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Housing for Persons Living with HIV/AIDS
Libby Perl
Specialist in Housing Policy
January 21, 2010
Congressional Research Service
7-5700
www.crs.gov
RL34318
CRS Report for Congress
P
repared for Members and Committees of Congress
c11173008
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Housing for Persons Living with HIV/AIDS
Summary
Since the beginning of the acquired immunodeficiency syndrome (AIDS) epidemic in the early
1980s, many individuals living with the disease have had difficulty finding affordable, stable
housing. As individuals become ill, they may find themselves unable to work, while at the same
time facing health care expenses that leave few resources to pay for housing. In addition, many of
those persons living with AIDS struggled to afford housing even before being diagnosed with the
disease. The financial vulnerability associated with AIDS, as well as the human
immunodeficiency virus (HIV) that causes AIDS, results in a greater likelihood of homelessness
among persons living with the disease. Further, recent research has indicated that those
individuals living with HIV who live in stable housing have better health outcomes than those
who are homeless or unstably housed, and that they spend fewer days in hospitals and emergency
rooms.
Congress recognized the housing needs of persons living with HIV/AIDS when it approved the
Housing Opportunities for Persons with AIDS (HOPWA) program in 1990 as part of the
Cranston-Gonzalez National Affordable Housing Act (P.L. 101-625). The HOPWA program,
administered by the Department of Housing and Urban Development (HUD), funds short-term
and permanent housing, together with supportive services, for individuals living with HIV/AIDS
and their families. In addition, a small portion of funds appropriated through the Ryan White
HIV/AIDS program, administered by the Department of Health and Human Services (HHS), may
also be used to fund short-term housing for those living with HIV/AIDS.
In FY2010, Congress appropriated $335 million for HOPWA as part of the Consolidated
Appropriations Act (P.L. 111-117). This is the most funding ever appropriated for the program,
exceeding the FY2009 appropriation by $25 million. HOPWA funds are distributed to states and
localities through both formula and competitive grants. HUD awards 90% of appropriated funds
by formula to states and eligible metropolitan statistical areas (MSAs) based on population,
reported cases of AIDS, and incidence of AIDS. The remaining 10% is distributed through a grant
competition. Funds are used primarily for housing activities, although grant recipients must
provide supportive services to those persons residing in HOPWA-funded housing.
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Contents
Introduction ................................................................................................................................ 1
Housing Status of Persons Living with HIV/AIDS ................................................................ 1
Creation of the Housing Opportunities for Persons with AIDS (HOPWA) Program................ 2
Distribution and Use of HOPWA Funds....................................................................................... 4
Formula Grants ..................................................................................................................... 4
Competitive Grants ............................................................................................................... 5
Eligibility for HOPWA-Funded Housing ............................................................................... 6
Eligible Uses of HOPWA Funds ............................................................................................ 6
HOPWA Program Formula and Funding...................................................................................... 8
The HOPWA Formula ........................................................................................................... 8
HOPWA Funding .................................................................................................................. 9
Housing Funded Through the Ryan White HIV/AIDS Program ................................................. 10
The Relationship Between Stable Housing and Health Outcomes ............................................. 12
Tables
Table 1. HOPWA Funding and Eligible Jurisdictions, FY2001-FY2010..................................... 10
Table A-1. HOPWA Formula Allocations, FY2004-FY2009 ...................................................... 14
Appendixes
Appendix. Recent HOPWA Formula Allocations ....................................................................... 14
Contacts
Author Contact Information ...................................................................................................... 18
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Introduction
Acquired immunodeficiency syndrome (AIDS), a disease caused by the human
immunodeficiency virus (HIV), weakens the immune system, leaving individuals with the disease
susceptible to infections. As of 2007, AIDS had been diagnosed and reported in an estimated
468,578 individuals in the fifty states, the District of Columbia, and territories.1 These estimates
do not include those diagnosed with HIV where the disease has not yet progressed to AIDS or
those who have not yet been diagnosed as HIV positive but are currently living with the disease.
Currently there is no cure for HIV/AIDS, and in the early years of the AIDS epidemic, those
persons infected with AIDS often died quickly. In recent years, however, medications have
allowed persons living with HIV and AIDS to live longer and to remain in better health.
Despite improvements in health outcomes, affordable housing remains important to many who
live with HIV/AIDS. This report describes recent research that shows how housing and health
status are related and the effects of stable housing on patient health. It also describes the Housing
Opportunities for Persons with AIDS (HOPWA) program, the only federal program that provides
housing and services specifically for persons who are HIV positive or who have AIDS, together
with their families. In addition, the report describes how a small portion of funds appropriated
through the Ryan White HIV/AIDS program may be used by states and local jurisdictions to
provide short-term housing assistance for persons living with HIV/AIDS.
Housing Status of Persons Living with HIV/AIDS
The availability of adequate, affordable housing for persons living with HIV and AIDS has been
an issue since AIDS was first identified in U.S. patients in the early 1980s. The inability to afford
housing and the threat of homelessness confront many individuals living with HIV/AIDS. From
the early years of the epidemic, those individuals who have been infected with HIV/AIDS face
impoverishment as they become unable to work, experience high medical costs, or lose private
health insurance coverage. The incidence of HIV/AIDS has also grown among low-income
individuals who were economically vulnerable even before onset of the disease.2
Not surprisingly, researchers have found a co-occurrence between HIV/AIDS and homelessness.
Homeless persons have a higher incidence of HIV/AIDS infection than the general population,
while many individuals with HIV/AIDS are at risk of becoming homeless.3 Research has found
that rates of HIV among homeless people may be as much as three to nine times higher than
1 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, HIV/AIDS Surveillance
Report 2007, vol. 19, Atlanta, GA, 2009, p. 25, table 12, http://www.cdc.gov/hiv/topics/surveillance/resources/reports/
2007report/pdf/2007SurveillanceReport.pdf (hereinafter, HIV/AIDS Surveillance Report 2007).
2 John M. Karon, Patricia L. Fleming, Richard W. Steketee, and Kevin M. DeCock, “HIV in the United States at the
Turn of the Century: An Epidemic in Transition,” American Journal of Public Health 91, no. 7 (July 2001): 1064-1065.
3 See, for example, D.P. Culhane, E. Gollub, R. Kuhn, and M. Shpaner, “The Co-Occurrence of AIDS and
Homelessness: Results from the Integration of Administrative Databases for AIDS Surveillance and Public Shelter
Utilization in Philadelphia,” Journal of Epidemiology and Community Health 55, no. 7 (2001): 515-520. Marjorie
Robertson, et al., “HIV Seroprevalence Among Homeless and Marginally Housed Adults in San Francisco,” American
Journal of Public Health 94, no. 7 (2004): 1207-1217. Angela A. Aidala and Gunjeong Lee, Housing Services and
Housing Stability Among Persons Living with HIV/AIDS, Joseph L. Mailman School of Public Health, May 30, 2000,
http://www.nyhiv.org/pdfs/chain/CHAIN%20Housing%20Stability%2032.pdf.
