
 
 
 
 
 
Phone Number 
 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 3 of 33 
Protocol Template Effective: 07 JAN 2015  
TABLE OF CONTENTS 
 
1 
BACKGROUND ................................................................................................................. 4 
1.1 
Overview of Non-Clinical Studies .............................................................................. 8 
1.2 
Overview of Clinical Studies
 
Error! Bookmark not defined. 
2 
STUDY RATIONALE ........................................................................................................ 9 
2.1 
Risk / Benefit Assessment ........................................................................................... 9 
3 
STUDY OBJECTIVES ....................................................................................................... 10 
3.1 
Primary Objective ....................................................................................................... 10 
3.2 
Secondary Objectives .................................................................................................. 10 
4 
STUDY DESIGN ................................................................................................................. 10 
4.1 
Study Overview ........................................................................................................... 10 
5 
CRITERIA FOR EVALUATION ..................................................................................... 11 
5.1 
Primary Efficacy Endpoint .......................................................................................... 11 
5.2 
Secondary Efficacy Endpoints .................................................................................... 11 
6 
PARTICIPANT SELECTION .......................................................................................... 13 
6.1 
Study Population ......................................................................................................... 13 
6.2 
Inclusion Criteria ......................................................................................................... 13 
6.3 
Exclusion Criteria ........................................................................................................ 14 
7 
CONCURRENT INTERVENTIONS ............................................................................... 14 
8 
STUDY TREATMENTS .................................................................................................... 14 
8.1 
Method of Assigning Participants to Treatment Groups ............................................. 14 
8.2 
Blinding ....................................................................................................................... 14 
9 
STUDY PROCEDURES AND GUIDELINES ................................................................. 15 
9.1 
Clinical Assessments ................................................................................................... 15 
10 EVALUATIONS BY VISIT ............................................................................................... 16 
10.1 Visit/Assessment 1 (Baseline) ..................................................................................... 16 
10.2 Visit/Assessment 2 (Month 6) ..................................................................................... 17 
10.3 Visit/Assessment 3 (Month 12) ................................................................................... 18 
10.4 Visit/Assessment 4 (Month 18) ................................................................................... 18 
10.5 Visit/Assessment 5 (Month 24) ................................................................................... 18 
10.6 Visit/Assessment 6 (Month 27) ................................................................................... 18 
10.7 Visit/Assessment 7 (Month 30) ................................................................................... 18 
10.8 Visit/Assessment 8 (Month 36) ................................................................................... 18 
10.9 Quarterly Secure Message Service (SMS) Assessment Via Cell Phone ..................... 18 
10.10 12-Month Qualitative Interview Assessment (between months 6-12, subset of 40) .. 20 
10.11 24-Month Qualitative Interview Assessment (between months 18-24, subset of 40) 20 
10.12 Early Withdrawal Visit ............................................................................................... 20 
11 ADVERSE EXPERIENCE REPORTING AND DOCUMENTATION ....................... 21 
11.1 Adverse Events ............................................................................................................ 21 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 4 of 33 
Protocol Template Effective: 07 JAN 2015  
12 DISCONTINUATION AND REPLACEMENT OF PARTICIPANTS ......................... 24 
12.1 Early Discontinuation .................................................................................................. 24 
12.2 Withdrawal of Participants .......................................................................................... 24 
12.3 Replacement of Participants ........................................................................................ 24 
12.4 Study Interruptions Due to Specific Circumstances ................................................... 24 
13 PROTOCOL VIOLATIONS ............................................................................................. 25 
14 STATISTICAL METHODS AND CONSIDERATIONS ............................................... 26 
14.1 Data Sets Analyzed ..................................................................................................... 26 
14.2 Demographic and Baseline Characteristics ................................................................. 26 
14.3 Analysis of Primary Endpoint ..................................................................................... 26 
14.4 Analysis of Secondary Endpoints ............................................................................... 27 
14.5 Interim Analysis .......................................................................................................... 27 
14.6 Sample Size and Randomization ................................................................................. 27 
15 DATA COLLECTION, RETENTION AND MONITORING ....................................... 27 
15.1 Data Collection Instruments ........................................................................................ 27 
15.2 Data Management Procedures ..................................................................................... 28 
15.3 Data Quality Control and Reporting ........................................................................... 28 
15.4 Archival of Data .......................................................................................................... 28 
15.5 Availability and Retention of Investigational Records ............................................... 28 
15.6 Monitoring ................................................................................................................... 29 
15.7 Participant Confidentiality .......................................................................................... 29 
16 ADMINISTRATIVE, ETHICAL, REGULATORY CONSIDERATIONS .................. 29 
16.1 Protocol Amendments ................................................................................................. 29 
16.2 Institutional Review Boards and Independent Ethics Committees ............................. 30 
16.3 Informed Consent Form .............................................................................................. 30 
16.4 Publications ................................................................................................................. 31 
16.5 Investigator Responsibilities ....................................................................................... 31 
 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 5 of 33 
Protocol Template Effective: 07 JAN 2015  
LIST OF ABBREVIATIONS 
 
AE 
adverse event 
BIPOC 
Black, Indigenous and People of Color 
CFR 
Code of Federal Regulations 
CRF 
case report form 
DMC 
Data Monitoring Committee 
GCP 
Good Clinical Practice 
GI 
guaranteed income 
HIPAA 
Health Insurance Portability and Accountability Act of 1996 
ICF 
informed consent form 
ICH 
International Conference on Harmonisation 
IEC 
Independent Ethics Committee 
IRB 
Institutional Review Board 
PI 
Principal Investigator 
RRH 
Rapid Rehousing Assistance 
VI-SPDAT 
Vulnerability Index – Service Prioritization Decision Assistance Tool 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 6 of 33 
Protocol Template Effective: 07 JAN 2015  
PROTOCOL SYNOPSIS 
TITLE 
Silicon Valley Guaranteed Income Pilot 
SPONSOR 
 
FUNDING 
ORGANIZATION 
UCSF Benioff Homelessness and Housing Initiative 
NUMBER OF SITES 
1 
RATIONALE 
Homelessness is a national public health crisis in the United States. 
Over 600,000 people experience homelessness on any given night, 
with Black, Indigenous, and People of Color (BIPOC) 
disproportionately affected, and with the highest rates of 
homelessness in regions with high housing costs. Individuals 
experiencing homelessness have high rates of chronic physical and 
mental health conditions, are at higher risk for contracting, 
transmitting, and suffering complications from communicable 
illnesses, and more frequently need emergency and acute health 
services. The cumulative consequences of homelessness are massive 
human suffering and strain on essential public health and medical 
systems, which spend vast resources on treating the downstream 
health sequelae of chronic homelessness. Guaranteed income (i.e., 
unconditional cash transfer) is a promising intervention for reducing 
poverty and material hardship but there are few U.S.-based studies on 
guaranteed income overall, and none designed for alleviating 
homelessness. Thus, our objective is to assess the effect of guaranteed 
income on housing stability among individuals experiencing 
homelessness. 
STUDY DESIGN 
Randomized controlled trial 
PRIMARY OBJECTIVE 
Assess the effect of guaranteed income on receipt of stable housing 
SECONDARY 
OBJECTIVES 
Assess the effect of guaranteed income on the health and well-being 
of families experiencing homelessness 
NUMBER OF 
PARTICIPANTS 
300 
PARTICIPANT 
SELECTION 
CRITERIA 
Inclusion Criteria: 
Families with children experiencing homelessness in Santa Clara 
County 
 
