Housing Services

Service Standard

Housing Services Service Standard print version

Subcategories Service Units
Housing Assistance – Short-Term - Housing assistance is limited to short-term assistance to support temporary and/or transitional housing to enable the individual or family to gain and/or maintain medical care. Use of Ryan White Program funds for short-term or emergency housing must be linked to medical and/or healthcare or be certified as essential to a client’s ability to gain or maintain access to HIV-related medical care or treatment. Per day
Housing Assistance – Emergency - Housing assistance is limited to emergency financial assistance to support temporary and/or transitional housing to enable the individual or family to gain and/or maintain medical care. Use of Ryan White Program funds for short-term or emergency housing must be linked to medical and/or healthcare or be certified as essential to a client’s ability to gain or maintain access to HIV-related medical care or treatment. Per day
Housing Referral/Housing Related Service - Housing related services include assessment, search, placement, and advocacy services provided by professionals who possess an extensive knowledge of local, State and Federal housing programs and how they can be accessed. Per 15 minutes

Health Resources and Services Administration (HRSA) Description

Housing provides transitional, short-term, or emergency housing assistance to enable a client or family to gain or maintain outpatient/ambulatory health services and treatment, including temporary assistance necessary to prevent experiencing homelessness and to gain or maintain access to medical care. Activities within the Housing category must also include the development of an individualized housing plan, updated annually, to guide the client’s linkage to permanent housing. Housing may provide some type of core medical (e.g., mental health services) or support services (e.g., residential substance use disorder services).

Housing activities also include housing referral services, including assessment, search, placement, and housing advocacy services on behalf of the eligible client, as well as fees associated with these activities.

Program Guidance

HRSA Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients that use funds to provide Housing must have mechanisms in place to assess and document the housing status and housing service needs of new clients, and at least annually for existing clients.

HRSA RWHAP recipients and subrecipients, along with local decision-making planning bodies, are strongly encouraged to institute duration limits to housing activities. HRSA HIV/AIDS Bureau (HAB) recommends recipients and subrecipients align duration limits with those definitions used by other housing programs, such as those administered by the Department of Housing and Urban Development (HUD), which currently uses 24 months for transitional housing.

Housing referral activities performed by Ryan White-funded medical or non-medical case managers are reported under the respective case management service category. Referral services provided by Ryan White-funded housing specialists are reported under the Housing service category.

Limitations

Housing services cannot be in the form of direct cash payments to clients and cannot be used for mortgage payments or rental deposits. These may be allowable costs under HUD Housing Opportunities for Persons with AIDS (HOPWA) grant awards.

Services:

Eligible housing may include housing that:

  • Provides some type of core medical or support services (such as mental health services, residential substance use disorder services, residential foster care, or assisted living residential services).
  • Does not provide direct core medical or support services but is essential for a client or family to gain or maintain access to and adherence to HIV-related medical care and treatment.

Funds received under this category may be used for the following housing-related expenditures:

  • Housing referral services provided by a housing case manager or other professional who possesses a comprehensive knowledge of local, state, and federal housing programs and how these programs can be accessed. These services may include assessment, search, placement, and advocacy services.
  • Emergency housing, defined as housing services provided in response to an unforeseen event that jeopardizes a household’s ability to pay housing costs. Assistance is limited to 1 month of rental/utility assistance within a contract year.
  • Transitional housing, defined as housing support for a person experiencing homelessness that helps the client to gain or maintain access to medical care. Funds may be used for rental and/or application fees; however, funds cannot be used for rental deposits. Funds may also be used for transitional residential housing that provides some type of core medical or support services. Transitional housing assistance is based on need and available resources and is limited to no more than 6 continuous months of funding within a contract year.
  • Short-term assistance, defined as support for a person currently in housing but needing financial support for rent and/or utilities to gain or maintain medical care.

The maximum amounts of emergency housing assistance, transitional housing assistance, and short-term housing assistance shall be uniform throughout each HIV Service Delivery Area (HSDA) and be determined by 1) planning councils (PCs) in areas where the PC determines recommended allocations for Ryan White Part B (RW/B) and State Services funds; or 2) by the Administrative Agency (AA) based on consumer input/planning processes in RW/B-only HSDAs.

Universal Standards

Service providers for Housing Services must follow HRSA/DSHS Universal Standards 1-46 and 153-158.

Service Standards and Measures

The following standards and measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.

Standard Measure

Emergency Housing Assistance: 

Agency staff will initiate an intake within 3 business days of the onset of the emergency housing need. Assessment of client housing status and housing service needs must be documented. Reason(s) for emergency assistance may include but are not limited to:

  • Client is unable to pay rent due to a recent job loss
  • Client is on an unpaid medical leave of absence or has exhausted all leave balances
  • Client is unable to work due to recent hospitalization
  • Client had to purchase unexpected costly HIV medications or pay for unexpected HIV-related medical expenses out-of-pocket 

The housing assessment must document the following:

  • The actual costs to avoid eviction
  • Other resources are not reasonably available to address the unmet housing need
  • Client will maintain and/or achieve stable housing as a result of housing assistance 

 
Staff will contact the client at the end of the month to determine if the housing emergency has been resolved. If the emergency is not resolved and the client needs additional assistance, the client may be assessed for short-term housing assistance.

  1. Percentage of client charts with documentation of an intake that occurred within 3 business days of emergency need.
     
  2. Percentage of client charts with an emergency housing needs assessment.
     
  3. Percentage of client charts with documentation of follow-up conducted after 1 month to determine if the client is stably housed. (Pilot Measure)
     
  4. Percentage of clients experiencing housing instability or homelessness in the 12-month measurement period. (HRSA HAB measure)

Housing Plan for Transitional and Short-Term Housing: All clients receiving assistance for transitional and/or short-term housing must have a housing plan that includes:

  • Housing status
  • Reason for housing service need
  • Other resources screened for housing assistance 

 
Plans must detail the on-going housing stability goal with a focus on access to medical treatment and supportive services. The plan must include: 

  • Sustainable short-term and long-term goals for alleviating risks of a lack of housing, establishing affordable permanent housing stability, and improving access to health care and supportive services
  • Identification of barriers to sustainable housing
  • Steps to address housing needs
  • Referral(s) to available housing support services
  • Budget and money management skills building, if indicated

The housing plan must be reviewed at least monthly and updated with progress toward housing goals.

  1. Percentage of client charts with a housing plan.
     
  2. Percentage of client charts with housing plans updated at least monthly.

Housing Referral Services: Housing-related referrals provided by housing assistance/referral providers should include a housing assessment, housing search, placement, and advocacy services to seek housing.  This may include applications to other funding sources or housing-related visits to court systems.
Staff will document in the client’s primary record all activity to assist the client in securing housing and the outcome of the assistance, including whether the client has obtained secure and stable housing. 

  1. Percentage of client charts with documentation of all elements of housing referral services provided.
     
  2. Percentage of clients with documentation of the outcome of referral services. (Pilot Measure)

References

Division of Metropolitan HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part A Recipients. Health Resources and Services Administration, June 2022.

Division of State HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part B Recipients. Health Resources and Services Administration, June 2022.

HIV/AIDS Bureau Ryan White HIV/AIDS Program. HIV/AIDS Bureau (HAB) Ryan White HIV/AIDS Program (RWHAP) Policy Clarification Notice 16-02: Eligible Individuals and Allowable Uses of Funds Housing Services Frequently Asked Questions. Health Resources & Services Administration, June 2017.

Ryan White HIV/AIDS Program. Policy Notice 16-02: Eligible Individuals & Allowable Uses of Funds. Health Resources & Services Administration, October 2018.