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among those living in stable housing.4 Further, those who are HIV positive and homeless have
been found to be more likely than those who are HIV positive and housed to engage in behaviors
associated with the spread of HIV/AIDS. In one study, the use of injectable drugs, sharing
needles, and exchanging sex for drugs or money were more likely among both homeless
individuals and those who were unstably housed compared to those with stable housing.5 (Those
who were considered unstably housed lived in transitional housing, in jail, drug treatment or a
halfway house, or were doubled up in someone else’s home.6) When housing improved for
individuals in the study, their odds of engaging in these behaviors were reduced. Another study
found that homeless persons living with HIV/AIDS were almost twice as likely to engage in
unprotected sex compared to those who had housing.7 (Individuals were considered housed if
they lived in a house or apartment alone or with others, a medical care facility, or a correctional
institution.8)
Creation of the Housing Opportunities for Persons with AIDS
(HOPWA) Program
In 1988, Congress established the National Commission on AIDS as part of the Health Omnibus
Extension Act (P.L. 100-607) to “promote the development of a national consensus on policy
concerning acquired immune deficiency syndrome (AIDS); and to study and make
recommendations for a consistent national policy concerning AIDS.” In April 1990, in its second
interim report to the President, the Commission recommended that Congress and the President
provide “[f]ederal housing aid to address the multiple problems posed by HIV infection and
AIDS.”9 About the same time that the Commission released its report, in March of 1990, the
House Committee on Banking, Finance, and Urban Affairs held a hearing about the need for
housing among persons living with HIV/AIDS. Witnesses as well as committee members
discussed various barriers to housing for persons living with HIV/AIDS. Among the issues
confronting those persons that were discussed at the hearing were poverty, homelessness, and
discrimination10 in attempting to secure housing. 11 Another issue discussed at the hearing was the
4 Daniel P. Kidder, Richard J. Wolitski, and Scott Royal, et al., “Access to Housing as a Structural Intervention for
Homeless and Unstably Housed People Living with HIV: Rational, Methods, and Implementation of the Housing and
Health Study,” AIDS and Behavior, vol. 11, no. 6 (November 2007, supplement), pp. 149-150.
5 Angela Aidala, Jay E. Cross, Ron Stall, David Harre, and Esther Sumartojo, “Housing Status and HIV Risk
Behaviors: Implications for Prevention and Policy,” AIDS and Behavior 9, no. 3 (2005): 251-265.
6 Ibid., p. 254
7 Daniel P. Kidder, Richard J. Wolitski, and Sherri L. Pals, et al., “Housing Status and HIV Risk Behaviors Among
Homeless and Housed Persons with HIV,” Journal of Acquired Immune Deficiency Syndromes, vol. 49, no. 4
(December 1, 2008), pp. 453-454.
8 Ibid., p. 452.
9 The second interim report was released on April 24, 1990. Its recommendations were reprinted in National
Commission on Acquired Immune Deficiency Syndrome, Annual Report to the President and Congress, August 1990,
pp. 106-109.
10 Individuals living with HIV/AIDS have experienced housing discrimination even though they are protected as
persons with a “handicap” under the Fair Housing Act (FHA). 42 U.S.C. §§ 3601-3631. A number of court cases have
established that the definition of “handicap” protects persons who are HIV positive and persons with AIDS. See, for
example, Baxter v. City of Belleville, Ill., 720 F.Supp. 720, 729-730 (S.D.Ill.1989), and Support Ministries for Persons
With AIDS, Inc. v. Village of Waterford, N.Y., 808 F.Supp. 120, 129-133 (N.D.N.Y. 1992).
11 Hearing before the House Committee on Banking, Finance, and Urban Affairs, Subcommittee on Housing and
Community Development, “Housing Needs of Persons with Acquired Immune Deficiency Syndrome,” March 21,
1990, (hereafter Hearing on Housing Needs). See also, Statement of Representative James A. McDermott, 135 Cong.
(continued...)
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eligibility for subsidized housing for persons living with the disease. A question raised during the
hearing but left unresolved was whether persons living with HIV or AIDS met the definition of
“handicap” in order to be eligible for the Section 202 Supportive Housing for the Elderly program
(which also provided housing for persons with disabilities).12 Another concern was that persons
living with HIV/AIDS often had difficulty obtaining subsidized housing through mainstream
HUD programs such as Public Housing and Section 8 due to the length of waiting lists;
individuals often died while waiting for available units.13
In the 101st Congress, at least two bills were introduced that contained provisions to create a
housing program specifically for persons living with AIDS. These proposed programs were called
the AIDS Housing Opportunity Act (which was part of the Housing and Community
Development Act of 1990, H.R. 1180) and the AIDS Opportunity Housing Act (H.R. 3423). The
bills were similar, and both proposed to fund short-term and permanent housing together with
supportive services for individuals living with AIDS and related diseases. The text from one of
these bills, H.R. 1180, which included the AIDS Housing Opportunity Act, was incorporated into
the Cranston-Gonzalez National Affordable Housing Act (S. 566) when it was debated and passed
by the House on August 1, 1990. In conference with the Senate, the name of the housing program
was changed to Housing Opportunities for Persons with AIDS (HOPWA). In addition, the several
separate housing assistance programs that had been proposed in H.R. 1180—one for short-term
housing, one for permanent housing supported through Section 8, and one for community
residences—were consolidated into one formula grant program in which recipient communities
could choose which activities to fund. The amended version of S. 566 was signed by the President
on November 28, 1990, and became P.L. 101-625, the Cranston Gonzalez National Affordable
Housing Act.
The HOPWA program is administered by the Department of Housing and Urban Development
(HUD) and remains the only federal program solely dedicated to providing housing assistance to
persons living with HIV/AIDS and their families.14 The program addresses the need for
reasonably priced housing for thousands of low-income individuals (those with incomes at or
below 80% of the area median income). HOPWA was last reauthorized by the Housing and
Community Development Act of 1992 (P.L. 102-550). Although authorization for HOPWA
expired after FY1994, Congress continues to fund the program through annual appropriations.
(...continued)
Rec. 23641, October 5, 1989.
12 Hearing on Housing Needs, pp. 25-30. See footnote 11.
13 U.S. Congress, House Committee on Banking, Finance, and Urban Affairs, Housing and Community Development
Act of 1990, report to accompany H.R. 1180, 101st Cong., 2nd sess., June 21, 1990, H.Rept. 101-559.