Exclusion Criteria:  
Substantial/severe level of problematic substance use;  
Hazardous/harmful alcohol consumption and/or active and severe 
alcohol use disorder  

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 7 of 33 
Protocol Template Effective: 07 JAN 2015  
TEST PRODUCT, DOSE, 
AND ROUTE OF 
ADMINISTRATION 
A total of $24,000 will be disbursed to participants in the intervention 
group over a period of 24 months. 
CONTROL PRODUCT, 
DOSE AND ROUTE OF 
ADMINISTRATION 
Usual care 
DURATION OF 
PARTICIPANT 
PARTICIPATION AND 
DURATION OF STUDY 
Participants will be followed for 36 months after enrollment. 
Follow-up:  36 months (24 concomitant with period over which 
participants will be receiving guaranteed income, plus an 
additional 12 months after the end of guaranteed income 
payments). 
The total duration of the study is expected to be 48 months. 12 months 
for participant recruitment and 36 months for final participant follow-
up. 
CONCOMMITANT 
INTERVENTIONS 
Allowed: Any and all other federal, state, county, and 
local/community assistance services that are available to 
participants  
EFFICACY 
EVALUATIONS 
 
PRIMARY ENDPOINT 
Our primary endpoint is number of days experiencing homelessness  
SECONDARY 
ENDPOINTS 
• 
Time spent unsheltered and/or in unstable housing; physical, 
mental, social, financial well-being; use of health care and public 
assistance/social services 
STATISTICS 
Primary Analysis Plan 
We will conduct intention-to-treat analyses to assess our primary 
endpoint, including difference in numbers of days spent homeless 
using Poisson regression 
Rationale for Number of 
Participants 
Our community partner service organizations have resources to 
provide guaranteed income assistance to 150 families; we plan for a 
total of 300 participants to enable enrollment of a control group of 
equal size. 
 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 8 of 33 
Protocol Template Effective: 07 JAN 2015  
1 
BACKGROUND 
Homelessness is a national public health crisis in the United States. Over 600,000 people 
experience homelessness on any given night, with Black, Indigenous, and People of Color 
(BIPOC) disproportionately affected, and with the highest rates of homelessness in 
regions with high housing costs. Individuals experiencing homelessness have high rates of 
chronic physical and mental health conditions, are at higher risk for contracting, 
transmitting, and suffering complications from communicable illnesses, and more 
frequently need emergency and acute health services. The cumulative consequences of 
homelessness are massive human suffering and strain on essential public health and 
medical systems, which spend vast resources on treating the downstream health sequelae 
of chronic homelessness. Guaranteed income (i.e., unconditional cash transfer) is a 
promising intervention for reducing poverty and material hardship with a robust evidence 
base from studies conducted in developing countries. However, there are few U.S.-based 
studies on guaranteed income overall, and none published on the effectiveness of 
guaranteed income in alleviating homelessness.  
1.1 
Overview of Studies 
Conceptually, guaranteed income is simple: give a meaningful sum of money directly to 
people so they are empowered to make purchasing and investment decisions for their own 
well-being. This is in contrast to existing financial assistance programs to alleviate 
homelessness which demonstrate promising results but have significant limitations as 
follows: a) consist of brief periods of assistance; b) are restricted to direct housing-related 
needs such as rental assistance or moving and utility costs; c) lack flexibility and do not 
account for the complex and potentially idiosyncratic needs of different families; and d) 
are associated with high per-person administrative costs. 
 
