• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (737) 255-4300

    Email the HIV/STD Program

    Email data requests to HIV/STD Program - This email can be used to request data and statistics on HIV, TB, and STDs in Texas. It cannot be used to get treatment or infection history for individuals, or to request information on programs and services. Please do not include any personal, identifying health information in your email such as HIV status, Date of Birth, Social Security Number, etc.

    For treatment/testing history, please contact your local Health Department.

    For information on HIV testing and services available to Persons Living with HIV and AIDS, please contact your local HIV services organization.

Housing Services

Service Standard

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HRSA Definition:

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 homelessness and to gain or maintain access to medical care. Housing services include housing referral services and transitional, short-term, or emergency housing assistance.

Housing services must also include the development of an individualized housing plan, updated annually, to guide the client’s linkage to permanent housing. Housing services also can 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 services.

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.

 

Limitations:

Housing services cannot be in the form of direct cash payments to clients and cannot be used for mortgage payments or rental deposits.[ 1] These may be allowable costs under HUD Housing Opportunities for Persons with AIDS grant awards.

 

Services:

Eligible housing may include housing that:

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

 

Program Guidance:

Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients must have mechanisms in place to assess the housing status and housing needs of new clients to ensure access to housing services. RWHAP recipients and subrecipients must assess and document existing clients’ housing needs at least annually to determine the need for new or additional services.

In addition, RWHAP recipients and subrecipients must develop an individualized housing plan for each client receiving housing services and update it annually. RWHAP recipients and subrecipients must provide HIV/AIDS Bureau (HAB) with a copy of the individualized written housing plan upon request.

RWHAP recipients and subrecipients are strongly encouraged to institute duration limits to housing services. HRSA HAB recommends recipients and subrecipients align duration limits with those definitions used by other housing programs; referencing the U.S. Department of Housing and Urban Development (HUD) definition of transitional housing as up to 24 months.

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 to include assessment, search, placement, and advocacy services, who possess a comprehensive knowledge of local, state, and federal housing programs and how these programs can be accessed.
  • Emergency housing defined as an unforeseen event that jeopardizes a household’s ability to pay housing costs. Assistance is limited to one (1) month of rental/utility assistance within a contract year. The maximum amount of emergency 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.
  • Transitional housing is defined as support for a homeless person to facilitate movement to independent living. Transitional housing also provides temporary assistance necessary to prevent homelessness and to gain or maintain access to medical care. Funds may be used for rent 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 such as residential substance use disorder services or mental health services, residential foster care, or assisted living residential 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. The maximum amount of transitional housing assistance shall be uniform throughout each HSDA and be determined by: 1) PCs in areas where the PC determines recommended allocations for RW/B and State Services funds; or 2) by the AA based on consumer input/planning processes in RW/B-only HSDAs.
  • 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 amount of short term assistance shall be uniform throughout each HSDA and be determined by: 1) PCs in areas where PCs determine recommended allocations for RW/B and State Services funds; or 2) by the AA based on consumer input/planning processes in RW/B-only HSDAs.

 

Service Standard and Performance Measure

The following Standards and Performance Measures are guides to improving healthcare outcomes for PLWH throughout the State of Texas within the Ryan White Part B and State Services Program.

 

Standards
Standard Performance Measure

Emergency Housing Assistance: Agency staff will initiate an intake within three (3) business days’ 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: recent job loss; unpaid medical leave of absence; exhausted all leave balances
  • Client is unable to work due to recent hospitalization
  • Client had to recently purchase unexpected costly HIV medications or to pay for unexpected HIV-related medical expenses out of pocket

Assessment that the household need is:

  • Actual costs to avoid eviction
  • Other resources are not reasonably available to address the unmet housing need
  • Client will maintain and/or have 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 not resolved and the client needs additional assistance, the client may be assessed for short-term housing assistance.

Percentage of client charts with documented evidence of emergency housing need assessed.

Percentage of client charts that have a documented assessment of other resources reviewed and determined not available to assist client in housing emergency.

Percentage of client charts with documented evidence of follow up to housing need with resolution of housing emergency.

Percentage of patients with an HIV diagnosis, who were homeless or unstably housed, in the 12-month measurement period. (HAB Performance Measure)

Percentage of client charts accessing housing assistance, with stabilized housing documented as a result of the assistance provided.

Housing Plan for Transitional (temporary) and Short-Term Housing: All clients receiving assistance for transitional and/or short-term housing must have a Housing Plan documented within the client files that includes:

  • Housing status;
  • Reason for housing assistance 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 homelessness, 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; and
  • Budget and money management skills building, if indicated.

Documentation in the client’s primary record/progress notes that the housing plan is reviewed at least monthly.

Percentage of client charts with a documented housing plan developed.

Percentage of client charts with documented evidence of monthly updated housing plans with progress toward goals identified.

Housing Referral Services: Housing related referrals provided by housing assistance/referral providers include housing assessment, search, placement, and advocacy services to seek housing (application to funding sources, visits to court systems). [2]

Staff will document in the client’s primary record all activity to assist client in securing housing and outcome of the assistance. 

Percentage of client charts with documented evidence of housing referral services provided, as applicable, including all elements as indicated.

Percentage of clients who received housing referral services that obtained secure, stable housing as a result of the assistance provided.

 

References

HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards – Part A April 2013. p. 33-36.

HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards – Program Part B April, 2013. p. 31-35.

Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02 (PDF) (Revised 10/22/2018).

HRSA/HAB Ryan White & Global HIV/AIDS Programs, Program & Grants Management, Policy Notices and Program Letters, Housing FAQ. (PDF) [HRSA]

 

Notes

[1] See sections 2604(i), 2612(f), 2651(b), and 2671(a) of the Public Health Service Act.

[2] Housing referral activities performed by Ryan White-funded case managers (NMCM or MCM) 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.


Last updated May 11, 2020