14 The law is codified at 42 U.S.C. §§ 12901-12912, with regulations at 24 C.F.R. Parts 574.3-574.655.
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Distribution and Use of HOPWA Funds
Formula Grants
HOPWA program funding is distributed both by formula allocations and competitive grants. HUD
awards 90% of appropriated funds by formula to states and eligible metropolitan statistical areas
(MSAs) that meet the minimum AIDS case requirements according to data reported to the Centers
for Disease Control and Prevention (CDC) in the previous year. (For the amounts distributed to
eligible states and MSAs in recent years, see Appendix.) HOPWA formula funds are available
through HUD’s Consolidated Plan initiative. Jurisdictions applying for funds from four HUD
formula grant programs, including HOPWA,15 submit a single consolidated plan to HUD. The
plan includes an assessment of community housing and development needs and a proposal that
addresses those needs, using both federal funds and community resources. Communities that
participate in the Consolidated Plan may receive HOPWA funds if they meet formula
requirements. Formula funds are allocated in two ways:
• First, 75% of the total available formula funds, sometimes referred to by HUD as
“base funding,” is distributed to
—the largest cities within metropolitan statistical areas (MSAs)16 with populations of at least
500,000 and with 1,500 or more cumulative reported cases of AIDS (which includes those
who have died); and
—to states with at least 1,500 cases of AIDS in the areas outside of that state’s eligible
MSAs.17
• Second, 25% of total available formula funds—sometimes referred to by HUD as
“bonus funding”—is distributed on the basis of AIDS incidence during the past
three years.18 Only the largest cities within MSAs that have populations of at
least 500,000, with at least 1,500 reported cases of AIDS and that have a higher
than average per capita incidence of AIDS are eligible.19 States are not eligible
for bonus funding.
Although HOPWA funds are allocated to the largest city within an MSA, these recipient cities are
required to allocate funds “in a manner that addresses the needs within the metropolitan statistical
area in which the city is located.”20 States that receive funds are to use them to benefit areas
outside of eligible MSAs. In FY2009, 90 MSAs (including the District of Columbia) received
funds, while 40 states and Puerto Rico received funds for use in the areas outside of recipient
15 The others are the Community Development Block Grant, the Emergency Shelter Grants, and HOME.
16 MSAs are defined as having at least one “urbanized” area of 50,000 or more and “adjacent territory that has a high
degree of social and economic integration with the core as measured by commuting ties.” See Office of Management
and the Budget Bulletin 09-01, Attachment, “Update of Statistical Area Definitions and Guidance on Their Uses,”
November 20, 2008, p. 2, http://www.whitehouse.gov/omb/bulletins/fy2009/09-01.pdf.
17 42 U.S.C. § 12903(c)(1)(A).
18 AIDS incidence is measured as the number of new AIDS cases during a given time period.
19 42 U.S.C. § 12903(c)(1)(B).
20 42 U.S.C. § 12903(f).
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MSAs.21 HUD jurisdictions that receive HOPWA funds may administer housing and services
programs themselves or may allocate all or a portion of the funds to subgrantee private nonprofit
organizations. HOPWA formula funds remain available for obligation for two years.
As a result of language included in every HUD appropriations law since FY1999 (P.L. 105-276),
states do not lose formula funds if their reported AIDS cases drop below 1,500, as long as they
received funding in the previous fiscal year. States generally drop below 1,500 AIDS cases when
a large metropolitan area becomes separately eligible for formula funds. These states are allocated
a grant on the basis of the cumulative number of AIDS cases outside of their MSAs.22
Competitive Grants
The remaining 10% of HOPWA funding is available through competitive grants. Funds are
distributed through a national competition to two groups of grantees: (1) states and local
governments that propose to provide short-term, transitional, or permanent supportive housing in
areas that are not eligible for formula allocations, and (2) government agencies or nonprofit
entities that propose “special projects of national significance.”23 A project of national
significance is one that uses an innovative service delivery model. In determining proposals that
qualify, HUD must consider the innovativeness of the proposal and its potential replicability in
other communities.24 Competitive grants may not be used to provide supportive services alone;
instead, services can only be provided in conjunction with housing activities, and funds for
services cannot exceed 35% of a project’s budget.25
The competitive grants are awarded through HUD’s annual SuperNOFA (Notice of Funding
Availability), which is generally published in the Federal Register in the early spring. Since
FY2000 (P.L. 106-377), Congress has required HUD to renew expiring contracts for permanent
supportive housing prior to awarding funds to new projects.26 Beginning in FY2006, competitive
funds remain available for obligation for three years (from FY2002 through FY2005, competitive
funds had been available only for two years). The extension makes the rules for HOPWA’s
competitive program consistent with those of other competitive programs advertised in HUD’s
SuperNOFA.
21 U.S. Department of Housing and Urban Development, Office of Community Planning and Development, Office of
HIV/AIDS Housing, list of FY2009 grantees, http://www.hud.gov/offices/cpd/about/budget/budget09/index.cfm.
22 The states that have retained funding under this provision are Arizona, Connecticut, Delaware, Hawaii,
Massachusetts, Minnesota, Nevada, Oklahoma, and Utah. See U.S. Department of Housing and Urban Development,
Congressional Justifications for FY2010, May 2009, p. X-14, http://www.hud.gov/offices/cfo/reports/2010/cjs/
cpd2010.pdf (hereinafter, FY2010 Congressional Budget Justifications).
23 42 U.S.C. § 12903(c)(3).
24 Ibid.
25 See, for example, U.S. Department of Housing and Urban Development, “FY2008 Notice of Funding Availability
Housing Opportunities for Persons With AIDS,” 73 Federal Register p. 27266, May 12, 2008.
26 In FY2009, the amount of funds required for project renewals meant that there were no funds available for additional
competitive grants. See HUD’s website, http://www.hud.gov/offices/adm/grants/nofa09/grphopwa.cfm.
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Eligibility for HOPWA-Funded Housing
In the HOPWA program, individuals are eligible for housing if they are either HIV positive or if
they are diagnosed with AIDS.27 In general, clients must also be low income, meaning that their
income does not exceed 80% of the area median income.28 HUD reports area median incomes for
metropolitan areas and non-metropolitan counties on an annual basis.29 Housing and some
supportive services are available for family members of persons living with AIDS. When a person
living in HOPWA-supported housing dies, his or her family members are given a grace period
during which they may remain in the housing.30 This period may not exceed one year, however.
Individuals who are HIV positive or living with AIDS may also be eligible for other HUD-
assisted housing for persons with disabilities. However, infection itself may not be sufficient to
meet the definition of disability in these other programs. For example, in the case of housing
developed prior to the mid-1990s under the Section 202 Supportive Housing for the Elderly
program and those units developed under the Section 811 Supportive Housing for Persons with
Disabilities program, an individual who is HIV positive or has AIDS must also meet the statutory
definition of disability (in which HIV/AIDS status alone is not sufficient) to be eligible for
housing.31 The project-based Section 8 and Public Housing programs may also set aside units or
entire developments for persons with disabilities. The definition of disability for these programs
does “not exclude persons who have the disease of acquired immunodeficiency syndrome or any
conditions arising from the etiologic agent” for AIDS.32 However, the definition does not indicate
whether the status of being HIV positive or having AIDS is alone sufficient to be considered
disabled.
Eligible Uses of HOPWA Funds
HOPWA grantees may use funds for a wide range of housing, social services, program planning,
and development costs. Supportive services must be provided together with housing. Formula
grantees may also choose to provide supportive services not in conjunction with housing,
although the focus of the HOPWA program is housing activities. Allowable activities include the
following.