Guaranteed income (i.e., unconditional cash transfer) is a promising intervention for 
reducing poverty and material hardship with a robust evidence base from studies 
conducted in low- and middle-income countries demonstrating decreased monetary 
poverty, decreased food insecurity, increased school attendance, increased savings, 
increased work participation, improved access to health care services, and improved child 
health. Despite the international evidence base, there are few published studies based in 
the U.S. or in other high-income countries on guaranteed income overall and none 
published on the effectiveness of guaranteed income in alleviating homelessness, though a 
number of pilot studies in a variety of settings and populations within the U.S. are 
currently pending. One study based in Vancouver, Canada assessed the impact of a single 
lump sum payment equivalent to $5,700 USD on time to housing; preliminary findings 
suggest that this form of cash assistance helped reduce time to stable housing and 
improved food security. A second study, the Denver Basic Income Project, will assess the 
impact of varying unconditional cash transfer payment strategies (monthly vs lump sum 
vs hybrid) on homelessness over a one-year period of payments; the study will start in 
Spring 2022. 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 9 of 33 
Protocol Template Effective: 07 JAN 2015  
2 
STUDY RATIONALE 
Although guaranteed income is a promising intervention for reducing poverty and material 
hardship, there are few U.S.-based studies on guaranteed income overall, and none 
published on the effectiveness of guaranteed income in alleviating homelessness. This 
study will be among the first studies of guaranteed income among families experiencing 
homelessness in the U.S. and will assess the impacts of guaranteed income over a longer 
duration (two years) than any other study targeted at individuals experiencing 
homelessness (other known studies have assessed or are planning to assess outcomes only 
up to one year). 
2.1 
Risk / Benefit Assessment 
The main risks of receiving guaranteed income (GI) are the same as the risks that would 
be incurred by the general population in daily life who experience any increase in overall 
household income: 1) increased income tax burden; and 2) the potential loss of existing 
public benefits and assistance among participants. Our community partners have primary 
responsibility for administering and implementing the guaranteed income intervention, 
and have developed a comprehensive approach to mitigating these risks, including a) 
limiting the total annual amount of GI to $12,000 per year, an amount that is considered a 
non-taxable gift rather than income by the Internal Revenue Service and therefore would 
not be subject to income tax; b) negotiating waivers to ensure that GI is exempt from 
being included in eligibility calculations for Santa Clara County and California state 
assistance services such that participants will maintain the same eligibility for services 
they would have in the absence of GI; c) providing individualized benefits counseling 
during the study enrollment process so that potential participants can make informed 
decisions about participation prior to enrolling in the study; and d) creating a Hold 
Harmless fund to reimburse participants for any unanticipated benefits losses. The 
primary potential benefit of guaranteed income is that it will act to enhance and 
supplement existing housing and social assistance services and decrease homelessness and 
improve housing stability, health, and well-being of participants. These potential benefits 
outweigh the risks to participants. 
The main risks of participating in our research evaluation activities are loss of privacy and 
confidentiality. There is also the risk of disappointment at not being selected for the 
guaranteed income intervention group. Our research evaluation activities involve 
secondary analyses of administrative program data, and prospective data collection 
through administration of surveys and conducting structured and semi-structured 
interviews. Our research study team will put into place comprehensive measures to protect 
the privacy of participants and confidentiality of their data, including a) conducting 
eligibility screening, informed consent, surveys and interviews by trained research staff 
in-person and/or by telephone in private settings where responses will not be overheard; b) 
informing and emphasizing that we will not disclose individual and/or identifiable data 
collected for the study to anyone outside of the immediate research study team including 
community partners, community service providers, and/or community members; c) 
ensuring that identifying information about individual participants will never be included 
in manuscripts or other presentations of data; d) storing all electronic research data on a 
secure, encrypted database on a UCSF server that is backed up nightly; e) storing all hard 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 10 of 33 
Protocol Template Effective: 07 JAN 2015  
copies of data in locked, secured cabinets behind locked office doors; and f) de-
identifying data for analysis by coding data for a unique evaluation identification number 
for each participant, and storing the document linking participant identifiers to evaluation 
identification numbers separate from research data and destroying this document at the 
end of the evaluation. There will no immediate benefit to participants participating in 
research evaluation activities, though consent and enrollment in the research evaluation 
will be a prerequisite to being eligible to being randomized to receive the guaranteed 
income intervention. Individuals who are randomized to the guaranteed income 
intervention group will benefit from receiving the income payments. 
3 
STUDY OBJECTIVES 
3.1 
Primary Objective 
The primary objective of this study is to assess the effect of guaranteed income on housing 
stability. 
3.2 
Secondary Objectives 
The secondary objectives of this study are to assess the effect of guaranteed income on the 
health and well-being of families with children experiencing homelessness. 
4 
STUDY DESIGN 
4.1 
Study Overview 
This is a single-site, single-blinded randomized controlled trial. The community partner 
service organizations, Destination: Home SV and the ¡Sí Se Puede! Collective, have 
raised funds to provide unconditional cash assistance in the form of guaranteed income 
(GI) for a period of two years to 150 families with children experiencing homelessness in 
Santa Clara County and who are eligible for referral to rapid rehousing assistance 
programs (RRH). The partner service organizations are prioritizing assistance to those 
awaiting RRH referral given the current extended wait time for RRH services. Because 
there are far more families who are eligible for GI than there are available resources, 150 
eligible families will be randomly selected to receive GI. From the pool of eligible 
families, we will also randomly select an additional 150 participants as matched controls 
for the purpose of evaluation.  
Thus, we are planning for a total of 300 participants. Participants will be assigned to either 
the control (usual care) or intervention (guaranteed income) groups in random order. 
Evaluations will be taken at baseline and every 6 months monthly via in-person and/or 
telephone assessments. 
Screening data will be reviewed to determine participant eligibility.  Participants who 
meet all inclusion criteria and none of the exclusion criteria will be entered into the study.  
The following treatment regimens will be used: 
• 
Intervention – guaranteed income, consisting of a total of $24,000 to be disbursed over 
24 months.  Participants may opt for either monthly ($1,000/month) or hybrid (lump 
sum of $6,500 the first month, then $500/month x 11 months for a total of $12,000 per 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 11 of 33 
Protocol Template Effective: 07 JAN 2015  
year) disbursement schedules, with the option to switch disbursement schedule after 
the first 12 months. Participants will also be invited to attend a Public Benefits 
Information Session to learn about public benefits and social assistance programs 
available to residents of Santa Clara County. Participation in this Benefits Information 
Session will be optional and not required for study participation. 
• 
Control – usual care as per the partner service organizations. Participants will be 
invited to also attend a Public Benefits Information Session to learn about public 
benefits and social assistance programs available to residents of Santa Clara County. 
Participation in this Benefits Information Session will be optional and not required for 
study participation. 
Total duration of participant participation will be 36 months from the time of enrollment.  
Total duration of the study is expected to be 48 months (12 months for recruitment and 36 
months for follow-up from the time of last participant enrolled). 
5 
CRITERIA FOR EVALUATION 
5.1 
Primary Efficacy Endpoint 
Our primary endpoint is number of days experiencing homelessness (with ‘homelessness’ 
as defined below in section 6.2) during the study period.  
For our primary endpoint, number of days experiencing homelessness, given our sample 
size of 300 with 150 participants in each arm, we estimate that we will have 80% power at 
a two-sided significance level of 0.05 to detect a mean reduction of 24.0 days in the 
intervention group, assuming a mean of 52.3±74.0 days experiencing homelessness from 
prior studies. Allowing for a 27% dropout rate as estimated from prior studies (for a total 
of sample size of 220 participants with 110 families in each arm), we will still have 80% 
power at a two-sided significance level of 0.05 to detect a mean reduction of 28.0 days in 
the intervention group.  
5.2 
Secondary Efficacy Endpoints 
• 
Time to stable housing after randomization 
• 
Proportion of families who obtain stable housing during the 24-month intervention 
period  
• 
Proportion of families who retain stable housing in the 12 months following the end of 
the 24-month intervention period 
• 
Number of days spent living in a homeless shelter, in a place not typically used for 
sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train 
station, or temporarily in an institution 
• 
Number of days spent residing in a hotel or motel as a form of temporary housing 
• 
Number of days spent residing in a space without any legal right to the space (i.e., 
residing in a space without a lease) 
• 
Number of days spent in a shared living situation intended to be temporary (‘doubled 
up’ with a friend or relative due to being unable to find or afford own housing) 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 12 of 33 
Protocol Template Effective: 07 JAN 2015  
• 
Proportion of people experiencing homelessness for ≥1 night during study period 
• 
Proportion of people living in a homeless shelter, in a place not typically used for 
sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train 
station, or temporarily, in an institution for ≥1 night during study period 
• 
Proportion of people living in a hotel or motel as a form of temporary housing for ≥1 
night during study period 
• 
Proportion of people residing in a space without any legal right to the space (i.e., 
residing in a space without a lease) for ≥1 night during study period 
• 
Proportion of people in a shared living situation intended to be temporary (‘doubled 
up’ with a friend or relative due to being unable to find or afford own housing) ≥1 
night during study period 
• 
Proportion of people with any return to a homeless shelter at any time after enrollment 
• 
Changes in household composition  
• 
Changes in employment status and household income 
• 
Number of moves 
• 
Overcrowding 
• 
Housing condition, quality, and affordability (i.e., housing cost burden) through 
selected questions adapted from the American Housing Survey and Family Options 
Study 
• 
Proportion of monthly income spent on housing-related expenses 
• 
Monthly household expenditures and categories of expenditures, assessed through 
selected questions adapted from the US Bureau of Labor Statistics Consumer 
Expenditures Survey 
• 
Physical well-being, as measured through the Short-Form 12 v2 
• 
Psychological well-being, as measured through the Kessler 6 
• 
Financial well-being, through selected questions adapted from the Consumer Financial 
Protection Bureau Financial Well-Being Scale and the Urban Institute Basic Needs 
and Well-Being Survey 
• 
Material hardship as measured through selected questions from the Survey of Income 
and Program Participation and the Urban Institute Basic Needs and Well-Being 
Survey 
• 
Food insecurity, as measured through the United States Department of Agriculture 
Household Food Insecurity Survey 
• 
Agency, as measured through the 12-item Adult Hope Scale 
• 
Self-efficacy, as measured through the Generalized Self-Efficacy Scale 
• 
Perceived stress, as measured through the Perceived Stress Scale 
• 
Household environment, as measured through the Chaos, Hubbub, and Order Scale 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 13 of 33 
Protocol Template Effective: 07 JAN 2015  
• 
Resilience, as measured through the Brief Resilience Scale 
• 
Health conditions and functional status through self-report and administrative data 
when available 
• 
Social service use through self-report and administrative data when available 
• 
Health service use (including health insurance type) through self-report and 
administrative data when available 
• 
How cash payments may interfere with vs enhance network strain and support, 
specifically in terms of the following domains, via semi-structured interviews:  
o Public benefits, services and/or assistance 
o Community and interpersonal relationships 
o Support of friends and family 
• 
The impact of cash payments on time scarcity, self care, and social goods, via semi-
structured interviews 
• 
The rationale behind selection of preferred cash payment disbursement schedule, via 
semi-structured interviews  
• 
The influence and perceived impact of preferred cash payment disbursement schedule 
on primary and secondary outcomes listed above, via semi-structured interviews 
• 
Household needs not addressed or affected by receipt of cash payments and alternate 
strategies to meet those needs, via semi-structured interviews 
• 
The long-term positive and adverse effects of cash payments, in the year following 
