Meaningful Dialogue: on Housing & Health

1. Meaningful Dialogue: on Housing & Health SYNChronicity - Federal Panel Remarks April 20, 2012 David Vos, Director, Office of HIV/AIDS Housing

2. Housing: Investing in the Future Housing is a critical component of HIV care and prevention systems. Helping homeless and unstably housed people: • enter into supportive housing and remain in care • reduce HIV risk behavior & • adhere to complex treatment regimens. • Addressing HIV disparities—seen in • retention in care & • delayed entry into care.

3. Housing: Investing in the Future No one should experience homelessness. No one should be without a safe, stable place to call home. Stable supportive housing is the cornerstone of HIV/AIDS treatment, allowing individuals to access care regularly. (Opening Doors: the Federal Strategic Plan to Prevent and End Homelessness, U.S. Interagency Council on Homelessness) Over 25,000 PLWH in homeless situations, sheltered homeless data (2010 AHAR); Sheltered/unsheltered homeless count of 630,000 at point in time, along with 1.6 Americans experiencing homelessness during year .

4. Housing: Platform to Improve Health • Maximum impacts • Coordination with mainstream & leveraged resources • Targeting to most pressing housing issues • Synergy in place-based outcomes • Strengthen understanding from cross-program perspectives • Engage with agencies & providers • Health-care City/State Planning • Housing Community Development • Employment Management • Veterans Finance • Social Services Stakeholders/Advisory bodies • Criminal Justice, Oversight

5. HOPWA: Investing in the Future • U.S. Department of Housing and Urban Development FY12 • $38.3 billion—83% used to support 4.5 million households with rental assistance, includes $1.9 billion in homeless assistance funds • HOPWA: $332 million, continues support for 60,234 households • Formula Allocations (90%): $298.8 million(125 grantees, established in annual action plans and 5 year Consolidated Plans) • Competitive Grants (10%): $33.2 million(28 renewals,3-29-12) including models for re-entry post-incarceration efforts, employment services and life skills, action to address chronic homelessness , and rural projects

7. HOPWA Modernization Proposals • A. Expanding Short-Term Housing Interventions. • Align with related short-term interventions & rapid rehousing • Add more flexible rental assistance terms, up to 24 months (vs. 21 weeks) • B. Targeting funding to areas with the greatest needs • Shift HOPWA data source to HIV case reports, and update targeting to address housing costs & community resources, such as use of Fair Market Rents (FMR) and Poverty • Protect current operations & administrative adjustments.

8. HOPWA & CPD Updates • OneCPD Technical Assistance on cross cutting needs for local capacity, on-line training on core curricula in grants management & housing service delivery • Community planning in Consolidated Plans that use meaningful data, map resources & needs and focus results with updated technology (IDIS) • Cross-program leveraging of resources on HIV, health & homelessness – use of core indicators, outcomes & reporting systems (HMIS) & related CARE • Use of new authorization -- HEARTH Act homeless assistance, e.g. Emergency Solution Grants (rapid re-housing/homelessness prevention) • Housing First service delivery, alignment of systems that target vulnerabilities, build supportive housing alliances

9. HOPWA & Other Updates • New Partnerships with housing authorities – Community Planning and Public Housing networks Promoting Partnerships to Utilize Housing as a Platform for Improving Quality of Life, CPD Notice 2011-09 issued 9/20/11 and related second chance activities in assisting ex-offenders in re-entry • HOPWA Integrated HIV Housing Plans – 7 demonstration grants for cross program coordination of housing and service models 2011-2014. Pilot on Getting to Work initiative in 9 communities. • LGBT WH Conference on Housing and Homelessness (Detroit 3/12) including issues on runaway and homeless youth. • HUD issued Equal Access rule (effective 3/5/12) on rights of LGBT people to prevent discrimination on basis of sexual orientation or gender • identity in HUD funded programs.

10. Opportunities to Lean Forward • Your help on three HUD planning related tasks • Identify the number of households of PLWH who have a housing need. • SUGGEST: Arrange with local Health Dept. to access depersonalized data on CARE beneficiaries who have non-permanent housing situations. Consider client viral load (VL) suppression & differences in homeless situations Map the # or Community VL by census track or geographic basis Targeting tools for future activities Dialogue on cross program support for these households • 2. Coordinate with area providers in sending HIV housing recommendations to local agencies that manage housing resources. • Expand partnerships & understanding on the link of affordable • housing & HIV care.

11. Slides used courtesy of Moupali Das-Douglas, Priscilla Chu, Glenn-Milo Santos , Eric Vittinghoff, Susan Scheer, Willi McFarland, Grant Colfax , Community Viral Load: Geographic, Clinical and Risk-Related Disparities in a Novel Population-Based Biomarker of HIV Prevention and Treatment, IDSA, 10/31/09

12. HOPWA Information • HOPWA documents, profiles, on-line financial management training, oversight/desk guide and links to webinars & eLearningresources • www.HUDHRE.info/HOPWA section • on the Homelessness Resource Exchange • Find a Local HOPWA Project Info • Email to HOPWA@hud.gov