27 The HOPWA statute defines an eligible person as one “with acquired immunodeficiency syndrome or a related
disease.” 42 U.S.C. § 12902(12). The regulations have further specified that “acquired immunodeficiency syndrome or
related diseases means the disease of acquired immunodeficiency syndrome or any conditions arising from the etiologic
agent for acquired immunodeficiency syndrome, including infection with the human immunodeficiency virus (HIV).”
24 C.F.R. § 574.3.
28 42 U.S.C. § 12908 and § 12909. The statutory provisions regarding short-term housing and community residences do
not require individuals to be low-income, although to be eligible for short-term housing a person must be homeless or
at risk of homelessness. See 42 U.S.C. § 12907 and § 12910.
29 U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Fiscal Year
2009 HUD Income Limits Briefing Material, April 20, 2009, p. 1, http://www.huduser.org/portal/datasets/il/il09/
IncomeLimitsBriefingMaterial_FY09.pdf. Tables showing area median incomes in recent years are available at
http://www.huduser.org/datasets/il.html.
30 24 C.F.R. § 574.310(e).
31 For more information about housing for persons with disabilities and the definitions of disability under these
programs, see CRS Report RL34728, Section 811 and Other HUD Housing Programs for Persons with Disabilities, by
Libby Perl.
32 42 U.S.C. § 1437a(b)(3).
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• The Development and Operation of Multi-Unit Community Residences, Including
the Provision of Supportive Services for Persons Who Live in the Residences.33
Funds may be used for the construction, rehabilitation, and acquisition of
facilities, for payment of operating costs, and for technical assistance in
developing the community residence.
• Short-Term Rental, Mortgage, and Utility Assistance to Persons Living with
AIDS Who Are Homeless or at Risk of Homelessness.34 Funds may be used to
acquire and/or rehabilitate facilities that will be used to provide short-term
housing, as well as to make payments on behalf of tenants or homeowners, and to
provide supportive services. Funds may not be used to construct short-term
housing facilities.35 Residents may not stay in short-term housing facilities more
than 60 days in any 6-month period, and may not receive short-term rental,
mortgage and utility assistance for more than 21 weeks in any 52 week period.
These limits are subject to waiver by HUD, however, if a project sponsor is
making an attempt to provide permanent supportive housing for residents and has
been unable to do so. Funds may also be used to pay operating and administrative
expenses.
• Project-Based or Tenant-Based Rental Assistance for Permanent Supportive
Housing, Including Shared Housing Arrangements.36 In general, tenants must pay
approximately 30% of their income toward rent.37 Grant recipients must ensure
that residents receive supportive services, and funds may also be used for
administrative costs in providing rental assistance.
• The New Construction or Acquisition and Rehabilitation of Property for Single-
Room Occupancy Dwellings.38
• Supportive Services, Which Include Health Assessments, Counseling for Those
with Addictions to Drugs and Alcohol, Nutritional Assistance, Assistance with
Daily Living, Day Care, and Assistance in Applying for Other Government
Benefits.39
• Housing Information Such as Counseling and Referral Services.40 Assistance
may include fair housing counseling for those experiencing discrimination.41
The majority of HOPWA funds are used to provide housing. According to HUD, in FY2007 and
FY2008, 64% of HOPWA funding was used for housing assistance such as rent and facility
operating costs. An additional 4% was used to help individuals find housing, and 3% for housing
33 42 U.S.C. § 12910.
34 42 U.S.C. § 12907.
35 HOWPA funds may only be used for construction of community residences and single-room occupancy dwellings.
See 24 C.F.R. § 574.300(b)(4).
36 42 U.S.C. § 12908.
37 See 24 C.F.R. § 574.310(d).
38 42 U.S.C. § 12909.
39 24 C.F.R. § 574.300(b)(7).
40 42 U.S.C. § 12906.
41 24 C.F.R. § 574.300(b)(1).
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development.42 Grantee performance reports indicate that clients who receive housing assistance
through HOPWA are often at the lowest income levels; in its FY2009 Annual Performance Plan,
HUD estimated that 81% of households served have either extremely-low incomes (at or below
30% of area median income) or very-low incomes (at or below 50% of area median income).43
HOPWA Program Formula and Funding
The HOPWA Formula
The HOPWA method for allocating formula funds has been an ongoing issue because the
cumulative number of AIDS cases—including those who have died—is used to distribute funds.
A 2006 Government Accountability Office (GAO) report found that the cumulative measure
resulted in disproportionate funding per living AIDS case, depending on the jurisdiction. The
GAO report looked at FY2004 HOPWA allocations and found that the amount of money grantees
received per living AIDS case ranged from $387 per person to $1,290.44 According to the report,
if only living AIDS cases had been counted in that year, 92 of 117 grantees would have received
more formula funding, while 25 would have received less.45
In each of President Bush’s budgets from FY2007 through FY2009, the Administration proposed
to change the way in which HOPWA funds are distributed. The FY2009 budget stated that
“[w]hereas the current formula distributes formula grant resources by the cumulative number of
AIDS cases, the revised formula will account for the present number of people living with AIDS,
as well as differences in housing costs in the qualifying areas.” The President’s FY2007 and
FY2008 budgets contained nearly identical language. HUD’s budget justifications for FY2009
elaborated somewhat on the Administration’s proposal to change the HOPWA distribution
formula. HUD’s explanation indicated that a new formula would use the number of persons living
with AIDS, and that eventually, when consistent data on the number of persons living with HIV
become available, that measure might also be used in determining the distribution of HOPWA
funding.46 In the FY2010 HUD budget justifications, HUD stated that it will review the formula
and “make related recommendations at a future time.”47
Discussions regarding the HOPWA formula and its use of cumulative AIDS cases to distribute
funds are not new. In 1997, GAO released a report regarding the performance of the HOPWA
program in which it recommended that HUD look at recent changes to the formula used by the
Ryan White CARE Act (now called the Ryan While HIV/AIDS program) to “determine what
legislative revisions are needed to make the HOPWA formula more reflective of current AIDS
42 FY2010 Congressional Budget Justifications, p. X-6.
43 U.S. Department of Housing and Urban Development, Annual Performance Plan FY2009, February 2008, p. 9,
http://www.hud.gov/offices/cfo/reports/pdfs/app2009.pdf.
44 U.S. Government Accountability Office, Changes Needed to Improve the Distribution of Ryan White CARE Act and
Housing Funds, GAO-06-332, February 2006, p. 23, http://www.gao.gov/new.items/d06332.pdf.
45 Ibid., p. 24.
46 U.S. Department of Housing and Urban Development, Congressional Justifications for FY2009, p. Q-2,
http://www.hud.gov/offices/cfo/reports/2009/cjs/cpd1.pdf.