completion of the cash payments 
• 
Incidence of adverse events: loss or reduction in public benefits, services and/or 
assistance directly resulting from receipt of cash payments 
6 
PARTICIPANT SELECTION 
6.1 
Study Population 
Participants living in Santa Clara County and experiencing homelessness who meet the 
inclusion and exclusion criteria will be eligible for participation in this study.   
6.2 
Inclusion Criteria 
1. ≥18 years of age at baseline visit and has a child ≤17 years of age living in household.  
2. A resident of Santa Clara County. 
3. Experiencing homelessness, as defined by: 
a. The Homeless Emergency Assistance and Rapid Transition to Housing Act 
(HEARTH Act) final rule on the definition of homelessness as published in the 
Federal Register in 2011; and/or 
b. Living in a public or private space intended for temporary (≤6 month) residence, 
such as residing in a hotel/motel; residing in a space without a legal right to the 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 14 of 33 
Protocol Template Effective: 07 JAN 2015  
space and therefore being at threat of being asked to leave at any time (i.e., no 
lease or unleased); and/or being in a shared living situations intended to be 
temporary (i.e., being ‘doubled up’ due to lack of available and/or affordable 
housing). 
4. Vulnerability-Index Service Prioritization Decision Assistance Tool (VI-SPDAT) 
score within the eligibility range for referral to rapid rehousing assistance programs in 
Santa Clara County (score of 4-8 for households), when available 
5. Written informed consent (and assent when applicable) obtained from participant or 
participant’s legal representative and ability for participant to comply with the 
requirements of the study. 
6.3 
Exclusion Criteria 
1. Substantial to severe level of problematic substance use as defined by the validated 
Drug Abuse Screening Test (DAST-10) (score of 6-8 or 9-10, respectively). 
2. Hazardous or harmful alcohol consumption, or active and severe alcohol use 
disorder, as defined by the validated Alcohol Use Disorders Identification Test 
(AUDIT) (score of 8-14 and ≥15, respectively). 
7 
CONCURRENT INTERVENTIONS 
All participants will maintain eligibility for all other available housing, social, and 
economic assistance programs. Participants will not be excluded from receipt of any other 
housing assistance (nor any other assistance programs) should any be available to them 
during the study period. 
8 
STUDY INTERVENTIONS 
8.1 
Method of Assigning Participants to Treatment Groups 
Up to 300 eligible participants will be randomly assigned to the guaranteed income group 
(intervention) or usual care (control group) using a computer-generated randomization 
scheme developed by the study team. Eligible participants will be referred by the 
community partners (DHSV and SSPC) to the study team for consent and enrollment into 
the study prior to randomization. Once participants are enrolled, they will undergo a 
baseline assessment before being randomly assigned to either the intervention or control 
group. Randomization will be stratified by referring community partner (DHSV vs SSPC). 
Group assignments will be known to our community partners at Sacred Heart Community 
Service, a neutral third community-based organization contracted by DHSV and SSPC to 
administer and provide support for the guaranteed income intervention; however, the core 
study team (investigators and core research staff at UCSF) will be blinded to group 
assignments. 
8.2 
Blinding 
Due to the objectives of the study, the identity of intervention and control groups will not 
be known to investigators or core research staff (i.e., the UCSF study team). Due to the 
nature of the intervention, participants themselves will not be blinded to whether they are 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 15 of 33 
Protocol Template Effective: 07 JAN 2015  
assigned to the intervention arm. Community partners at Sacred Heart Community 
Service, who are administering the guaranteed income intervention, will also not be 
blinded to participants’ group assignments. The following study procedures will be in 
place to ensure single-blinded administration of the study intervention: 
Randomization will take place using a computer-generated randomization scheme 
integrated into the REDCap randomization module, after participants are consented and 
enrolled into the study. The REDCap randomization module allows specification of which 
study team members are blinded vs unblinded to group assignments. Because our 
community partners at Sacred Heart Community Service are administering the guaranteed 
income intervention, they will be unblinded to group assignments out of necessity, and 
will receive the information on individuals’ group assignments via a UCSF data liaison 
working with the UCSF study team. The remainder of the core UCSF study team, 
including the PI and all key personnel (other than the biostatistician, the aforementioned 
data liaison, and a participant notification liaison) will be unaware and blinded to 
participant group assignments during the conduct of the study. The study blind will be 
broken on completion of the study and after the study database has been locked.  
9 
STUDY PROCEDURES AND GUIDELINES 
A Schedule of Events representing the data collection procedures to be performed for the 
duration of the study is diagrammed in Appendix 1. 
Prior to conducting any study-related activities, we will obtain written informed consent 
and the Health Insurance Portability and Accountability Act (HIPAA) authorization must 
be signed and dated by the participant or participant’s legal representative.  Participants 
will be eligible to participate in even if they decline HIPAA authorization and release of 
health-related data from health care providers (Santa Clara Valley Medical Hospital & 
Clinics). This HIPAA authorization has also been reviewed and approved by Santa Clara 
County Counsel for authorization of release of public benefits program-related data (i.e., 
social services-related data) from Santa Clara County Public Health and Santa Clara 
County Social Services Agency as detailed in section 14.1). 
9.1 
Clinical Assessments 
9.1.1 Concomitant Interventions 
All concomitant interventions in terms of receipt of assistance from other housing, social, 
and economic assistance programs will be documented at Baseline/Screening and 6-month 
follow-up surveys and early termination when possible. The type, frequency, and amount 
of assistance services will be captured. These data on concomitant interventions will be 
supplemented with administrative data from relevant Santa Clara County agencies and 
community organizations if available. 
9.1.2 Demographics  
Demographic information (date of birth, sex/gender, race/ethnicity, education) will be 
recorded at Baseline. 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 16 of 33 
Protocol Template Effective: 07 JAN 2015  
9.1.3 Medical History  
Relevant medical history, including history of current disease, other pertinent chronic 
illness history, and information regarding underlying diseases will be recorded at 
Baseline. 
9.1.4 Adverse Events 
Information regarding occurrence of adverse events will be captured throughout the study. 
Duration (start and stop dates and times), severity/grade, outcome, treatment and relation 
to the intervention will be recorded. 
10 EVALUATIONS BY VISIT 
10.1 Visit/Assessment 1: Baseline Survey Assessment (Month 0)  
1. 
Review the study with the participant (participant’s legal representative) and obtain 
written informed consent and HIPAA authorization and assent, if appropriate. 
2. 
Assign the participant a unique screening number. 
3. 
Record demographic data. 
4. 
Record household composition data (number of household members and children). 
5. 
Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
6. 
Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
7. 
Record concomitant interventions in terms of receipt of assistance from other 
housing, social, and economic assistance programs. 
8. 
Administer and record monthly expenditure amounts and categories, adapted from 
the Survey of Income and Participation. 
9. 
Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
10. 
Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
11. 
Administer and record the USDA Brief Food Security Survey (food security) 
12. 
Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
13. 
Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
14. 
Administer and record Short-Form 12 v2 (physical health)  
15. 
Administer and record Kessler 6 (psychological health) 
16. 
Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
17. 
Administer and record the Brief Resilience Scale (resilience) 
18. 
Administer and record the Perceived Stress Scale (perceived stress) 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 17 of 33 
Protocol Template Effective: 07 JAN 2015  
19. 
Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
20. 
Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
21. 
Schedule participant for Visit 2 in 180-240 days 
22. 
Randomize participant to study group 
23. 
Connect participant with community partner organization (Sacred Heart Community 
Service) for further social service assessment and assistance (both control and 
intervention groups) and orientation/navigation for initiation of guaranteed income 
payments (intervention group) 
10.2 Visit/Assessment 2: 6-Month Survey Assessment (Month 6) 
1. 
Record any Adverse Experiences 
2. 
Concomitant interventions review 
3. 
Record changes in household composition  
4. 
Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. 
Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. 
Record concomitant interventions in terms of receipt of assistance from other 
housing, social, and economic assistance programs. 
7. 
Administer and record monthly expenditure amounts and categories, adapted from 
the Survey of Income and Participation. 
8. 
Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. 
Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. 
Administer and record the USDA Brief Food Security Survey (food security) 
11. 
Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. 
Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. 
Administer and record Short-Form 12 v2 (physical health)  
14. 
Administer and record Kessler 6 (psychological health) 
15. 
Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. 
Administer and record the Brief Resilience Scale (resilience) 
17. 
Administer and record the Perceived Stress Scale (perceived stress) 
18. 
Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. 
Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 18 of 33 
Protocol Template Effective: 07 JAN 2015  
10.3 Visit/Assessment 3: 12-Month Survey Assessment (Month 12) 
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
10.4 Visit/Assessment 4: 18-Month Survey Assessment (Month 18)  
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 19 of 33 
Protocol Template Effective: 07 JAN 2015  
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
10.5 Visit/Assessment 5: 24-Month Assessment (Month 24)  
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 20 of 33 
Protocol Template Effective: 07 JAN 2015  
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
10.6 Visit/Assessment 6: 27-Month Assessment (Month 27)  
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 21 of 33 
Protocol Template Effective: 07 JAN 2015  
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
10.7 Visit/Assessment 7: 30-Month Assessment (Month 30)  
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
10.8 Visit/Assessment 8: 36-Month Assessment (Month 36)  
1. Record any Adverse Experiences 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 22 of 33 
Protocol Template Effective: 07 JAN 2015  
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
10.9 12-Month Qualitative Interview Assessment (between months 6-12, subset of 40 
participants) 
1. Record any Adverse Experiences 
2. Conduct semi-structured interview on impact of homelessness and guaranteed income 
(if applicable) on household strain and well-being, decision-making, time scarcity and 
future planning 
10.10 24-Month Qualitative Interview Assessment (between months 18-24, subset of 
40 participants) 
1. Record any Adverse Experiences 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 23 of 33 
Protocol Template Effective: 07 JAN 2015  
2. Conduct semi-structured interview on impact of homelessness and guaranteed income 
(if applicable) on household strain and well-being, decision-making, time scarcity and 
future planning 
10.11 Early Withdrawal Visit/Assessment 
1. Record any Adverse Experiences 
2. Concomitant interventions review 
3. Record household composition data (number of household members and children). 
4. Administer and record current housing situation and history of homelessness 
instruments, adapted from the Family Options Study and the California Statewide 
Survey on Homelessness. 
5. Administer and record income and employment survey, adapted from the California 
Statewide Survey on Homelessness. 
6. Record concomitant interventions in terms of receipt of assistance from other housing, 
social, and economic assistance programs. 
7. Administer and record monthly expenditure amounts and categories, adapted from the 
Survey of Income and Participation. 
8. Administer and record Financial Well-Being Scale, adapted from the Consumer 
Financial Protection Bureau (financial well-being). 
9. Administer and record Material Hardship Survey, adapted from the Urban Institute 
Well-Being and Basic Needs and the Survey of Income and Program Participation  
(material hardship) 
10. Administer and record the USDA Brief Food Security Survey (food security) 
11. Administer and record healthcare utilization survey, adapted from the California 
Statewide Survey on Homelessness 
12. Administer and record health conditions and functional status survey, adapted from 
the California Statewide Survey on Homelessness 
13. Administer and record Short-Form 12 v2 (physical health)  
14. Administer and record Kessler 6 (psychological health) 
15. Administer and record the Generalized Self-Efficacy Scale (self-efficacy) 
16. Administer and record the Brief Resilience Scale (resilience) 
17. Administer and record the Perceived Stress Scale (perceived stress) 
18. Administer and record the Confusion, Hubbub and Order Scale (household chaos) 
19. Administer and record the Future Scale (aka the Adult Hope Scale) (agency) 
 
