Analysis of Integrated HIV Housing and Care Services. B. HIV Housing Integration Study Findings

02/01/2014

  • The project studied four IHHP sites representing a range of service models and approaches: (1) the River Region Human Services (RRHS) FUSE project in Jacksonville, Florida; (2) the Frannie Peabody Center (FPC) statewide Maine IHHP project; (3) the Portland (Oregon) Housing Bureau (PHB) S4H project; and (4) the Albany Corporation for AIDS Research, Education, and Services (CARES) Foundations for Living (FFL) project in upstate New York.
  • The four IHHP sites in this study have extensive experience providing HIV housing assistance and support services in collaboration with local partners. They have also been involved in community-level planning of homeless services through their participation and leadership of CoC planning processes and in RWP planning councils, task forces, and provider networks.
  • The IHHP program models show a gradient of service integration (from most to least): (1) all four sites provide direct housing assistance; (2) all four sites fund “housing coordinator” positions; two sites contract them out; (3) two sites fund “employment coordinator” positions; both sites contract them out; and (4) no sites fund medical case management directly; all four sites collaborate with medical case managers funded by RWP.
  • Program components that facilitate service integration include (1) in-depth screening of clients’ housing, health care, and other support service needs at intake; (2) development of individualized care plans for program clients tailored to their needs and circumstances; and (3) frequent in-person contact between housing coordinators, peer specialists, and clients and their medical providers and medical case managers.
  • Two IHHP sites are also participating in a HRSA Special Project of National Significance addressing the coordination of housing and HIV care. In those medical home-focused programs, the sites are working with clients who are more medically needy and less likely than IHHP clients to become employed and mainstreamed into public housing.
  • Recent funding restrictions at the federal, state, and local levels are limiting the grantees’ ability to fully realize their IHHP goals. Additional concerns include (1) the lack of affordable housing available; (2) uncertainty about the potential impact of the Affordable Care Act on RWP-funded services, notably medical case management; and (3) the need for HIV service providers to shift from simply securing HIV-specific benefits for their clients to helping clients move into mainstream housing and employment.
  • Neither HUD’s Homeless Management Information System (HMIS) nor HRSA’s CAREWare data system has the comprehensive set of housing and health care data needed to evaluate the effectiveness of the IHHP grantees’ programs. All four sites are working on data system integration to address this problem.
  • The IHHP grantees plan to bring together groups from public housing, homeless (CoC) grantees and service providers, city planning, RWP grantees, and AIDS service organizations to create community-wide IHHP plans, but note two challenges: (1) CoC and RWP grantees do not typically have a history of working together, and (2) some worried that HOPWA programs were historically marginalized in both CoC and RWP planning processes.

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