By Kathie Hiers, CEO of AIDS Alabama and the President of the National AIDS Housing Coalition
This week the Health Resources and Services Administration (HRSA) finally unveiled its recommendations for the use of Ryan White funding for housing. The National AIDS Housing Coalition (NAHC) has been advocating for several years to allow the use of Ryan White funds to keep people stably housed. After all, reams of data now exist proving that stable housing may be the most important factor in the health outcomes of persons living with HIV disease. Housing improves medical outcomes, reduces risky behaviors, and ultimately reduces new transmissions. Thus, NAHC was pleased that the new recommendations expand how funds received under the Ryan White HIV/AIDS Program may be used for housing referral services or short-term or emergency housing and recommends that local decision making planning bodies, i.e. Part A and Part B, institute their own housing assistance duration limits. Of concern, however, is the following component of the recommendations:
Ryan White HIV/AIDS Program Grantees and local decision making planning bodies, i.e. Part A and Part B, are strongly encouraged to institute duration limits to provide transitional and emergency housing services. HUD defines transitional housing as 24 month, and HRSA/HAB recommends that grantees consider using HUD's definition as their standard.
One of the great strengths of the Ryan White program has always been the ability to prioritize needs on the local level with input from all stakeholders, particularly meaningful input from persons living with HIV/AIDS. Obviously the needs and the availability of resources in various jurisdictions are quite different. But if HRSA strongly encourages time limits in the guidance, then many grantees will bow to the will of the funder, no matter what the need in their areas. The consequences could be dire for many people who lose their housing.
I will add that while I support and defend this position, I will also admit that we have never had enough Ryan White money to spend on housing in Alabama, other than an occasional emergency expenditure on a motel. I suspect that many southern and Part B areas are in the same boat. Then mix in the AIDS Drug Assistance Program waiting lists with almost 8,000 people on those lists (95% of which is southern), and one thing becomes painfully clear: we need more federal dollars to be invested in Ryan White.
Kathie Hiers is the CEO of AIDS Alabama and the President of the National AIDS Housing Coalition, as well as the Chair of the Disparities Committee of the Presidential Advisory Council on HIV/AIDS. AIDS Alabama is one of the premier agencies in the United States that provides housing to low-income, HIV-positive persons. In addition to the provision of permanent supportive housing to Alabama's HIV-positive population, AIDS Alabama also manages a statewide rental assistance program; the state's only HIV-specific, residential substance abuse program; many programs for HIV-positive persons and families dealing with homelessness; transitional facilities designed to prepare residents for permanent housing; a facility for HIV-positive persons who also have a severe mental health diagnosis; rural housing and supportive services, and many other programs. Last year AIDS Alabama provided more than 180,000 nights of safe, decent, affordable housing in Alabama.