11 ADVERSE EXPERIENCE REPORTING AND DOCUMENTATION 
11.1 Adverse Events 
The study team will probe, via discussion with the participant, for the occurrence of 
adverse events (AEs) during each participant visit and record the information in the site’s 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 24 of 33 
Protocol Template Effective: 07 JAN 2015  
source documents.  Adverse events will be recorded in the patient CRF.  Adverse events 
will be described by duration (start and stop dates and times), severity, outcome, treatment 
and relation to study intervention, or if unrelated, the cause. For this study, the primary 
potential adverse events of concern associated with the study intervention are potential 
loss of existing public benefits and assistance among participants, and increased income 
tax burden, similar to the risks that would be incurred by the general population in daily 
life who might experience a similar increase in overall household income. 
12 DISCONTINUATION AND REPLACEMENT OF PARTICIPANTS 
12.1 Early Discontinuation of Study Intervention 
A participant may discontinue receipt of the study intervention (guaranteed income) and 
participation in the evaluation activities at any time if the participant, investigator, or 
sponsor feel that it is not in the participant’s best interest to continue.  The following is a 
list of possible reasons for study treatment discontinuation:  
• 
Participant withdrawal of consent (or assent) 
• 
Adverse event that in the opinion of the investigator would be in the best interest of 
the participant to discontinue study treatment 
• 
Lost to follow-up 
• 
Sponsor request for early termination of study 
If a participant is withdrawn from treatment due to an adverse event, the participant will 
be followed and treated by the Investigator, study team, and community partners until the 
issue has resolved or stabilized (i.e., assistance applying for additional public benefits, 
assistance programs, and/or social services from local, county, state, and federal entities in 
case of the loss of benefits).   
All participants who discontinue the study intervention will be encouraged to undergo an 
early discontinuation visit/assessment as soon as possible and then should be encouraged 
to complete all remaining scheduled assessments if possible. 
All participants are free to withdraw from participation at any time, for any reason, 
specified or unspecified, and without prejudice. 
Reasonable attempts will be made by the investigator to provide a reason for participant 
withdrawals.  The reason for the participant’s withdrawal from the study will be specified 
in the participant’s source documents. Refer to Section 10 for early termination 
assessment procedures. 
12.2 Withdrawal of Participants from the Study 
A participant may withdraw from the study at any time if the participant, investigator or 
sponsor feel that it is not in the participant’s best interest to continue. All participants are 
free to withdraw from participation at any time, for any reason, specified or unspecified, 
and without prejudice. 
Reasonable attempts will be made by the investigator to provide a reason for participant 
withdrawals.  The reason for the participant’s withdrawal from the study will be specified 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 25 of 33 
Protocol Template Effective: 07 JAN 2015  
in the participant’s source documents.  As noted above, participants who discontinue 
study treatment early (i.e., they withdraw prior to the end of the 36-month study period) 
should have an early discontinuation assessment. Refer to Section 10 for early termination 
procedures assessment.  Participants who withdraw after Visit/Assessment 4 but prior to 
Visit 5 should be encouraged to come in for a final visit (and the procedures to be 
followed would include those for their next scheduled visit).   
12.3 Replacement of Participants 
Participants who withdraw from the study intervention will not be replaced.   
Participants who withdraw from the study will not be replaced.   
12.4 Study Interruptions Due to Specific Circumstances 
a) If the participant is no longer able to act as a payee for guaranteed income due to 
incarceration, we will contact the designated secondary payee for recruitment, consent, 
and enrollment as a study participant so that they may continue survey and interview 
assessments on behalf of the household. Additionally, our community partners will 
transfer any remaining guaranteed income payments to the secondary payee so that 
households will continue to receive the income.  
b) In case of family separation, guaranteed income payments will continue to the adult 
who continues to reside with the children in the household.  
c) If families move out of Santa Clara County during the study period, they will be 
eligible to continue to participate in the study and will be eligible to continue to receive 
the guaranteed income periods for the duration of the study period as long as their contact 
information remains up to date. This is because moving from the area may be a positive 
outcome enabled by receipt of public assistance, benefits, and/or the guaranteed income 
that would be relevant to ascertain for the purpose of the study.  
d) If participants opt for early withdrawal from the study (i.e., participating in the surveys 
and interviews), they will still be eligible to receive guaranteed income payments as a 
form of economic assistance provided by the community partners. However, only 
participants who consent and enroll in the study will be eligible for initial randomization. 
 
