Responding to Concerns Over Ryan White Emergency Housing Policy

The Health Resources and Services Administration (HRSA) announced today that it is rescinding enforcement of its 24-month cumulative cap on short-term and emergency housing assistance under the Ryan White program. This is a temporary step pending a broader review of Ryan White housing policies.  See the announcement in the Federal Register.

Late last year, I became aware of growing community concern over the impact of this policy, especially as the date (late March) was approaching when the first persons subject to this limit faced the possibility of losing their housing.  In December, I met with a number of HIV community advocates who shared their concerns with the perceived inflexibility of this policy.  The situation is compounded by the difficult economic situation.  The need for housing assistance exceeds the available resources in many communities in the best of circumstances, but is further constrained by tight local and state budgets as the country works to recover from the most serious economic downturn in many peoples’ lifetimes. 

In October, the President signed into law the fourth reauthorization of the Ryan White program.  This is a strong law that underscores the ongoing commitment of the Administration and the Congress to provide for the care and treatment of people living with HIV/AIDS.  The HIV/AIDS Bureau, under the leadership of Deborah Parham Hopson, is determined to implement the law and ensure that resources are effectively deployed to provide critical medical care and supportive services to people living with HIV/AIDS across the country. 

Numerous studies have demonstrated the positive and essential role of housing in ensuring that people living with HIV/AIDS come into care and stay in care. Recognition of this link provides a basis for Ryan White supporting short-term, emergency housing assistance.  At the same time, the Ryan White program is intended to primarily support primary medical care and related health care supports.  The Department of Housing and Urban Development (HUD), and in particular the Housing Opportunities for People with AIDS (HOPWA) program, has lead responsibility for providing housing assistance to people with HIV/AIDS.  Going back through many Administrations, the role of Ryan White in providing housing supports has always been understood to be limited to short-term and emergency assistance.  We are not currently contemplating any expansion of Ryan White’s role beyond providing short-term emergency assistance. 

I have heard the community concerns and believe it is important to ensure that our implementation of this policy reaches an appropriate balance that achieves several goals: it should strengthen linkages to HUD programs and state and local housing resources for providing longer-term assistance; it should minimize housing disruptions for people living with HIV/AIDS; it should integrate housing with a broader range of supports that collectively can support individuals in maintaining their health; it should provide flexibility to respond to exceptional circumstances; and it should minimize the burden on Ryan White providers who are responsible for assisting us in implementing any housing policy.  Administering the Ryan White program is an important responsibility that necessarily entails making difficult choices as we respond to multiple and competing needs of people living with HIV/AIDS all over the United States. As I work with the HIV/AIDS Bureau to undertake a comprehensive review of Ryan White housing policies, I look forward to the continued insights and perspectives of people living with HIV/AIDS, housing experts, and our network of local, state, and community-based partners.

Mary Wakefield, Ph.D., R.N. is the Administrator of the Health Resources and Services Administration (HRSA)

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