HIV/AIDS Housing Inventory

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1 24 5-Year Chicago Area HIV/AIDS Housing Plan HIV/AIDS Housing Inventory This section provides an overview of the housing resources dedicated to people living with HIV/AIDS in the Chicago eligible metropolitan area (EMA) in 2000 and compares it to the inventory of housing resources available in 1995, when the first HIV/AIDS housing plan for the Chicago EMA was issued. Since 1995, the number of housing units available to people living with HIV/AIDS has increased 67 percent and the number of HOPWA rental assistance certificates has increased 168 percent. Overall, there are 106 percent more housing units and rental certificates available to people living with HIV/AIDS in 2000 than In addition, shifts in the percentage of units located in parts of the city and in surrounding counties has changed, as well as the number of units of different housing types. These changes have been considered throughout this planning process in relation to the housing needs of persons living with HIV/AIDS in the EMA. An Overview of Housing Resources Housing resources can be perceived as a continuum from homelessness to permanent, independent housing. For people living with HIV, and particularly those who are also struggling to manage mental illness, developmental delays, and/or chronic addiction, the continuum includes supportive housing and longer-term transitional programs. This housing resource inventory only counts beds, units, and rental assistance programs specifically targeting people living with HIV/AIDS using the following categories: Emergency Housing and Assistance Programs. These programs respond to immediate homelessness or temporary housing crises. Transitional Housing Programs. These programs provide or help to maintain an interim residence for people until they can find stable, permanent housing. They usually have certain eligibility requirements. Rental Subsidy Programs. These programs may be long or short term; they provide financial assistance to help individuals maintain their privately-owned place of residence. Assisted Living Programs and Skilled Nursing Facilities. These provide intensive care for persons whose illness has reached an advanced stage. Permanent Housing Programs. These programs provide housing that does not place a limit on the length of residency. Unlike private market units, they may have certain eligibility requirements. In addition, Housing Advocate Programs provide information and referrals on available housing options, and may provide legal assistance and tenant education to prevent eviction and subsequent homelessness.

2 5-Year Chicago Area HIV/AIDS Housing Plan 25 Key Findings Since 1995, housing assistance in the Chicago EMA in the form of beds, units, and rental subsidies available to people living with HIV/AIDS has increased 106 percent. Many recent housing programs have been created and implemented in accordance with the recommendations established in the Chicago EMA 5-Year HIV/AIDS Housing Plan: Housing units have been built in areas of growing need, such as the west and south sides of the city of Chicago, both of which have seen increases of approximately 170 percent in the number of housing units for people living with HIV/AIDS. 191 permanent housing units for people with HIV/AIDS have been created in the last five years. 14 transitional housing units and 29 permanent housing units for families have also been added to the HIV/AIDS housing stock. For 2001, 570 HOPWA short-term rental subsidies are available for eligible people living with HIV/AIDS, compared to 213 rental subsidies available in 1995, an increase of 168 percent. Over the past five years, there has been more than a six-fold increase in the number of individuals with HIV/AIDS who can receive housing assistance at any one time in the Chicago metropolitan area. The shift from the provision and development of skilled nursing and assisted living programs to expanded rental assistance and transitional living programs reflects the changing needs of the population. As more people living with HIV/AIDS experience some success with new medications and are living longer, the need for emergency and transitional resources will continue to increase, especially resources that can respond to the episodic recurrences of the illness. Similarly, as the epidemic increasingly impacts families, and people whose long term mental illness, substance use, and chronic poverty inhibits their ability to maintain housing, needs for new and different housing resources will continue. Clearly, HIV/AIDS resources alone cannot address the wide range of housing and housing-related needs of people living with HIV/AIDS. Although there has been an upswing of mainstream housing service agencies collaborating with AIDS service organizations (ASO s) to meet the needs specifically for people with HIV/AIDS such as Lakefront SRO and Community Supportive Living Systems (CSLS) this is only occurring informally without an overall plan. A structured framework is needed to eliminate the duplication of services while seamlessly coordinating a continuum of care to provide equitable access to all people living with HIV/AIDS in the Chicago EMA. Emergency Housing and Assistance Throughout the Chicago EMA, homeless individuals including those with HIV in need of an immediate place to sleep, may access an emergency bed on any given night using a toll-free number. A total of 1,256 emergency and 2,887 transitional beds for families and individuals are available throughout the Chicago EMA, along with an additional 980 slots in warming centers during the winter months. Although very comprehensive in its locations and availability, these shelters do not specifically target people with HIV, and cannot accommodate their special needs such as confidentiality issues or health-related issues for those who are taking medications requiring refrigeration and/or complicated dosage schedules.

