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FAQs

  • Housing is a critical part of HIV healthcare. Overwhelming evidence shows that safe, stable housing not only improves health outcomes for people with HIV but also helps prevent the virus from spreading to others. 

     

    People with HIV who have stable housing are more likely to stay engaged in their HIV/Primary Care and adhere to their daily antiretroviral therapy (ART). This adherence is crucial, as it leads to viral load suppression, meaning they can achieve better health and cannot transmit HIV to others. Studies indicate that, even when controlling for other factors like race and ethnicity, access to stable housing is the strongest predictor of viral load suppression. 

     

    Receiving housing assistance has been shown to improve health outcomes, reduce the need for costly emergency healthcare, and stop ongoing transmission of the virus. In contrast, people with HIV who lack stable housing are less likely to be on ART, less likely to be virally suppressed, face higher healthcare costs, and have a higher risk of premature death. 

  • New York State already has a longstanding program to address this need. Our proposed changes would ensure all people with HIV have access to it, regardless of where they live in the state.  

     

    In the 1980s, New York State put in place an HIV Emergency Shelter Allowance. In New York City, this program has been administered by the NYC HIV/AIDS Services Administration (HASA) and has successfully provided low-income people with HIV the rental assistance they need to secure or maintain stable housing. 

     

    In 2014, the state also established a 30% rent cap to protect extremely low-income individuals with HIV in nYC, ensuring they don’t pay more than 60% of their disability benefits or fixed income toward rent. 

     

    Our proposal would require other localities throughout New York State to implement programs similar to NYC’s HASA, with state funding covering 100% of the cost. 

  • Currently, approximately 2,735 extremely low-income households living with HIV Upstate and on Long Island are homeless or unstably housed due to lack of access to rental assistance.  

     

    Three main factors contribute to their inequity:  

    1. Low Rent Limits: Upstate and on Long Island, people with HIV have to find apartments for less than $480. This limit, set in the 1980s, is unrealistic in today’s housing market. In New York City, HASA approves exceptions to this $480 rule (in line with NYC standard for Section 8 and other low-income housing subsidies), but no other locality is required to do so. 
    1. Lack of the 30% Rent Cap: The 30% rent cap that exists in NYC is not available outside NYC. 

    Absence of Local Programs: Localities outside NYC are not mandated to administer this program and lack the funds to do so.

Why is housing important for people with HIV? 

Housing is a critical part of HIV healthcare. Overwhelming evidence shows that safe, stable housing not only improves health outcomes for people with HIV but also helps prevent the virus from spreading to others. 

People with HIV who have stable housing are more likely to stay engaged in their HIV/Primary Care and adhere to their daily antiretroviral therapy (ART). This adherence is crucial, as it leads to viral load suppression, meaning they can achieve better health and cannot transmit HIV to others. Studies indicate that, even when controlling for other factors like race and ethnicity, access to stable housing is the strongest predictor of viral load suppression. 

Receiving housing assistance has been shown to improve health outcomes, reduce the need for costly emergency healthcare, and stop ongoing transmission of the virus. In contrast, people with HIV who lack stable housing are less likely to be on ART, less likely to be virally suppressed, face higher healthcare costs, and have a higher risk of premature death, even when controlling for other factors known to impact treatment effectiveness such as substance use and mental health needs.

How would this rental assistance program work?  

New York State already has a longstanding program to address this need. Our proposed changes would ensure all people with HIV have access to it, regardless of where they live in the state.  

In the 1980s, New York State put in place an HIV Emergency Shelter Allowance. In New York City, this program has been administered by the NYC HIV/AIDS Services Administration (HASA) and has successfully provided low-income people with HIV the rental assistance they need to secure or maintain stable housing. 

In 2014, the state also established a 30% rent cap to protect extremely low-income individuals with HIV in nYC, ensuring they don’t pay more than 60% of their disability benefits or fixed income toward rent. 

Our proposal would require other localities throughout New York State to implement programs similar to NYC’s HASA, with state funding covering 100% of the cost.

Why is this statewide program only available in NYC? 

Currently, approximately 2,735 extremely low-income households living with HIV Upstate and on Long Island are homeless or unstably housed due to lack of access to rental assistance.  

Three main factors contribute to their inequity:  

  1. Low Rent Limits: Upstate and on Long Island, people with HIV have to find apartments for less than $480. This limit, set in the 1980s, is unrealistic in today’s housing market. In New York City, HASA approves exceptions to this $480 rule (in line with NYC standard for Section 8 and other low-income housing subsidies), but no other locality is required to do so. 
  2. Lack of the 30% Rent Cap: The 30% rent cap that exists in NYC is not available outside NYC. 
  3. Absence of Local Programs: Localities outside NYC are not mandated to administer this program and lack the funds to do so. 

 All of this means that no localities outside of NYC have opted to administer this program, and thus not a single person has been housed.  

What are the specific changes proposed by HIV Housing for NY? 

HIV Housing for NY urges the Governor to: 

Include language in the FY26 Executive Budget to: 

  • Provide all PWH facing homelessness or housing instability access to HIV Emergency Shelter Allowances up to 110% of local HUD Fair Market Rent (FMR), aligning with standards for NYC and other low-income housing subsidies. 
  • Extend the 30% rent cap to PWH outside NYC who rely on disability benefits or other extremely low income. 
  • Recognize the fiscal reality of communities outside NYC by providing state funding to cover 100% of the additional rental assistance costs in districts with populations of 5 million or less.

Amend Social Services Law: Implement ELFA Article VII language to empower the Office of Temporary and Disability Assistance (OTDA) to execute these changes.

Budget Allocation: Fund the HIV shelter allowances and 30% rent cap through the “public assistance” bucket of the Aid to Localities budget, similar to NYC programs.

What are the estimated public costs/savings associated with this change?  

Investing in HIV Housing for NY will save lives and money. Improved housing leads to better health outcomes, resulting in significant Medicaid savings from avoided inpatient and emergency health care and from averted new infections. 

  • Research indicates that improved housing reduces annual health costs for formerly unstably housed PWH by an average of $15,000/year per person (in 2014 USD, which would be $20,505 in 2024 USD). 
  • Analyses conservatively show the present value of lifetime for each averted new infection of at least $400,000 in medical costs alone. 

Our cost analysis, developed in collaboration with OTDA, shows that the program would cost the State $3.3M in the first year, offset by $4.6M in Medicaid savings. If fully utilized by all 2,735 eligible individuals, the annual cost to the State would not exceed $43.5M, with projected savings of $61.2M in Medicaid expenses.