13 PROTOCOL VIOLATIONS 
A protocol violation occurs when the participant, investigator, or Sponsor fails to adhere 
to significant protocol requirements affecting the inclusion, exclusion, participant safety 
and primary endpoint criteria.  Protocol violations for this study include, but are not 
limited to, the following: 
• 
Failure to meet inclusion/exclusion criteria 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 26 of 33 
Protocol Template Effective: 07 JAN 2015  
Failure to comply with Good Clinical Practice (GCP) guidelines will also result in a 
protocol violation. The Sponsor will determine if a protocol violation will result in 
withdrawal of a participant. 
When a protocol violation occurs, it will be discussed with the investigator and a Protocol 
Violation Form detailing the violation will be generated. This form will be signed by a 
Sponsor representative and the Investigator. A copy of the form will be filed in the site’s 
regulatory binder and in the Sponsor’s files. 
14 STATISTICAL METHODS AND CONSIDERATIONS 
Prior to the analysis of the final study data, a detailed Statistical Analysis Plan (SAP) will 
be written describing all analyses that will be performed.  The SAP will contain any 
modifications to the analysis plan described below.   
14.1 Data Sets Analyzed 
All participants who are enrolled, complete a baseline assessment, are randomized, and, 
for the intervention group, agree to receive GI payments will be included in the modified 
intention-to-treat analyses. The primary dataset used will be data prospectively collected 
by the study team via the use of survey instruments and structured interviews as outlined 
here. We will obtain complementary administrative data on housing status, housing 
assistance, housing service use, social service use, and health care service use from the 
Santa Clara Office of Supportive Housing (Homeless Management Information System), 
Santa Clara Valley Medical Center Hospital & Clinics (Santa Valley Medical Center 
HealthLink), Santa Clara County Public Health, County of Santa Clara Social Services 
Agency (including the Department of Employment and Benefit Services), and from 
community partners (Destination: Home SV, ¡Sí Se Puede! Collective, Sacred Heart 
Community Service). 
14.2 Demographic and Baseline Characteristics 
We will summarize the following demographic variables and characteristics at baseline by 
group assignment: age, gender, race/ethnicity, education, housing status, housing 
quality/condition, employment, income, financial well-being, material hardship, food 
security, household composition, health conditions, functional status, healthcare 
utilization, social service utilization, agency, self-efficacy, perceived stress, household 
environment.   
14.3 Analysis of Primary Endpoint 
We will conduct modified intention-to-treat analyses to assess our primary endpoint, 
differences in numbers of days spent homeless using Poisson regression.  
Analyses will be adjusted for key demographic and clinical characteristics, including: a) 
referring organization; b) subtype of homelessness; c) preferred payment disbursement 
schedule (monthly vs hybrid), as well as for covariates that remain unbalanced across the 
control and intervention groups after randomization. For missing data, we will use 
multiple imputation, and will employ the last observation carried forward (LOCF), as a 
sensitivity analysis to assess the robustness of our multiple imputation approach. 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 27 of 33 
Protocol Template Effective: 07 JAN 2015  
14.4 Analysis of Secondary Endpoints 
We will conduct intention-to-treat analyses to assess our secondary endpoints, using Cox 
proportional hazards, logistic and linear regression models as appropriate to the endpoint 
of interest. Analyses will be adjusted for key demographic and clinical characteristics, as 
well as for covariates that remain unbalanced across the control and intervention groups 
after randomization. As sensitivity analyses, we will also conduct per protocol analyses 
for both our primary and secondary endpoint measures. For missing data, we will employ 
multiple imputation and use the last observation carried forward (LOCF) as a sensitivity 
analysis to assess the robustness of the LOCF approach. 
For our qualitative assessments, we will use a thematic approach with simultaneous data 
collection and analysis based on modified grounded theory methodologies. We will 
review interview transcripts and initial analytic memos to develop a preliminary 
codebook, code transcripts and iteratively discuss with the study team to add or revise 
existing codes, have two reviewers independently review transcripts and conduct coding, 
and hold regular study team meetings to discuss emergent themes until reaching 
consensus. 
14.5 Interim Analysis 
We do not plan to conduct any interim analyses. 
14.6 Sample Size and Randomization 
Up to 300 eligible participants will be randomly assigned to the guaranteed income group 
(intervention) or usual care (control group) using a computer-generated randomization 
scheme developed by the study team. Eligible participants will be referred by the 
community partners to the study team for consent and enrollment into the study prior to 
randomization. Once participants are enrolled, they will be randomly assigned to either 
the intervention or control group. Group assignments will be known to our community 
partners, who are administering the guaranteed income intervention; however, the study  
team (investigators and research staff) will be blinded to group assignments. 
For our primary endpoint, number of days experiencing homelessness, given our sample 
size of 300 with 150 participants in each arm, we estimate that we will have 80% power at 
a two-sided significance level of 0.05 to detect a mean reduction of 24.0 days in the 
intervention group, assuming a mean of 52.3±74.0 days experiencing homelessness from 
prior studies. Allowing for a 27% dropout rate as estimated from prior studies (for a total 
of sample size of 220 participants with 110 families in each arm), we will still have 80% 
power at a two-sided significance level of 0.05 to detect a mean reduction of 28.0 days in 
the intervention group.  
15 DATA COLLECTION, RETENTION AND MONITORING 
15.1 Data Collection Instruments 
The Investigator will prepare and maintain adequate and accurate source documents 
designed to record all observations and other pertinent data for each participant treated 
with the study intervention.   