3 26 5-Year Chicago Area HIV/AIDS Housing Plan Using Ryan White Care Act Title I funds designated for emergency housing assistance, the Emergency Client Assistance (ECA) program administered by the AIDS Foundation of Chicago specifically targets people living with HIV/AIDS in the Chicago EMA and is available if an individual is facing immediate eviction, loss of services (electricity, phone, etc.), or is already homeless. Eligible individuals may access this financial assistance program through an HIV case manager. Payments can be as high as $800 for individuals and $1,200 for families. However, assistance is available only once per year per client. In 2000, 393 clients received financial assistance for housing-related expenses. 31 Transitional Housing Transitional housing provides or helps maintain an interim residence for people until they can find stable, permanent housing in either a congregate or scattered-site setting. Programs that provide transitional housing generally provide extensive support services to their residents to assist them in increasing income, finding employment, and developing skills to maintain independent housing. Transitional services may include short-term placement for people waiting to enter or exit from a residential mental health or drug treatment program, or short-term care for those recently released from inpatient hospital care. This category also includes rental subsidy programs that temporarily help the client pay rent to a private landlord until he or she can find more affordable housing. Rental Subsidies The most significant addition to the HIV/AIDS housing continuum since 1995 has been the expansion of the HOPWA short-term rental subsidy program for the Chicago EMA. This program is coordinated by the AIDS Foundation of Chicago and is administered regionally by four local agencies (TIA/Chicago Connections, Better Existence with HIV (BEHIV), Community Response, Inc., and AIDS Ministry of Illinois). These agencies worked together to develop and adopt common policies concerning eligibility for the program and criteria for the evaluation of applications. Intake to the HOPWA system takes place through HIV case managers at agencies throughout the EMA, and AFC coordinates the partners in the process and monitors utilization. Rent subsidies are available for persons who are disabled by HIV, are very low-income and live in the nine-county EMA. The amount of the subsidy is based on the deficit between the applicant s income and expenses related to housing. Rent cannot exceed the individual s monthly income. Procedures for the rental subsidy program are outlined below: Persons living with HIV/AIDS fill out an application, including a long-term housing plan, with their HIV case manager at one of 59 participating agencies, which is then submitted to AFC for intake and review. AFC then forwards the applications to the partner agencies, which approve and administer the subsidies. Reassessments are conducted by the recipient s case manager after three months to ensure the recipients continued eligibility. The subsidy expires after nine months. Recipients are eligible to reapply. 31 AIDS Foundation of Chicago, 2000 Annual Administrative Review for Title I, 2000.

4 5-Year Chicago Area HIV/AIDS Housing Plan 27 The program currently is funded to provide approximately 570 certificates at an average monthly subsidy of $215. More than 600 households participated in the program in 1999 a vast increase over the 77 households receiving this assistance in Clients cases are periodically reviewed, and clients are strongly encouraged to seek more permanent housing solutions. Chart 3 shows the location of residence for 1999 HOPWA recipients. Chart 3 Location of Residents of HOPWA Rental Assistance Recipients in the Chicago EMA West Side 17% Other Counties 3% N/A 2% North Cook 2% West Cook 6% South Cook 4% South Side 25% North Side 41% Other Counties North Cook West Cook South Cook North Side South Side West Side N/A Housing Units Since 1995, the number of beds/units available in transitional housing programs for people with HIV/AIDS in the Chicago EMA has expanded. While there were 111 beds in 1995, there are now approximately 229 transitional beds. Responding to demographic changes, some of these programs do not require participants to be drug- and alcohol-free. Instead, they follow a harm-reduction model to work with clients who may be in initial stages of recovery and may relapse while residing within the program. Another trend reflecting changing demographics has been a moderate expansion of units for families and young people. Table 10 presents a listing of transitional housing programs in the Chicago EMA by location, total number of beds or units, number of family units, and the maximum length of time a resident can stay in the program.