47 FY2010 Congressional Budget Justifications, p. X-13.
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cases ...”48 (At the time of the GAO report, Congress had recently changed the CARE Act
formula to use estimates of persons living with AIDS instead of cumulative AIDS cases.49) In
response to the GAO report, the House Appropriations Committee included the GAO language in
its report accompanying the FY1998 HUD Appropriations Act (P.L. 105-65) and directed HUD to
make recommendations to Congress about its findings regarding an update to the formula.50
In response to the FY1998 Appropriations Act, HUD then issued a report to Congress in 1999 that
proposed changes that could be made to the HOPWA formula.51 The proposed formula in HUD’s
1999 report would have used an estimate of persons living with AIDS (instead of all cumulative
AIDS cases), together with housing costs, to distribute formula funds. It also would have included
a protection for existing grantees. Those recommendations were not adopted by Congress.
No legislation to change the HOPWA formula has been introduced since the 109th Congress,
when two bills (S. 2339 and H.R. 5009) would have changed the way that HOPWA formula funds
are allocated by counting the number of “reported living cases of HIV disease” instead of
cumulative AIDS cases. Neither bill was enacted.
HOPWA Funding
As a result of advances in medical science and in the care and treatment of persons living with
HIV and AIDS, individuals are living longer with the disease.52 As the number of those with
AIDS grows, so do the jurisdictions that qualify for formula-based HOPWA funds. Since 1999,
there has been a steady increase in the number of jurisdictions that meet the eligibility test to
receive formula-based HOPWA funds. Funding for the HOPWA program has increased in almost
every year since the program was created, with the exception of FY2005 through FY2007, when
funding dropped from the FY2004 level of $295 million. (See Table 1.) In FY2010, Congress
appropriated $335 million as part of the Consolidated Appropriations Act (P.L. 111-117), the most
ever appropriated for the program.
The number of households receiving HOPWA housing assistance (including short-term housing
assistance, housing provided through community residences, or rental assistance in permanent
housing) has declined in every year but one from FY2003 through FY2009. (See Table 1.)
Between FY2003 and FY2009, the number of households served has dropped from 78,467 to
48 U.S. Government Accountability Office, HUD’s Program for Persons with AIDS, GAO/RCED-97-62, March 1997,
p. 27, http://www.gao.gov/archive/1997/rc97062.pdf.
49 Ryan White CARE Act Amendments of 1996, P.L. 104-146. In 2006, when the Ryan White HIV/AIDS program was
reauthorized as part of the Ryan White HIV/AIDS Treatment Modernization Act of 2006 (P.L. 109-415), the formula
began to incorporate living HIV cases in addition to living AIDS cases.
50 See U.S. Congress, House Committee on Appropriations, Subcommittee on VA, HUD, and Independent Agencies,
Departments of Veterans Affairs and Housing and Urban Development and Independent Agencies Appropriations Bill,
report to accompany H.R. 2158, 105th Cong., 1st sess., July 11, 1997, H.Rept. 105-175, pp. 33-34.
51 U.S. Department of Housing and Urban Development, 1999 Report on the Performance of the Housing
Opportunities for Persons with AIDS Program, October 6, 1999 (hereafter 1999 HUD Report).
52 According to CDC data, in 1993 there were 137,529 people reportedly living with AIDS in the 50 states, the District
of Columbia, and the territories. By 2007, there were 468,578 people reportedly living with HIV/AIDS in the same
areas. See Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report 1993, Vol. 5, Atlanta, GA,1994,
p. 26, table 3, http://www.cdc.gov/hiv/topics/surveillance/resources/reports/pdf/hivsur54.pdf, and HIV/AIDS
Surveillance Report 2007, footnote 1, p. 25, table 12.
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58,367.53 These general reductions in households served could be due to a number of factors,
including the growth in jurisdictions eligible for HOPWA grants (which have increased from 111
in FY2003 to 131 in FY2009), the amount of available funds, and housing costs.
Table 1. HOPWA Funding and Eligible Jurisdictions, FY2001-FY2010
Number of
Households
Qualifying
Receiving Housing
Funding
Fiscal Year
Jurisdictions
Assistancea
(thousands of dollars)
2001 105
72,117
257,432
2002 108
74,964
277,423
2003 111
78,467
290,102
2004 117
70,779
294,751
2005 121
67,012
281,728
2006 122
67,000
286,110
2007 123
67,850
286,110
2008 127
62,210
300,100
2009 131
58,367
310,000
2010 134b —
335,000
Source: Table prepared by the Congressional Research Service based on data from the Department of Housing
and Urban Development budget justifications (number of qualifying jurisdictions and funding levels), P.L. 111-8,
P.L. 111-117, and FY2004, FY2006, FY2007, FY2008, and FY2009 HUD Performance and Accountability Reports
(number of households assisted). For a breakdown of formula funding by jurisdiction, see the Appendix.
a. Housing assistance includes short-term assistance with rent, mortgage, or utilities; residence in short-term
housing facilities; housing provided through community residences and single-room occupancy dwellings;
and rental assistance for permanent supportive housing.
b. In the FY2010 Congressional Budget Justifications, HUD estimated that 134 jurisdictions would qualify for
HOPWA funds. As of the date of this report, formula funds had not yet been awarded.
Housing Funded Through the Ryan White
HIV/AIDS Program
In addition to funds for housing provided through HUD, funds appropriated to the Department of
Health and Human Services (HHS) Ryan White HIV/AIDS program may be used to provide
short-term housing assistance to persons living with HIV/AIDS. The Ryan White Comprehensive
AIDS Resources Emergency Act (P.L. 101-381) established the Ryan White program in 1990.
The program provides funds to states and metropolitan areas to help pay for health care and
supportive services for persons living with HIV/AIDS (referred to as “support services” in the
statute).54 The statute governing the use of Ryan White funds does not specifically list housing as
53 HUD provides estimates of the numbers of households served in its annual Performance and Accountability Reports.
The most recent is the FY2009 Performance and Accountability Report, November 16, 2009, p. 349,
http://www.hud.gov/offices/cfo/reports/hudfy2009par.pdf.
54 For more information about the Ryan White program, see CRS Report RL33279, The Ryan White HIV/AIDS
Program, by Judith A. Johnson.
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an eligible activity for which grantees may use funds. However, the statute provides that grantees
may use Ryan White funds to provide support services for persons living with HIV and AIDS.
These services are defined as those “that are needed for individuals with HIV/AIDS to achieve
their medical outcomes ...”55 In 1999, the HIV/AIDS Bureau of the Health Resources and
Services Administration (HRSA) within HHS released policy guidance regarding the type of
housing that Ryan White grantees could provide for their clients.56 According to the guidance,
grantees may use funds for housing referral services and for emergency or short-term housing.
Ryan White funds must be the payer of last resort, meaning that other sources of funds for
housing must be exhausted before using Ryan White funds.
