Unlike HOPWA, which focuses primarily on housing, most RWP funds are allocated to core medical services as required by law. In 2010, only 3.2 percent of total RWP Part A and Part B funds were spent on housing assistance. In contrast, two-thirds (67 percent) of HOPWA’s 2010 expenditures were allocated to housing (Figure II.2). In total housing program expenditures, in 2010, RWP’s Part A grants (to metropolitan areas) and Part B grants (to states) spent a total of $27,541,664 on housing assistance, compared to the $211,114,260 spent on housing services through HOPWA’s formula and competitive grants (Appendices C and D). While HOPWA’s housing assistance expenditures rose substantially between 2007 and 2010, RWP expenditures for housing services remained relatively constant over the same period (Figure II.3).
RWP housing program allocations vary across states. Eighteen states and territories that received Part A or B grant funding in 2010 spent nothing on housing assistance, while another six spent less than 0.5 percent of their funding on housing services (Appendix C).14 Only the Part A grantees in Massachusetts and Oregon spent 10 percent or more of their Part A grant on housing assistance. The states with the greatest share of Part B housing expenditures were Hawaii and Nebraska, which spent 19 and 13 percent of their Part B grants, respectively, on housing services. RWP housing policy limits the use of funding to short-term and emergency housing assistance. Due to the statutory limitation on RWP grantees’ spending on non-medical support services such as housing assistance, it is difficult to draw conclusions from these spending data about the actual level of need that exists.
Figure II.2. Distribution of HOPWA and RWP Expenditures in 2010
Source: HRSA Ryan White Expenditure Reports, Part A and Part B, 2010; HUD HOPWA formula grant Consolidated Annual Performance Evaluation Report (CAPER) and HUD HOPWA competitive grant Annual Performance Report (APR), 2010.
MAI = Minority AIDS Initiative.
* Part B includes only Consortia, State Direct Services, and Emerging Communities Expenditures.
HOPWA formula funds are awarded to eligible cities on behalf of their metropolitan areas and to eligible States. Under current law, to be eligible for awards, states must have more than 1,500 cumulative AIDS cases outside of eligible metropolitan statistical areas.15 The proportion of total HOPWA funds spent on housing services varied by state. Of the states with entitlement grant expenditures (reported through CAPER), 12 spent three-fourths (75 percent) or more of their reported total expenditures in 2010 on housing services, and 7 that received formula funding spent 44 percent or less of their grant on housing services. Of the states with competitive grant expenditures in 2010 (reported through APR), six spent three-fourths (75 percent) or more of their total expenditures on housing services, and four others spent 44 percent or less (Appendix C). States’ combined formula and competitive spending on housing services ranged from 8.6 to 56.2 percent of their total funds.16
In 2010, of the two-thirds of HOPWA funds that were spent on housing assistance, more than half (51 percent) were spent on TBRA (Figure II.4). Of the total HOPWA housing funds, one quarter (26 percent) was spent on permanent housing facilities. HOPWA housing assistance resources (including capital, leasing, and operating resources, permanent and transitional project-based assistance, and TBRA assistance) often leverage RWP resources for case management at the project level, allowing HOPWA resources to be focused on providing housing assistance.
Figure II.3. HOPWA and RWP Housing Assistance Expenditures
Source: HRSA Ryan White Expenditure Reports, 2007–2010; HUD HOPWA CAPER and APR data, 2007–2010.
Housing assistance services vary by cost, duration, and intensity; some are more short-term or temporary than others. Among the primary types of HOPWA housing (TBRA, PSH, short-term, and STRMU), the average cost of housing a family in permanent facilities with operating subsidies or leased units is comparatively high. In 2010, in housing facilities with operating subsidies or leased units, average permanent assistance costs per household were more than twice the average cost per household in transitional/short-term housing facilities (in part because the two programs cover different activities). Permanent housing facilities assistance also cost 30 percent more, on average, per household than TBRA. In contrast, STRMU assistance costs were far less per household: three to seven times less than other types of HOPWA housing assistance (Table II.2 and Appendix E).
Table II.2. Average Annual Cost per Household, by Type of HOPWA Housing Service
Source: HUD HOPWA CAPER and APR data, 2010.
Figure II.4. Percentage of HOPWA Housing Expenditures, by Type
Source: HUD HOPWA CAPER and APR data, 2010.
14 Percentage expenditures were rounded to the nearest whole number, so this total includes states that spent less than 0.5 percent of their funds on housing.
15 Although HOPWA funds are awarded only to states, for the purposes of this report, the funds were aggregated at the state and national levels for comparison purposes.
16 Guam has 0 percent but received only $78,927 total funds. South Dakota has 0 percent, and North Dakota has 1 percent; however, this is because their data are reported under Montana. Montana has a percentage of 60.68, but that includes North and South Dakota and thus is inflated.