5 28 5-Year Chicago Area HIV/AIDS Housing Plan Table 10 Transitional Housing Programs in the Chicago EMA, by Location, Total Beds/Units, Family Units, and Maximum Stay Location Total Beds/Units Family Units Maximum Stay (In Months) Abstinence-Based Programs AIDSCARE North Side AIDS Ministry of Illinois (AMI) Will County Alexian Brothers - The Harbor Lake County Chicago Connections First Step North Side Chicago Connections TLC North Side Chicago Connections Next Step North Side Chicago House Supportive Living West Side CSLS Langley House South Side CSLS HUD Transitional South Side Interfaith House* West Side New Phoenix Assistance Center South Side New Phoenix Assistance Center Teens South Side Non-Abstinence-Based Programs Community Response Inc (CRI) W. Suburban Cook CSLS Ex-Offender Program South Side Sisters of Sobriety West Side Other The Children s Place West Side Inventory Total Inventory Total Percent change 1995 to % +175% *Interfaith House is the only respite center within Chicago s shelter system and is available for homeless medically frail individuals, including people living with HIV/AIDS. Assisted Living Programs Many people with advanced HIV disease are not able to live in independent housing and require assistance with daily living activities. Assisted living programs provide 24-hour care and support in small residential or group home facilities. Since 1995, some projects have closed most notably Chicago House s North Side facility although others have opened including Emerald House on the South Side, where a growing percentage of new HIV/AIDS cases are located. Overall, the number of beds slightly dropped from 55 in 1995 to 42 in 2000.

6 5-Year Chicago Area HIV/AIDS Housing Plan 29 Table 11 presents a listing of assisted living programs with beds dedicated for people living with HIV/AIDS in the Chicago EMA, by location and total number of beds. Table 11 Assisted Living Programs in the Chicago EMA, by Location and Total Beds Location Total Beds Abstinence-Based Programs Alexian Brothers - Bonaventure House North Side 34 CSLS Emerald House South Side 8 Total Units 2001 Inventory 42 Total Units 1995 Inventory 55 Percent change 1995 to % Skilled Nursing Facilities Skilled nursing facilities provide 24-hour care for those who need frequent medical intervention and licensed nursing services. As noted, with many people living with HIV/AIDS leading longer, healthier lives due to medical advances, this category has seen a significant drop in the number of beds from 75 in five different locations in 1995 to 20 beds in only two locations today. Table 12 presents a listing of skilled nursing facilities with set-asides for people living with HIV/AIDS in the Chicago EMA, by location and total number of beds. Table 12 Skilled Nursing Facilities in the Chicago EMA, by Location and Total Beds Location Total Beds Abstinence-Based Programs Oak Forest Hospital S. Suburban Cook 20 Total 2001 Inventory 20 Total 1995 Inventory 75 Percent change 1995 to %

7 30 5-Year Chicago Area HIV/AIDS Housing Plan Permanent Housing Permanent housing is housing that does not place a limit on the length of residency. There are several different housing options in this category, ranging from group or congregate homes to scattered-site apartments to single-room-occupancy units. There is also a wide variety in the number and type of services either offered by or linked to these programs from no services to a range of comprehensive services, including 24-hour supervision. There are now also several projects that are part of the Shelter Plus Care (S+C) program, a HUD program targeted toward homeless persons that links housing to comprehensive social services for those who are disabled by one or more of the following: HIV, substance use, and/or mental illness. Reflecting the changing nature of the epidemic, permanent housing programs have also greatly expanded since the last housing plan. In 1995, there were 94 designated beds/units in permanent housing programs and 136 long-term rental certificates. In 2001, there are 268 beds/units, 43 of which are designated for families. The HOPWA rental assistance program was also redefined in 2001 as a short-term rental subsidy program in order to continue to serve the greatest number of individuals (see Rental Subsidies, p. 26). A thorough review of the HOPWA rental subsidy program is planned for Table 13 presents a listing of permanent housing programs in the Chicago EMA, by location, total number of beds or units, and number of family units.

8 5-Year Chicago Area HIV/AIDS Housing Plan 31 Table 13 Permanent Housing Programs in the Chicago EMA, by Location, Total Beds/Units, and Family Units Location Total Beds/Units Family Units Abstinence-Based Programs Anixter Center/CALOR West Side 17 8 Chicago Connections-Rafael Center South South Side 17 0 Chicago Connections San Miguel Apts. North Side 30 0 Chicago Connections-Shelter Plus Care North Side 24 0 Chicago Connections Sutherland South Side 8 0 Chicago House Family Support Program North Side 12 9 Chicago House Independent Living Prog. North Side 24 0 Children s Place West Side 3 3 Cornerstone-AIDS Ministry of Illinois Will County 16 0 CSLS-Shelter Plus Care (S+C) South Side 10 0 CSLS-Low Income Trust South Side 10 2 Lakefront SRO South Loop South Side 10 0 New Phoenix Low Income Trust South Side 6 0 Samaritan Housing St. Luke s Place South Side 14 0 Vision House South Side Non-Abstinence-Based Programs BEHIV Safe Start North Side 12 2 Canticle Place DuPage County 12 4 Chicago Connections-Epoch North Side 6 0 CSLS Safe Start South Side 12 2 Total 2001 Inventory Total 1995 Inventory Percent change from 1995 to % +207%

