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Housing Services
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HRSA/HAB Category Definition:
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Housing services are the provision of short-term assistance to support emergency, temporary or transitional housing to enable an individual or family to gain or maintain medical care. Housing-related referral services include assessment, search, placement, advocacy, and the fees associated with them. Eligible housing can include both housing that does not provide direct medical or supportive services and housing that provides some type of medical or supportive services such as residential mental health services, foster care, or assisted-living residential services.
Emergency Financial Assistance
Emergency financial assistance is the provision of short-term payments to agencies or the establishment of voucher programs to assist with emergency expenses related to essential utilities, housing, food (including groceries, food vouchers, and food stamps) and medication, when other resources are not available. Part A and Part B programs must allocate, track and report these funds under specific service categories as described under 2.6 in DSS Program Policy Guidance No. 2 (formally Policy No. 97-02).
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Source: Definition provided by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). 2009. Ryan White HIV/AIDS Treatment Modernization Act of 2006 Definitions for Eligible Services. Rockville, Md.: HRSA HAB, August 20, 2009.
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Category Notes:
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Clarifications
The following definition clarification is from a HRSA policy statement on housing referral sent to all Ryan White grantees on March 19, 2008 (HRSA 2008).
Housing services are limited to two years over the lifetime of the consumer.
The following clarification was distributed by HRSA on February 5, 2010 (HRSA 2010b).
Following the rescission of Amendment 1 to Policy Notice 99-02, effective February 10, 2010, Ryan White HIV/AIDS Program, grantees will not be required to enforce the amendment for beneficiaries that might be at or near the 24-month cumulative cap on short-term and emergency housing assistance.
• Funds received under the Ryan White HIV/AIDS Program 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 professionals 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: including, but not limited to, residential substance abuse or mental health services (not including facilities classified as an Institute of 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 and compliance with HIV-related medical care and treatment. Necessity of housing services for purposes of medical care must be certified or documented.
• Short-term or emergency assistance is understood as transitional in nature and for purposes of moving or maintaining an individual or family in a long-term, stable living situation. Thus, such assistance cannot be permanent and must be accompanied by a strategy to identify, relocate, and/or ensure the individual or family is moved to, or capable of maintaining, a long-term, stable living situation.
• Housing funds cannot be in the form of direct cash payments to recipients for services and cannot be used for mortgage payments.
• 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 HAB with documentation related to the use of funds as the payer of last resort and the coordination of such funds with other local, State, and Federal funds.
• Housing-related expenses are limited to Parts A, B, and D of the Ryan White HIV/AIDS Program, and are not allowable expenses under Part C.
The following clarifications were distributed by HRSA on April 8, 2010 (HRSA 2010a).
• Funds awarded under the Ryan White HIV/AIDS Program may be used to purchase essential non-food household products as part of a Ryan White HIV/AIDS Program funded Food Bank support service. These include essential items such as:
-Personal hygiene products,
-Household cleaning supplies, and/or
-Water filtration/purification devices (either portable filter/pitcher combinations or filters attached to a single water tap) in communities/areas where recurrent problems with water purity exist. Such devices (including their replacement filter cartridges) purchased with Ryan White HIV/AIDS Program funds must meet National Sanitation Foundation standards for absolute cyst removal of particles less than one micron. This policy does not permit installation of permanent systems for filtration of all water entering a private residence.
-Funds may not be used for household appliances, pet foods or other non-essential products.
• Ryan White HIV/AIDS Program funds may be used to provide Emergency Financial Assistance (EFA) as an allowable support service. The decision-makers deliberately and clearly must set priorities and delineate and monitor what part of the overall allocation for emergency assistance is obligated for transportation, food, essential utilities and /or prescription assistance. Careful monitoring of expenditures within a category of “emergency assistance” is necessary to assure that planned amounts for specific services are being implemented, and to indicate when reallocations may be necessary. In addition, Grantees and planning councils/consortia must develop standard limitation on the provision of Ryan White HIV/AIDS Program funded emergency assistance to eligible individuals/households and mandate their consistent application by all contractors. It is expected that all other sources of funding in the community for emergency assistance will be effectively utilized and that any allocation of Ryan White HIV/AIDS Program funds to these purposes will be the payer-of-last-resort, and for limited amounts, limited use and limited periods of time.
History
Housing services is the result of a merger of two categories in 2004. What is now referred to as housing services is mostly derived from the former category entitled “housing assistance services”; this service continues to be funded in the Baltimore EMA. Housing-related referral services is no longer funded as a service, but all programs that temporarily house or provide other housing assistance are expected to help all consumers locate long-term or permanent housing.
Emergency rental assistance to prevent eviction and emergency payment to prevent utility cut-off, formerly tracked under emergency financial assistance, are now tracked and reported under the housing services category.
Current Directives
Ongoing 2006: The administrative agent is to report, by client and the corresponding dollar expenditures, the number of bed nights and the number of rental assistance vouchers utilized. The administrative agent is to provide dollar amounts on the number of bed nights and the number of rental assistance vouchers utilized. This is being incorporated into standard practice (IGS 2011a). +The dollar amounts that are indicated as indirect are funding streams that have been passed from a federal agency to a fiscal intermediary (e.g., DHMH, a local housing agency, etc.) and then to the source listed. Each item indicated, therefore, may not be a unique funding stream. It was not possible to parse out exactly how much money was duplicated between direct and indirect funding streams.
For the following categories: emergency financial assistance (EFA), early intervention services (EIS), food bank/home-delivered meals, legal, medical case management and outpatient ambulatory health services.
Ratified on October 16, 2007: To give guidance to the administrative agent on how to apportion funds to those categories that have subset activities based on percentages utilized by each subset.
The administrative agent will divide the allocation according to the percentage of those subset activities based on the service utilization percentage of each sub activity. The AA will report out by total category performance and expenditure and by each subset performance and expenditure. (IGS 2007b)
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