Initially, the policy regarding use of Ryan White funds for housing did not require that specific
time limits be placed on short-term housing. In its report regarding the new guidance, HRSA
stated: “Although we are restricting the policy to transitional/temporary housing, we don’t define
‘transitional/temporary.’ Because we don’t know yet what the recent changes in medical treatment
of HIV/AIDS mean to the evolution of the epidemic, it is foolish to adopt any definition of ‘short-
term.’” 57 However, when the Ryan White program was reauthorized in 2006, the new law limited
the amount of grants to states and urban areas that could be used for supportive services to no
more than 25% by requiring that at least 75% of funds be used for “core medical services.”58
Previously the law did not limit the amount of funds that could be used for supportive services. In
December 2006, in response to the “more restrictive funding limits established for support
services in the 2006 reauthorization,” HHS issued a proposed policy notice to limit the amount of
time that any client could spend in Ryan White-funded transitional housing to 24 months in a
lifetime, effective retroactively.59 This would have meant that those individuals who had already
exhausted the 24-month time period would not be able to receive housing benefits. After
receiving over 200 comments regarding the policy proposal, HHS eventually removed the
provision requiring retroactive application of the 24-month lifetime limit and released a final
policy notice on February 27, 2008.60 The policy took effect on March 27, 2008.
In 2007, HRSA reported that 476 Ryan White-funded service organizations provided housing
services for individuals living with HIV/AIDS.61 In 2006, an estimated 42,178 persons living with
AIDS received some sort of housing service. Note that this estimate includes duplicated services,
55 42 U.S.C. § 300ff-14(d)(1) and § 300ff-22(c)(1). At the time that HHS established its housing policy, the statute
stated that funds could be used “for the purpose of delivering or enhancing HIV-related outpatient and ambulatory
health and support services, including case management and comprehensive treatment services ... ” The statute was
amended to read as stated in the text of this report as part of the Ryan White HIV/AIDS Treatment Modernization Act
of 2006, P.L. 109-415.
56 The use of funds for housing was established in HIV/AIDS Bureau Notice 99-02. The notice is reproduced in U.S.
Department of Health and Human Services, Health Resources and Services Administration, Housing is Health Care: A
Guide to Implementing the HIV/AIDS Bureau (HAB) Ryan White CARE Act Housing Policy, 2001, p. 3,
ftp://ftp.hrsa.gov/hab/housingmanualjune.pdf, (hereafter Housing is Health Care).
57 Housing is Health Care, p. 7. See footnote 56.
58 The program was reauthorized in the Ryan White HIV/AIDS Treatment Modernization Act of 2006 (P.L. 109-415).
See Section 105.
59 U.S. Department of Health and Human Services, “HIV/AIDS Bureau Policy Notice 99-02 Amendment #1,” 73
Federal Register 10261, February 26, 2008.
60 Ibid., pp. 10260-10261.
61 Information provided to CRS by HRSA on December 4, 2008.
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so an individual who received both housing referral services and spent time in emergency housing
may be counted more than once.62
The Relationship Between Stable Housing
and Health Outcomes
As mentioned earlier in this report, HIV/AIDS status is associated with homelessness: those
persons who are homeless are more likely to be HIV positive than those who are housed. In
addition, recent research has found that the health outcomes of homeless individuals living with
HIV/AIDS may be improved with stable housing. For example, in a study of HIV positive
individuals living in New York City that was conducted over twelve years from 1994 to 2006,
those who were unstably housed—meaning that they were either living on the street, in a shelter,
in some form of transitional housing, or temporarily living in someone else’s home—were less
likely to access and retain medical care for their disease than those receiving some form of
housing assistance.63
In addition, preliminary findings from two recent studies have found favorable health outcomes
for HIV positive individuals who are stably housed. In one of these studies, called the Housing
and Health Study, HUD, together with the CDC, provided HIV positive individuals who were
homeless or at severe risk of homelessness with HOPWA-funded rental housing. (The study
considered individuals to be at severe risk of homelessness if they frequently moved from one
temporary housing situation to another.) Those individuals in the comparison group received
services, including assistance with finding housing, but did not receive HOPWA-funded
housing.64 Despite the differences in rental assistance provided between the treatment and
comparison groups, both groups had a statistically significant increase in stable housing.65
Although 4% of all participants were stably housed when the study began, 82% of HOPWA-
assisted renters and 52% of individuals in the comparison group retained housing 18 months after
the start of the study. Perhaps due to the fact that the comparison group also had some success in
achieving and maintaining housing, both groups saw some improvements in health outcomes.
Findings from the study show that individuals in both groups had fewer emergency room visits,
fewer hospitalizations, reduced opportunistic infections (those infections that occur due to
weakened immune systems), reduced participation in sex trade, and reductions in depression.
62 U.S. Department of Health and Human Services, Health Resources and Services Administration, Ryan White
HIV/AIDS Program Annual Data Summary, 2006, p. P11.
63 Angela A. Aidala, Gunjeong Lee, and David M. Abramson, et al., “Housing Need, Housing Assistance, and
Connection to HIV Medical Care,” Aids and Behavior, vol. 11, no. 6 (November 2007, supplement), pp. 109-112.
64 The methodology of the study is described in Daniel P. Kidder, Richard J. Wolitski, and Scott Royal, et al., “Access
to Housing as a Structural Intervention for Homeless and Unstably Housing People Living with HIV: Rationale,
Methods, and Implementation of the Housing and Health Study,” AIDS and Behavior, vol. 11, no. 6 (November 2007,
supplement), pp. 149-161.
65 Preliminary findings from the Housing and Health Study were presented at the National Housing and HIV/AIDS
Research Summit III, March 6, 2008. Findings are summarized in The National AIDS Housing Coalition, Examining
the Evidence: The Impact of Housing on HIV Prevention and Care, Policy Paper from the Third Housing and
HIV/AIDS Research Summit, 2008, pp. 6-7, http://www.nationalaidshousing.org/PDF/FinalSummit.pdf (hereafter
Examining the Evidence).
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A second study, called the Chicago Housing for Health Partnership study, identified homeless
individuals with chronic illnesses, including HIV, for participation. Among those who participated
in the study, 36% were HIV positive. The treatment group received housing funded through either
HOPWA or HUD’s Supportive Housing Program for homeless individuals, while the comparison,
or usual care group, received available supportive services but no separate assistance with rent.
According to preliminary findings, 12 months after the study began, the group receiving housing
assistance had higher rates of intact immunity compared to the comparison group and were more
likely to have undetectable viral loads.66 At the conclusion of the study, the treatment group was
found to have spent fewer days in emergency rooms and hospitals during the 18 month period in
which the researchers followed participants. Specifically, compared to those in the usual care
group, those in the treatment group showed 29% reduction in hospitalizations, a 29% reduction in
the number of days spent in the hospital, and a 24% reduction in visits to the emergency room.67
66 Like the preliminary findings from the Housing and Health Study, the preliminary findings from the Chicago
Housing for Health Partnership Study were presented at the National Housing and HIV/AIDS Research Summit III.
The findings are summarized in Examining the Evidence, pp. 5-6. See footnote 65.
67 Laura S. Sadowski, Romina A. Kee, and Tyler J. VanderWeele, et al., “Effects of a Housing and Case Management
Program on Emergency Department Visits and Hospitalizations Among Chronically Ill Homeless Adults,” Journal of
the American Medical Association, vol. 301, no. 17 (May 6, 2009), pp. 1775-1776.
