Law & Policy: Policy Notice - 08-01:
The Use of Ryan White HIV/AIDS Program Funds
for Housing Referral Services and Short-term
or Emergency Housing Needs
Date: March 19, 2008
To: All Ryan White HIV/AIDS Program Grantees
Attached is the HIV/AIDS Bureau (HAB) updated
policy describing the use of Ryan White
HIV/AIDS Program funds for housing referral
services and short-term or emergency housing
needs. This policy was originally published
in 1997 as Policy Notice 97-02 - Emergency
Assistance for Eligible Individuals and
subsequently replaced by Policy Notice 99-02
- The Use of Ryan White Comprehensive AIDS
Resources Emergency (CARE) Act funds for
Housing Referral Services and Short-term
or Emergency Housing Needs. The Health Resources
and Services Administration (HRSA)/HAB Policy
Notice 99-02 Amendment 1, as addressed in
the February 26 Federal Register Notice,
is newly entitled Policy Notice 08-01
- The Use of Ryan White HIV/AIDS Program
Funds for Housing Referral Services and
Short-term or Emergency Housing Needs.
In response to the United States Senate
Finance Committee's request to investigate
the use of Ryan White funds for housing
services, the Department of Health and Human
Services, Office of the Inspector General
(OIG), conducted an investigation in 2004.
The OIG determined that housing services
exceeded a "reasonable" time limitation
as evidenced by some clients receiving housing
services for a 4-8 year consecutive time
period. As such, the OIG instructed HRSA
to clarify the definition of short-term
and emergency housing assistance by establishing
a time limit.
On December 6, 2006, a proposed amendment
of HAB Policy Notice 99-02 was published
in the Federal Register. During the 60-day
public comment period, ending February 5,
2007, HRSA received over 200 comments. There
were several comments in favor of the draft
policy stating that the proposed changes
allow for more funds to be allocated to
life-saving core medical services, including
medications. Three main areas of concern
were raised and addressed: allowing sufficient
time to implement the policy, the grandfathering
of clients currently receiving housing service,
and the 24-month timeframe being seen as
too restrictive. In response, HRSA addressed
the requested time for implementing the
policy by providing 1-year for comment review;
HRSA agreed that the 24-month time period
not be retroactive; and HRSA retained the
24-month time period per household to comply
with OIG and better define short-term and
emergency housing.
The amendment of Policy Notice 99-02 reflects
considerations and modifications based on
public comment. In addition, the policy
reflects the new nomenclature in Title XXVI
of the Public Health Service Act as amended
by the Ryan White HIV/AIDS Treatment Modernization
Act of 2006 (Ryan White HIV/AIDS Program)
and establishes guidelines for the use of
Part A, Part B, and Part D of the Ryan White
HIV/AIDS Program funds for allowable expenditures
for housing referral services and time limited
short or emergency housing services for
eligible persons living with HIV/AIDS.
This policy becomes effective March 27.
If you have any questions regarding the
content of this Policy Notice, please contact
your project officer.
/s/
Deborah Parham Hopson, Ph.D., R.N.
Assistant Surgeon General
Associate Administrator
Attachment
HRSA HAB Policy Notice -08-01
Document Title: The Use of Ryan White
HIV/AIDS Program Funds for Housing Referral
Services and Short-term or Emergency Housing
Needs
The following policy establishes guidelines
for allowable housing-related expenditures
under the Ryan White HIV/AIDS Program. The
purpose of all Ryan White HIV/AIDS Program
funds is to ensure that eligible HIV-infected
persons and families gain or maintain access
to medical
care.
A. Funds received under the Ryan White
HIV/AIDS Program (Title XXVI of the Public
Health Service Act) may be used for the
following housing expenditures:
i. Housing referral services defined
as assessment, search, placement, and
advocacy services must be provided by
case managers or other professional(s)
who possess a comprehensive knowledge
of local, State, and Federal housing programs
and how they can be accessed; or
ii. Short-term or emergency housing defined
as necessary to gain or maintain access
to medical care and must be related to
either:
a. Housing services that include some
type of medical or supportive service
(a listing of supportive services can
be found at: http://hab.hrsa.gov/reports/data2b.htm)
including, but not limited to, residential
substance abuse treatment or mental health
services (not including facilities classified
as an Institution for Mental Diseases
under Medicaid), residential foster care,
and assisted living residential services;
or
b. Housing services that do not provide
direct medical or supportive services
but are essential for an individual or
family to gain or maintain access to and
compliance with HIV-related medical care
and treatment. Necessity of housing services
for purposes of medical care must be certified
or documented by a case manager, social
worker,
or other licensed healthcare professional(s).
B. Short-term or emergency housing assistance
is understood as transitional in nature
and for the purposes of moving or maintaining
an individual or family in a long-term,
stable living situation. Such assistance
is limited to a
cumulative period of 24-months per household.
Short-term or emergency assistance must
be accompanied by a
strategy to:
i. Identify, relocate, and/or ensure
the individual or family is moved to a
long-term, stable housing; or
ii. Identify an alternate funding source
for support of housing assistance.
C. Housing funds cannot be in the form
of direct cash payments to recipients or
services and cannot be used for mortgage
payments.
D. The Ryan White HIV/AIDS Program must
be the payer of last resort. In addition,
funds received under the Ryan White HIV/AIDS
Program must be used to supplement but not
supplant funds currently being used from
local, State, and Federal agency programs.
Grantees must be capable of providing the
HIV/AIDS Bureau (HAB) with documentation
related to the use of funds as payer of
last resort and
the coordination of such funds with other
local, State, and Federal funds.
E. Housing-related expenses are limited
to Part A, Part B, and Part D of the Ryan
White HIV/AIDS Program and are not allowable
expenses under Part C.
F. For all clients, new or current, the
24-month cumulative period of eligibility
becomes effective as of March 27. Grantees
are responsible for tracking the 24-month
cumulative period of eligibility beginning
on that date.
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