As the city of Atlanta tries to solve a crisis that has left those living with AIDS and HIV homeless, the program that it runs to shelter them sits on the edge of a financial cliff.
A national shift in how the federal Housing Opportunities for Persons with AIDS program funds local rental assistance and other programs will slash Atlanta’s budget from $23 million to as low as $9 million in about two years, according to estimates. This 60% drop will be the second steepest in the nation and comes as the metro experiences one of the nation’s highest rates of new AIDS/HIV diagnoses, according to public health experts.
Atlanta runs HOPWA for more than two dozen metro counties, so declines in funding could mean fewer people with AIDS/HIV will be able to secure housing through the program. A recent study showed those who lack stable housing upon being diagnosed with HIV are 27 times more likely to die than those who have it.
The city could have begun preparing for the cuts as early as 2016, which is when Congress passed the funding formula. But its work began in earnest only in recent months, after the U.S. Department of Housing and Urban development called it out for failing to make effective use of free planning assistance the federal agency has offered since August 2017.
Mayor Keisha Lance Bottoms proposed to reorganize the program to address the crisis. She also sent top city officials to meetings on HOPWA to assure clients, public health advocates, and providers that solving its problems is one of her top priorities.
The city declined a request to interview Cathryn Marchman, Executive Director for Partners for HOME, the city-founded nonprofit that is supposed to take over the HOPWA program. Spokesman Michael Smith said the city is working with the state and philanthropic organizations and others to find funding.
“Our number one priority is to ensure that no client in HOPWA permanent housing becomes homeless because of these (federal) cuts,” the city’s statement said.
Planning funds unused
Congress passed the 2016 bill that changed the federal HOPWA funding formula to ensure the money went to places that needed it. The previous formula concentrated funds in urban areas, even as suburban and rural needs grew.
While funding for many areas will jump under the new rules, lawmakers knew that Atlanta, New York City and other jurisdictions would lose out. To help them, the bill said none would lose more than 5% of its funding in any of the five years leading up to fiscal year 2022.
“It’s basically training wheels helping the community prepare,” said Lauren Banks Killelea, director of policy for the National AIDS Housing Coalition. HUD wants to keep these shifts from causing anyone to become homeless, putting the onus on jurisdictions to use the lead up to find other funding sources.
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Congress also boosted overall funding to HOPWA to $393 million so that local jurisdictions could use the additional funds to prepare for the changes, said Killelea.
This national increase pushed funding for Atlanta’s HOPWA program to its current high of $23 million. But the local system has been so poorly run that it has been unable to spend it. During the past decade, the city left as much as $41 million in federal HOPWA funds untouched, all while paying the nonprofits that house those with AIDS and HIV months late. The nonprofits used short term loans to stay afloat.
The problems came to a head last summer, when former city HOPWA contractor Living Room shut down saying it was a victim of retaliation by the city and that the late payments wrecked its finances. The city had to scramble to prevent some 250 of its former clients from being evicted and replace the services that the nonprofit provided.
Clients, providers anxious
The urgent needs created by the Living Room shutdown make it hard for the city and those pushing for reform to turn their attention to the coming cuts. At a recent public meeting on HOPWA’s future, a mother of six with HIV cried into a paper napkin and pleaded for help.
“I’m scared to death of being thrown out on the street,” said the HOPWA client, who asked that her name be withheld because of the stigma that comes with the disease. She only learned that the Living Room had stopped paying her rent when her landlord told her they were months behind. A different nonprofit took her on, but she needed a home inspection to keep the monthly subsidy for her four-bedroom house and remain in the program.
She had been waiting for the inspection for months, she told the crowd of about 70 at the DeKalb County Board of Health offices. Without it, HOPWA would not pay her Nov. 1 rent. Two of her children who live with her are disabled, and she is losing her vision as a side effect of HIV medications, she said.
Social workers said they are still struggling to find shelter for HIV clients with the shutdown of the Living Room. Housing for people recovering after hospital stays has yet to be replaced.
“It’s absolutely careless to take someone who has just been released from the hospital and say, ‘Okay, you can lay in a hotel room by yourself. Best of luck’,” said Rasheeda Jordan, who directs housing for nonprofit HOPWA provider Positive Impact Health Centers.
Plan yet to take shape
The city has made some progress to prepare for the pending federal cuts, creating an advisory committee in September to make HOPWA decisions more transparent.
If HUD allows the city to keep what it failed to spend, as much as $41 million, it can use the funds to rebuild its system, Killelea said. The city could pitch in with housing funds, and it can also use other sources of federal funding such as Medicaid and the federal Ryan White HIV/AIDS Program to pay for services it can no longer afford.
Atlanta leaders need to reach out to other jurisdictions such as New York, San Francisco and Miami to learn what they’re doing to cope with cuts, Killelea said.
But even reforms carry risks. The city scrapped a bidding process it had started for next year’s HOPWA dollars so that the new committee can oversee spending. This sparked worries that changes will cause funding delays.
Providers need plenty of time to ensure clients don’t end up on the streets, said Nicole Roebuck, executive director of city HOPWA contractor AID Atlanta.
“If priorities are different because of huge budget cuts, we can’t prepare the clients the month before to say, ‘Sorry, you’re cut off,’” Roebuck said.
Our reporting
The Atlanta Journal-Constitution reported in June that 250 people with HIV or AIDS were at risk of being evicted from subsidized housing, following the city’s failure to transmit federal funds to a nonprofit provider. Subsequent reporting revealed long-standing disputes between the city and housing providers and raised questions about the city’s management of the $23 million Housing Opportunities for Persons With AIDS program. Now, city officials are late planning for how to absorb a 60% budget cut to the program.
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