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Housing for Persons Living with HIV/AIDS
Appendix. Recent HOPWA Formula Allocations
Table A-1. HOPWA Formula Allocations, FY2004-FY2009
MSA, State, or
Territory
FY2004 FY2005 FY2006 FY2007 FY2008 FY2009
Alabama State
Program
1,139,000 1,117,000 1,145,000 1,163,000 1,241,000 1,299,792
Birmingham
520,000 497,000 511,000 516,000 538,000 554,848
Arkansas State
Program
752,000 723,000 707,000 720,000 766,000 797,682
Arizona State
Program
164,000 164,000 173,000 180,000 191,000 198,919
Phoenix
1,434,000 1,391,000 1,433,000 1,456,000 1,541,000 1,608,397
Tucson
402,000 390,000 389,000 390,000 411,000 420,497
California State
Program
3,042,000 2,869,000 2,929,000 2,926,000 2,746,000 2,557,875
Bakersfielda
— — — —
323,000
472,334
Fresno
— — — — —
315,824
Los
Angeles
10,476,000 11,848,000 10,310,000 10,393,000 10,437,000 10,764,091
Oakland
2,006,000 1,879,000 1,905,000 1,896,000 1,952,000 2,038,921
Riverside
1,772,000 1,683,000 1,684,000 1,689,000 1,751,000 1,850,429
Sacramento
844,000 795,000 786,000 784,000 818,000 844,003
San
Diego
2,683,000 2,527,000 2,549,000 2,551,000 2,646,000 2,731,528
San
Francisco
8,562,000 8,466,000 8,070,000 8,189,000 8,193,000 9,233,417
San
Jose
792,000 736,000 738,000 739,000 767,000 796,679
Santa
Anna
1,436,000 1,342,000 1,359,000 1,345,000 1,402,000 1,458,807
Colorado State
Program
366,000 354,000 364,000 363,000 379,000 392,424
Denver
1,424,000 1,342,000 1,359,000 1,361,000 1,414,000 1,452,390
Connecticut State
Program
251,000 242,000 253,000 252,000 263,000 268,902
Bridgeport
779,000 717,000 737,000 739,000 771,000 854,931
Hartford
1,023,000 1,285,000 1,108,000 1,098,000 1,140,000 1,084,029
New
Haven
1,232,000 1,624,000 1,178,000 1,075,000 946,000 963,113
Washington,
DC 11,802,000 10,535,000 11,370,000 11,118,000 11,541,000 12,213,518
Delaware State
Program
164,000 162,000 166,000 167,000 179,000 186,286
Wilmingtonb
798,000 703,000 679,000 552,000 604,000 651,902
Florida State
Program
4,063,000 3,581,000 3,312,000 3,316,000 3,191,000 3,012,662
Cape Coralc
—
— 336,000 332,000 350,000 368,963
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Housing for Persons Living with HIV/AIDS
MSA, State, or
Territory
FY2004 FY2005 FY2006 FY2007 FY2008 FY2009
Deltona
— — — — —
312,215
Fort
Lauderdale
6,240,000 6,106,000 6,637,000 6,878,000 7,351,000 7,545,922
Jacksonville 1,564,000 1,624,000 1,587,000 1,630,000 1,988,000 2,265,720
Lakelandc
— 378,000 445,000 418,000 509,000 491,383
Miami
10,715,000 10,351,000 11,189,000 11,689,000 12,370,000 12,599,526
Orlando
3,189,000 2,871,000 2,906,000 2,895,000 3,234,000 3,533,132
Palm Bayc
— — — —
311,000
317,829
Sarasota/Bradenton 397,000 548,000 390,000 391,000 409,000 421,099
Tampa
2,389,000 3,049,000 2,542,000 2,772,000 3,193,000 3,449,810
West
Palm
Beach 3,836,000 3,426,000 3,595,000 3,235,000 3,271,000 3,200,060
Georgia State
Program
1,515,000 1,527,000 1,576,000 1,621,000 1,744,000 1,860,455
Atlanta
4,899,000 6,592,000 5,290,000 6,801,000 7,034,000 8,788,464
Augusta
373,000 418,000 376,000 394,000 385,000 398,640
Hawaii State
Program
181,000 169,000 162,000 160,000 164,000 168,039
Honolulu
452,000 428,000 429,000 419,000 433,000 444,761
Iowa
State
Program 347,000 329,000 330,000 336,000 354,000 367,359
Illinois State Program
864,000 827,000 875,000 875,000 916,000 945,467
Chicago
8,338,000 5,379,000 5,561,000 5,572,000 5,819,000 5,993,040
Indiana State
Program
836,000 806,000 818,000 822,000 863,000 892,730
Indianapolis
759,000 738,000 751,000 752,000 782,000 806,705
Kansas State
Program
363,000 349,000 331,000 332,000 346,000 357,333
Kentucky State
Program
423,000 407,000 410,000 408,000 431,000 452,782
Louisville
462,000 443,000 447,000 453,000 476,000 502,511
Louisiana State
Program
940,000 932,000 951,000 975,000
1,034,000
1,090,045
Baton
Rouge
1,813,000 1,659,000 1,572,000 1,409,000 1,433,000 1,797,197
New
Orleans
2,992,000 3,398,000 2,997,000 2,914,000 2,769,000 3,089,672
Massachusetts State
Program
525,000 178,000 168,000 166,000 173,000 180,471
Boston
1,829,000 1,721,000 1,719,000 1,690,000 1,747,000 1,779,243
Lowel
659,000 623,000 627,000 622,000 644,000 658,318
Lynn
— 316,000 317,000 312,000 326,000 331,866
Springfield
461,000 433,000 424,000 418,000 426,000 445,162
Worcester
369,000 348,000 354,000 349,000 368,000 377,385
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Housing for Persons Living with HIV/AIDS
MSA, State, or
Territory
FY2004 FY2005 FY2006 FY2007 FY2008 FY2009
Maryland State
Program
345,000 335,000 348,000 345,000 357,000 362,346
Baltimore
7,936,000 7,754,000 7,649,000 8,038,000 8,195,000 8,657,224
Frederickd
535,000 518,000 524,000 539,000 575,000 603,776
Michigan State
Program
911,000 862,000 877,000 893,000 941,000 980,158
Detroit
1,979,000 1,554,000 1,597,000 1,640,000 1,979,000 2,066,997
Warren
405,000 392,000 397,000 409,000 437,000 456,391
Minnesota State
Program
110,000 105,000 112,000 114,000 119,000 124,525
Minneapolis
839,000 797,000 829,000 833,000 873,000 903,558
Missouri State
Program
496,000 475,000 455,000 450,000 473,000 492,485
Kansas
City
978,000 924,000 918,000 918,000 955,000
1,016,453
St.