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 28 of 33 
Protocol Template Effective: 07 JAN 2015  
Study personnel at each site will enter data from source documents corresponding to a 
participant’s visit into the protocol-specific electronic Case Report Form (eCRF) OR 
paper CRF when the information corresponding to that visit is available.  Participants will 
not be identified by name in the study database or on any study documents to be collected 
by the Sponsor (or designee), but will be identified by a site number, participant number 
and initials. 
For eCRFs: If a correction is required for an eCRF, the time and date stamps track the 
person entering or updating eCRF data and creates an electronic audit trail.  For paper 
CRFs:  If a correction is made on a CRF, the study staff member will line through the 
incorrect data, write in the correct data and initial and date the change. 
The Investigator is responsible for all information collected on participants enrolled in this 
study.  All data collected during the course of this study must be reviewed and verified for 
completeness and accuracy by the Investigator.  A copy of the CRF will remain at the 
Investigator’s site at the completion of the study. 
15.2 Data Management Procedures 
The data will be entered into a validated database.  The Data Management group will be 
responsible for data processing, in accordance with procedural documentation.  Database 
lock will occur once quality assurance procedures have been completed. 
All procedures for the handling and analysis of data will be conducted using good 
computing practices meeting FDA guidelines for the handling and analysis of data for 
clinical trials. 
15.3 Data Quality Control and Reporting 
After data have been entered into the study database, a system of computerized data 
validation checks will be implemented and applied to the database on a regular basis. The 
study database will be updated in accordance with the resolved queries.  All changes to 
the study database will be documented. 
15.4 Archival of Data 
The database is safeguarded against unauthorized access by established security 
procedures; appropriate backup copies of the database and related software files will be 
maintained.  Databases are backed up by the database administrator in conjunction with 
any updates or changes to the database.   
At critical junctures of the protocol (e.g., production of interim reports and final reports), 
data for analysis is locked and cleaned per established procedures. 
15.5 Availability and Retention of Investigational Records 
The Investigator must make study data accessible to the monitor, other authorized 
representatives of the Sponsor (or designee), IRB/IEC, and Regulatory Agency (e.g., 
FDA) inspectors upon request.  A file for each participant must be maintained that 
includes the signed Informed Consent, HIPAA Authorization and Assent Form and copies 
of all source documentation related to that participant.  The Investigator must ensure the 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 29 of 33 
Protocol Template Effective: 07 JAN 2015  
reliability and availability of source documents from which the information on the CRF 
was derived. 
All study documents (patient files, signed informed consent forms, copies of CRFs, Study 
File Notebook, etc.) must be kept secured for a period of two years following marketing of 
the investigational product or for two years after centers have been notified that the IND 
has been discontinued.  There may be other circumstances for which the Sponsor is 
required to maintain study records and, therefore, the Sponsor should be contacted prior to 
removing study records for any reason. 
15.6 Monitoring 
Monitoring visits will be conducted by representatives of the Sponsor according to the 
U.S. CFR Title 21 Parts 50, 56, and 312 and ICH Guidelines for GCP (E6).    By signing 
this protocol, the Investigator grants permission to the Sponsor (or designee), and 
appropriate regulatory authorities to conduct on-site monitoring and/or auditing of all 
appropriate study documentation. 
15.7 Participant Confidentiality 
In order to maintain participant confidentiality, only a site number, participant number and 
participant initials will identify all study participants on CRFs and other documentation 
submitted to the Sponsor.  Additional participant confidentiality issues (if applicable) are 
covered in the Clinical Study Agreement. 
16 ADMINISTRATIVE, ETHICAL, REGULATORY CONSIDERATIONS 
The study will be conducted according to the Declaration of Helsinki, Protection of 
Human Volunteers (21 CFR 50), Institutional Review Boards (21 CFR 56), and 
Obligations of Clinical Investigators (21 CFR 312). 
To maintain confidentiality, all laboratory specimens, evaluation forms, reports and other 
records will be identified by a coded number and initials only.  All study records will be 
kept in a locked file cabinet and code sheets linking a patient’s name to a patient 
identification number will be stored separately in another locked file cabinet.  Clinical 
information will not be released without written permission of the participant, except as 
necessary for monitoring by the FDA.  The Investigator must also comply with all 
applicable privacy regulations (e.g., Health Insurance Portability and Accountability Act 
of 1996, EU Data Protection Directive 95/46/EC). 
16.1 Protocol Amendments 
Any amendment to the protocol will be written by the Sponsor.  Protocol amendments 
cannot be implemented without prior written IRB/IEC approval except as necessary to 
eliminate immediate safety hazards to patients.  A protocol amendment intended to 
eliminate an apparent immediate hazard to patients may be implemented immediately, 
provided the IRBs are notified within five working days. 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 30 of 33 
Protocol Template Effective: 07 JAN 2015  
16.2 Institutional Review Boards and Independent Ethics Committees 
The protocol and consent form will be reviewed and approved by the IRB/IEC of each 
participating center prior to study initiation.  Serious adverse experiences regardless of 
causality will be reported to the IRB/IEC in accordance with the standard operating 
procedures and policies of the IRB/IEC, and the Investigator will keep the IRB/IEC 
informed as to the progress of the study.  The Investigator will obtain assurance of 
IRB/IEC compliance with regulations. 
Any documents that the IRB/IEC may need to fulfill its responsibilities (such as protocol, 
protocol amendments, Investigator’s Brochure, consent forms, information concerning 
patient recruitment, payment or compensation procedures, or other pertinent information) 
will be submitted to the IRB/IEC.  The IRB/IECs written unconditional approval of the 
study protocol and the informed consent form will be in the possession of the Investigator 
before the study is initiated.  The IRB/IECs unconditional approval statement will be 
transmitted by the Investigator to the Sponsor or designee prior to the shipment of study 
supplies to the site.  This approval must refer to the study by exact protocol title and 
number and should identify the documents reviewed and the date of review. 
Protocol and/or informed consent modifications or changes may not be initiated without 
prior written IRB/IEC approval except when necessary to eliminate immediate hazards to 
the patients or when the change(s) involves only logistical or administrative aspects of the 
study.  Such modifications will be submitted to the IRB/IEC and written verification that 
the modification was submitted and subsequently approved should be obtained.   
The IRB/IEC must be informed of revisions to other documents originally submitted for 
review; serious and/or unexpected adverse experiences occurring during the study in 
accordance with the standard operating procedures and policies of the IRB; new 
information that may affect adversely the safety of the patients of the conduct of the study; 
an annual update and/or request for re-approval; and when the study has been completed. 
16.3 Informed Consent Form  
Informed consent will be obtained in accordance with the Declaration of Helsinki, ICH 
GCP, US Code of Federal Regulations for Protection of Human Participants (21 CFR 
50.25[a,b], CFR 50.27, and CFR Part 56, Subpart A), the Health Insurance Portability and 
Accountability Act (HIPAA, if applicable), and local regulations. 
The Investigator will prepare the informed consent form, assent and HIPAA authorization 
and provide the documents to the Sponsor or designee for approval prior to submission to 
the IRB/IEC.  The consent form generated by the Investigator must be acceptable to the 
Sponsor and be approved by the IRB/IEC.  The written consent document will embody the 
elements of informed consent as described in the International Conference on 
Harmonisation and will also comply with local regulations. The Investigator will send an 
IRB/IEC-approved copy of the Informed Consent Form to the Sponsor (or designee) for 
the study file. 
A properly executed, written, informed consent will be obtained from each participant 
prior to entering the participant into the trial.  Information should be given in both oral and 
written form and participants (or their legal representatives) must be given ample 
opportunity to inquire about details of the study.  If appropriate and required by the local 