9 32 5-Year Chicago Area HIV/AIDS Housing Plan Housing Advocacy Services Housing advocacy has been provided in the Chicago EMA using Housing Opportunities for People with AIDS (HOPWA) funds, and was identified as a priority in the 1995 plan. In 1998, the AIDS Foundation of Chicago (AFC), in partnership with AIDS Ministry of Illinois, Better Existence with HIV (BEHIV), and Community Response, Inc., developed and refined the concept of central coordination for HIV/AIDS housing advocacy in the Chicago EMA. Recently, the program was expanded with a new partner agency, New Phoenix Assistance Center, and will include an agency serving the Latino community. In addition, TIA/Chicago Connections entered into a partnership with AFC for their housing advocacy program. Housing advocates help persons with HIV/AIDS move toward permanent, affordable housing situations by: Developing a comprehensive housing inventory that identifies available housing units and vacancies in residential programs. Building relationships with for-profit and nonprofit landlords in order to facilitate client placement in the private housing market. Assessing client needs and resources, and, when appropriate, working with clients to develop a budget to move them towards self-sufficiency and successful tenancy. Advocating on behalf of clients with landlords and providers. Serving as both a referral point to and resource for the case management system. AFC administers and coordinates the program, while the service providers, located throughout the EMA, provide the advocacy services. In addition, legal advocacy services to prevent the eviction of HIV-infected tenants are provided through the AIDS Legal Council and the Legal Assistance Foundation of Metropolitan Chicago. Future Developments Three new programs opened that serve the West and South Sides and underserved populations, including the Hispanic/Latino/a community, families, and people who have recently been released from prison. In 2001, several programs are being developed with a total of 93 units, 25 of which will be reserved for families. Each of these new projects will be on the South and West Sides of Chicago, where increasing numbers of HIV/AIDS cases are located.

10 5-Year Chicago Area HIV/AIDS Housing Plan 33 Table 14 presents a listing of projects in development in the Chicago EMA in 2001, by location, total beds or units, and expected date of completion. Table 14 Projects in Development in the Chicago EMA, by Location, Total Beds/Units, and Expected Date of Completion Location Total Beds/Units Expected Date of Completion Abstinence-Based Programs New Phoenix Teen Shelter South Side AIDSCARE West Side AIDSCARE (Family Program) West Side Total 93 Comparison of 1995 and 2001 inventories Chart 4 compares the 1995 and 2001 housing inventories by number of units and type of housing. Chart 4 Comparison of 1995 and 2001 Housing Inventories, by Number of Units and Type of Housing 600 Number of Units Rental Certificates Transitional Housing Permanent Housing Assisted Living Skilled Nursing Since 1995, housing resources dedicated to people with HIV/AIDS in the Chicago EMA has increased 106 percent to a total of 1,129 units of housing or beds and rental certificates. This increase resulted largely from the recommendations of the 1995 plan. Responding to the changing population, there has been an increase in the number of units and certificates available throughout the continuum. Permanent housing in particular has experienced a significant increase 191 units have been added since The number of skilled nursing beds dedicated for people living with HIV/AIDS has declined by 55 since In the transitional and permanent housing categories, the number of units for families almost tripled (from 22 to 65).

11 34 5-Year Chicago Area HIV/AIDS Housing Plan Table 15 provides a summary of HIV/AIDS-dedicated housing by type and location in 2001, total units for 2001 and 1995, and percent change from 1995 to The percent of total units available in each location in 2001 and 1995 is also included. Table 15 Housing Units Dedicated for People Living with HIV/AIDS by Location, Type, 2001 and 1995 Totals, and Percent Change from 1995 to 2001 Location Cook County Chicago Skilled Nursing Facility 2001 Inventory Total Units 2001 Assisted Living Transitional Permanent Number Percent of total Total Units 1995 Number Percent of total Percent Change from 1995 to 2001 North Side % % +42% South Side % 61 18% +169% West Side % 47 14% +134% Chicago Total % % +90% Suburban North South % 75 22% 73% West 6 6 1% 5 1% +20% Suburban Total % 80 24% 68% Cook County Total % % +52% DuPage County % Lake County 8

12 5-Year Chicago Area HIV/AIDS Housing Plan 35 Transitional programs, although increasing, are fewer than permanent housing programs, and resources for families are limited in all areas. The last five years have been productive, yet much more is needed to respond to the ongoing epidemic.

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