Louis
1,217,000 1,158,000 1,150,000 1,140,000 1,227,000 1,264,901
Mississippi State
Program
756,000 749,000 778,000 783,000 833,000 858,039
Jackson
724,000 998,000 868,000 899,000 885,000 881,503
North Carolina
Program
2,082,000 2,010,000 2,097,000 2,154,000 2,272,000 2,387,029
Charlotte
571,000 565,000 597,000 626,000 671,000 714,063
Wake
County
352,000 337,000 366,000 382,000 434,000 459,800
Nebraska State
Program
— — — —
306,000
317,829
New Jersey State
Programb
1,106,000 1,050,000 1,064,000 1,056,000 1,079,000 1,109,696
Camden
657,000 628,000 620,000 610,000 642,000 655,912
Jersey
City
— 2,240,000 2,545,000 2,443,000 2,534,087 2,358,602
Newark
5,182,000 5,014,000 5,246,000 4,924,000 5,167,000 4,913,428
Paterson
— 1,265,000 1,282,000 1,250,000 1,286,736 1,301,766
Woodbridge
1,462,000 1,366,000 1,375,000 1,351,000 1,390,000 1,408,877
New Mexico State
Program
533,000 503,000 514,000 514,000 532,000 552,442
Nevada State
Program
238,000 219,000 219,000 219,000 228,000 236,818
Las
Vegas
916,000 886,000 882,000 897,000 952,000
1,002,015
New York State
Program
1,776,000 1,702,000 1,797,000 1,809,000 1,897,000 1,938,459
Albany
429,000 415,000 436,000 439,000 462,000 471,430
Buffalo
472,000 456,000 480,000 480,000 507,000 521,962
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Housing for Persons Living with HIV/AIDS
MSA, State, or
Territory
FY2004 FY2005 FY2006 FY2007 FY2008 FY2009
Islip
1,660,000 1,565,000 1,617,000 1,608,000 1,675,000 1,711,266
New
York
City
60,355,000 47,056,000 56,610,000 54,723,000 56,811,177 52,654,359
Poughkeepsie
604,000 577,000 679,000 812,000 947,000 655,310
Rochester
597,000 575,000 599,000 605,000 640,000 658,519
Ohio
State
Program 1,041,000 1,024,000 1,037,000 1,051,000 1,108,000 1,157,420
Cincinnati
550,000 517,000 518,000 530,000 562,000 584,124
Cleveland
854,000 822,000 826,000 840,000 870,000 895,337
Columbus
584,000 584,000 596,000 608,000 641,000 667,342
Oklahoma State
Program
518,000 494,000 498,000 506,000 226,000 230,000
Oklahoma
City
466,000 441,000 435,000 437,000 459,000 483,261
Tulsae
— — — —
307,000
324,647
Oregon State
Program
— 321,000 319,000 317,000 335,000 350,114
Portland
1,006,000 949,000 947,000 943,000 988,000
1,016,854
Pennsylvania State
Program
1,540,000 1,511,000 1,548,000 1,527,000 1,670,000 1,755,180
Philadelphia
7,632,000 7,336,000 7,083,000 6,650,000 7,052,000 8,716,376
Pittsburgh
626,000 620,000 623,000 619,000 649,000 676,967
Puerto Rico State
Program
1,748,000 1,636,000 1,633,000 1,616,000 1,679,000 1,709,461
San
Juan
7,140,000 5,324,000 5,874,000 5,632,000 6,144,000 6,266,967
Providence
807,000 764,000 776,000 773,000 801,000 820,541
South Carolina State
Program
1,387,000 1,356,000 1,387,000 1,403,000 1,491,000 1,563,881
Charleston
418,000 390,000 397,000 401,000 419,000 437,943
Columbia
1,270,000 1,160,000 1,041,000 1,034,000 1,138,000 1,404,470
Tennessee State
Program
739,000 718,000 747,000 756,000 796,000 830,568
Memphis
2,134,000 1,462,000 1,882,000 1,879,000 2,115,000 2,019,277
Nashville 737,000 840,000 737,000 757,000 795,000 829,966
Texas
State
Program 2,736,000 2,634,000 2,691,000 2,733,000 2,841,000 2,625,853
Austin
988,000 931,000 940,000 947,000 987,000
1,029,086
Dal as
3,192,000 3,867,000 3,141,000 3,134,000 3,332,000 3,642,608
El
Paso
— — — — —
327,655
Fort
Worth
835,000 805,000 813,000 819,000 863,000 892,529
Houston
5,068,000 9,669,000 6,039,000 6,579,000 6,038,000 7,315,504
San
Antonio
1,027,000 960,000 971,000 972,000
1,025,000
1,064,378
Utah
State
Program 120,000 111,000 112,000 111,000 115,000 117,707
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Housing for Persons Living with HIV/AIDS
MSA, State, or
Territory
FY2004 FY2005 FY2006 FY2007 FY2008 FY2009
Salt
Lake
City
386,000 354,000 353,000 346,000 357,000 363,348
Virginia State
Program
640,000 612,000 618,000 615,000 634,000 667,943
Richmond
692,000 658,000 665,000 660,000 690,000 702,433
Virginia
Beach
1,022,000 958,000 941,000 937,000 968,000
1,002,215
Washington State
Program
652,000 619,000 620,000 622,000 651,000 671,553
Seattle
1,688,000 1,611,000 1,615,000 1,604,000 1,663,000 1,705,852
Wisconsin State
Program
405,000 383,000 389,000 391,000 407,000 422,102
Milwaukee
512,000 487,000 497,000 492,000 515,000 531,988
West Virginia State
Program
— — — — —
309,608
—Subtotal formula
grants
263,039,000 251,323,000 256,162,000 256,162,000 267,417,000 276,089,000
—Subtotal competitive
grants
29,227,000 27,925,000 28,463,000 28,463,000 29,713,000 30,676,000
—Subtotal technical
asst.
2,485,000 2,480,000 1,485,000 1,485,000 1,485,000 1,485,000
Total
HOPWA
294,751,000 281,728,000 286,110,000 286,110,000 300,100,000 310,000,000
Source: U.S. Department of Housing and Urban Development, Office of Community Planning and Development
Program Formula Allocations, available at http://www.hud.gov/offices/cpd/about/budget/budget08/index.cfm, and
FY2006-FY2010 Congressional Budget Justifications.
a. The State of California administers the grant for the Bakersfield MSA (See FY2010 HUD Congressional
Budget Justifications, p. X-14).
b. According to directions in HUD Appropriations Acts, funds awarded to the Wilmington MSA are
transferred to the State of New Jersey to administer the HOPWA program for the one New Jersey county
that is in the Wilmington MSA (Salem county).
c. The State of Florida administers the grants for the Cape Coral, Lakeland, and Palm Bay MSAs.
d. The State of Maryland administers the grant for the Bethesda-Frederick-Gaithersburg MSA.
e. The State of Oklahoma administers the grant for the Tulsa MSA.
Author Contact Information
Libby Perl
Specialist in Housing Policy
eperl@crs.loc.gov, 7-7806
Congressional Research Service
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