Nguyen, Oanh Kieu 
Confidential 
 
Version #: 1.4 
Version Date: 11/27/2022 
Page 31 of 33 
Protocol Template Effective: 07 JAN 2015  
IRB/IEC, assent from the participant will also be obtained.  If a participant is unable to 
sign the informed consent form (ICF) and the HIPAA authorization, a legal representative 
may sign for the participant. A copy of the signed consent form (and assent) will be given 
to the participant or legal representative of the participant and the original will be 
maintained with the participant’s records. 
16.4 Publications  
The preparation and submittal for publication of manuscripts containing the study results 
shall be in accordance with a process determined by mutual written agreement among the 
study Sponsor and participating institutions.  The publication or presentation of any study 
results shall comply with all applicable privacy laws, including, but not limited to, the 
Health Insurance Portability and Accountability Act of 1996.  
16.5 Investigator Responsibilities 
By signing the Agreement of Investigator form, the Investigator agrees to: 
1. Conduct the study in accordance with the protocol and only make changes after 
notifying the Sponsor (or designee), except when to protect the safety, rights or 
welfare of participants. 
2. Personally conduct or supervise the study (or investigation). 
3. Ensure that the requirements relating to obtaining informed consent and IRB review 
and approval meet federal guidelines, as stated in § 21 CFR, parts 50 and 56. 
4. Report to the Sponsor or designee any AEs that occur in the course of the study, in 
accordance with §21 CFR 312.64. 
5. Ensure that all associates, colleagues and employees assisting in the conduct of the 
study are informed about their obligations in meeting the above commitments. 
6. Maintain adequate and accurate records in accordance with §21 CFR 312.62 and to 
make those records available for inspection with the Sponsor (or designee). 
7. Ensure that an IRB that complies with the requirements of §21 CFR part 56 will be 
responsible for initial and continuing review and approval of the clinical study. 
8. Promptly report to the IRB and the Sponsor (or designee) all changes in the research 
activity and all unanticipated problems involving risks to participants or others (to 
include amendments and IND safety reports). 
9. Seek IRB approval before any changes are made in the research study, except when 
necessary to eliminate hazards to the patients/participants. 
10. Comply with all other requirements regarding the obligations of clinical investigators 
and all other pertinent requirements listed in § 21 CFR part 312. 

Protocol Number 
Confidential 
 
Version Date: 10/14/22  
Page 32 of 33 
 
APPENDIX 1.  SCHEDULE OF STUDY SURVEY ASSESSMENTS 
 
INTERVENTION PERIOD 
POST-INTERVENTION PERIOD 
 
ASSESSMENT #1 
(Baseline) 
ASSESSMENT #2 
(6 Months)a 
ASSESSMENT #3 
(12 Months)a 
ASSESSMENT #4 
(18 Months)a 
ASSESSMENT #5 
(24 Months)a 
ASSESSMENT #6 
(27 Months)a 
ASSESSMENT #7 
(30 Months)a 
ASSESSMENT #8 
(36 Months)a 
Informed Consent 
X 
 
 
 
 
 
 
 
Adverse Experiences 
X 
X 
X 
X 
X 
X 
X 
X 
Demographic data 
X 
 
 
 
 
 
 
 
Household composition 
X 
X 
X 
X 
X 
X 
X 
X 
Current housing situation 
X 
X 
X 
X 
X 
X 
X 
X 
History of homelessness 
X 
 
 
 
 
 
 
 
Income, employment, benefits 
X 
X 
X 
X 
X 
X 
X 
X 
Social services and assistance 
X 
X 
X 
X 
X 
X 
X 
X 
Monthly expenditures 
X 
X 
X 
X 
X 
X 
X 
X 
Financial well-being 
X 
X 
X 
X 
X 
X 
X 
X 
Material hardship 
X 
X 
X 
X 
X 
X 
X 
X 
Food security 
X 
X 
X 
X 
X 
X 
X 
X 
Healthcare utilization 
X 
X 
X 
X 
X 
X 
X 
X 
Health conditions and functional status 
X 
X 
X 
X 
X 
X 
X 
X 
Physical health (SF-12 v2) 
X 
X 
X 
X 
X 
X 
X 
X 
Kessler 6 (psychological health) 
X 
X 
X 
X 
X 
X 
X 
X 
Generalized Self-Efficacy Scale 
X 
X 
X 
X 
X 
X 
X 
X 
Brief Resilience Scale 
X 
X 
X 
X 
X 
X 
X 
X 
Perceived Stress Scale 
X 
X 
X 
X 
X 
X 
X 
X 
Confusion, Hubbub and Order Scale 
X 
X 
X 
X 
X 
X 
X 
X 
Semi-Structured 1-on-1 Interviews 
 
 
X 
 
X 
 
 
X 
a 
±4 weeks 

Protocol Number 
Confidential 
 
Version #: 
Version Date: Date  
Page 33 of 33 
Protocol Template © CFFT TDN   Effective: 12 SEP 2007 
This page intentionally left blank.