In response to the unique and varied housing needs of people living with HIV/AIDS the Housing Opportunities for Persons with AIDS (HOPWA) program was created in 1992. The program, housed in the Office of Community Planning and Development in the U.S. Department of Housing and Urban Development (HUD), directly addresses the housing and service needs of people living with HIV/AIDS. Research has shown that housing is the greatest unmet service need for people living with the disease.
Housing is healthcare. Stable, affordable housing offers the best opportunity for persons living with HIV/AIDS to access drug therapies and treatments and supportive services that will enhance the quality of life for themselves and their families. When people are housed, they can access and adhere to drug treatments and therapies and require fewer hospitalizations and less emergency room care. It has been estimated that as many as half of all people living with HIV/AIDS will need housing assistance at some point in their illness. For many of those, short-term assistance with rent, mortgage, or utility costs alone will provide the necessary support to remain healthy and in stable housing. But others are struggling with multiple diagnoses of HIV and mental illness and/or substance use. Access to housing assistance and services is often further complicated by histories of incarceration, institutionalization, and homelessness. HOPWA housing assistance helps prevent homelessness and creates access to medical care and support services for individuals and families affected by HIV and AIDS.
The President’s proposed FY2018 budget of $330 million for the HOPWA program is once again far below NAHC’s recommendation based on housing need. NAHC recommends $375 million in appropriations for FY2018, which would provide urgently needed housing assistance for people with HIV/AIDS and their families. NAHC’s recommendation also includes funding to keep all jurisdictions level-funded, even those who are poised to lose due to HOPWA Modernization.
Prior to the HOPWA formula update, program funds were based on the number of cumulative AIDS cases since the epidemic began, including those who have died. Public Law 114-201, the Housing Opportunity Through Modernization Act (HOTMA), signed by President Obama on July 29, 2016, included the long-sought switch to counting those living with HIV in a given jurisdiction rather than cumulative AIDS. Such distribution better reflects the nature of the HIV epidemic that has evolved over the years through advances in HIV care and surveillance, and the increasingly disproportionate impact of HIV on communities of poverty. The update will phase in full implementation of the formula change over five years beginning in FY17, it will cap grantee gains at 10% and losses at 5%, and includes a housing cost factor and poverty factor.