Federal Leads Explore Intersection of HIV/AIDS and Housing Insecurity or Homelessness

Last Monday, January 24, 2011, representatives from the six Federal agencies designated by the President as lead agencies with responsibility for implementing the National HIV/AIDS Strategy (NHAS) reconvened as part of our ongoing efforts to work toward the Strategy’s goals and achieve a more coordinated national response to the HIV epidemic in the United States. During this meeting, we focused on the issues of HIV/AIDS and homelessness and housing insecurity. We began dialogue about how the agencies could enhance collaborative efforts to address the NHAS’ charge to us to improve housing security for people living with HIV/AIDS as a means to improve health outcomes for them.  The Federal Implementation Plan directs the nation to “Support people living with HIV and co-occurring health conditions and those who have challenges meeting their basic needs, such as housing.”

Participants included representatives from the Departments of Labor, Justice, Health and Human Services, Housing and Urban Development (HUD), and Veterans Affairs and the Social Security Administration. In addition, we were joined by several colleagues from the Department of Health and Human Services who deal with homeless issues at the Centers for Disease Control and Prevention, Health Resources and Services Administration (both the Community Health Centers program and the Ryan White program), and Substance Abuse and Mental Health Services Administration.

Participants shared their deep knowledge about their agency’s relevant programs and populations served, legislative mandates, local partners, and outcome measures. Each also came to listen and learn from one another so that we can identify opportunities to strengthen existing collaborative activities or, possibly, initiate new ones that will help us work toward realizing the Strategy’s goals.

Addressing the housing needs of people living with HIV/AIDS can be seen in the bigger context of ending homelessness in America.  A Federal report issued last summer, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, calls for a coordinated Federal response to homelessness and for the creation of a national partnership at every level of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the Federal government in contributing to the end of homelessness. Also supporting our efforts are the growing efforts at HUD to better coordinate housing services with positive health outcomes for beneficiaries.

Our discussion included examinations of efforts to address the housing needs of specific HIV/AIDS sub-populations including Veterans and formerly incarcerated individuals in addition to individuals receiving or in need of housing supports.

The Federal leads have agreed to continue our dialogue on this important issue over the coming weeks and months. Among the issues for further discussion are:

• Developing joint strategies to encourage co-location/enhanced availability of HIV-related services at housing and other nontraditional HIV care sites.
• Identifying ways to collaborate on policies and programs that increase access for PLWH to nonmedical supportive services (e.g., housing, food, transportation) which enable people living with HIV to obtain and adhere to HIV treatment as critical elements of an effective HIV care system. This will include ideas about how to engage and incentivize our State and local partners to move in this direction.
• Considering opportunities to adopt government-wide definitions and, possibly, measures related to homelessness and housing insecurity that would better position the agencies to share information, identify both unmet need and gaps in knowledge, and more closely coordinate planning and programs
• Opportunities to integrate housing security into the “12 Cities” project
• Opportunities to integrate data and measures related to client-level housing status into both the statewide HIV/AIDS plans called for in the NHAS and as requirements in relevant Federal grants to State and local agencies.
• Identifying Federal partners and grantees at the State and local levels who are engaged in both housing services and HIV/AIDS prevention and care (i.e., recipients of Federal funds and technical assistance on both issues)

Please help inform our ongoing discussion of this important issue. How does your community support housing assistance and other services that enable people living with HIV to obtain and adhere to HIV treatment? What gaps in service or unmet need have you observed that we should consider in our cross-agency planning?  How can we do a better job of coordinating housing and other critical support services for people living with HIV/AIDS? Share your thoughts in the Comments section below.

Together, we are working to identify ways we can improve health outcomes for people living with HIV/AIDS through preventing homelessness and reducing housing insecurity. Motivated by the NHAS and Opening Doors and inspired by the innovative and caring work of our State, local, and community partners, we can make significant improvements in both housing security and health outcomes for people living with HIV/AIDS across the nation.