[Federal Register Volume 73, Number 38 (Tuesday, February 26, 2008)]
[Notices]
[Pages 10260-10262]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-3607]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


HIV/AIDS Bureau; Policy Notice 99-02 Amendment 1

AGENCY: Health Resources and Services Administration (HRSA), HHS.

ACTION: Final Notice.

-----------------------------------------------------------------------

SUMMARY: The HRSA HIV/AIDS Bureau (HAB) Policy Notice 99-02 entitled, 
The Use of Ryan White HIV/AIDS Program Funds for Housing Referral 
Services and Short-term or Emergency Housing Needs, provides grantees 
with guidance on the use of Title XXVI of the Public Health Service Act 
(Ryan White HIV/AIDS Program) funds for short-term and

[[Page 10261]]

emergency housing assistance for persons living with HIV/AIDS. This 
Federal Register notice seeks to make public the final policy notice 
99-02 Amendment  1 which places a cumulative period of 24 
months on short-term and emergency housing assistance under the Ryan 
White HIV/AIDS Program, and clarifies and updates certain nomenclature 
found in the original housing policy 99-02. This policy becomes 
effective March 27, 2008.

SUPPLEMENTARY INFORMATION: HAB Policy Notice 99-02 Amendment  
1 establishes a cumulative 24-month period per household for use of 
Ryan White HIV/AIDS Program funds for short-term and emergency housing 
assistance. The final policy notice 99-02 Amendment  1 
reflects modifications based on public comment received in response to 
the HAB policy notice published in the Federal Register on December 6, 
2006. During the 60-day comment period, ending February 5, 2007, HAB 
received over 200 comments from the public.
    Comments on the Proposed Housing Policy Amendments and HRSA 
Response: There were several public comments in favor of the draft 
policy stating that the proposed changes allow more money to be 
allocated to life-saving core medical services, including medications. 
The following three areas of concern were the main points raised in the 
public comments.
    Comment: The imposition of a lifetime cap of 24 months on housing 
assistance was felt to be restrictive and does not allow for 
exceptions.
    Response: HRSA disagrees that the 24-month cap is too restrictive 
and retains that requirement in order to balance the housing policy 
with the more restrictive funding limits established for support 
services in the 2006 reauthorization of the Ryan White HIV/AIDS 
Program. In addition, this time limit emphasizes that Ryan White HIV/
AIDS Program funds for housing assistance must be short-term in nature, 
and designed to obtain more permanent and stable assistance from other 
funding sources.
    Comment: The immediate effective date does not allow programs 
sufficient time to plan the implementation of the policy.
    Response: With respect to concerns that the immediate effective 
date did not allow programs time to properly implement the amended 
policy, the effective date is moved to March 27, 2008 allowing programs 
additional time to plan the implementation of the final housing policy 
99-02 Amendment 1.
    Comment: Current clients that are at or close to the 24-month 
period of their use of funds for housing services are not grandfathered 
into the draft policy; and additional concerns regarding the 
establishment of new tracking systems is particularly difficult if it 
is necessary to back-track and count clients currently receiving 
housing assistance.
    Response: The cumulative 24-month period does not include any 
previous housing assistance received prior to the effective date which 
responds to concerns related to the grandfathering of current clients 
receiving such assistance. The fact that the policy is not retroactive 
eliminates concerns related to the burden of tracking previous clients 
utilizing housing assistance through Ryan White HIV/AIDS Program funds. 
Grantees must be capable of tracking future housing payments and 
providing HAB with documentation related to the use of funds for 
housing assistance, including evidence of compliance with the 24-month 
limit established in this final HAB Policy Notice 99-02 Amendment 
 1.
    The final policy notice also addresses new nomenclature needed as 
the result of the reauthorization of the Ryan White HIV/AIDS Program in 
2006. For instance, the amended Ryan White Comprehensive AIDS Resources 
Emergency (CARE) Act is referred to as Title XXVI of The Public Health 
Service Act (Ryan White HIV/AIDS Program). Furthermore, the programs 
under Titles I-IV are now referred to as programs under Parts A-D.

HRSA HAB Policy Notice--99-02, Amendment  1

    Document Title: The Use of Ryan White HIV/AIDS Program Funds for 
Housing Referral Services and Short-term or Emergency Housing Needs
    The following policy establishes guidelines for allowable housing-
related expenditures under the Ryan White HIV/AIDS Program. The purpose 
of all Ryan White HIV/AIDS Program funds is to ensure that eligible 
HIV-infected persons and families gain or maintain access to medical 
care.
    A. Funds received under the Ryan White HIV/AIDS Program (Title XXVI 
of the Public Health Service Act) may be used for the following housing 
expenditures:
    i. Housing referral services defined as assessment, search, 
placement, and advocacy services must be provided by case managers or 
other professional(s) who possess a comprehensive knowledge of local, 
State, and Federal housing programs and how they can be accessed; or
    ii. Short-term or emergency housing defined as necessary to gain or 
maintain access to medical care and must be related to either:
    a. Housing services that include some type of medical or supportive 
service (a listing of supportive services can be found at: http://hab.hrsa.gov/reports/data2b.htm) including, but not limited to, 
residential substance abuse treatment or mental health services (not 
including facilities classified as an Institution for Mental Diseases 
under Medicaid), residential foster care, and assisted living 
residential services; or
    b. Housing services that do not provide direct medical or 
supportive services but are essential for an individual or family to 
gain or maintain access to and compliance with HIV-related medical care 
and treatment. Necessity of housing services for purposes of medical 
care must be certified or documented by a case manager, social worker, 
or other licensed healthcare professional(s).
    B. Short-term or emergency housing assistance is understood as 
transitional in nature and for the purposes of moving or maintaining an 
individual or family in a long-term, stable living situation. Such 
assistance is limited to a cumulative period of 24 months per 
household. Short-term or emergency assistance must be accompanied by a 
strategy to:
    i. Identify, relocate, and/or ensure the individual or family is 
moved to a long-term, stable housing; or
    ii. Identify an alternate funding source for support of housing 
assistance.
    C. Housing funds cannot be in the form of direct cash payments to 
recipients or services and cannot be used for mortgage payments.
    D. The Ryan White HIV/AIDS Program must be the payer of last 
resort. In addition, funds received under the Ryan White HIV/AIDS 
Program must be used to supplement but not supplant funds currently 
being used from local, State, and Federal agency programs. Grantees 
must be capable of providing the HIV/AIDS Bureau (HAB) with 
documentation related to the use of funds as payer of last resort and 
the coordination of such funds with other local, State, and Federal 
funds.
    E. Housing-related expenses are limited to Part A, Part B, and Part 
D of the Ryan White HIV/AIDS Program and are not allowable expenses 
under Part C.
    F. For all clients, new or current, the 24-month cumulative period 
of eligibility becomes effective as of March 27, 2008. Grantees are 
responsible for tracking the 24-month cumulative period of eligibility 
beginning on that date.


[[Page 10262]]


    Dated: February 19, 2008.
Elizabeth M. Duke,
Administrator.
 [FR Doc. E8-3607 Filed 2-25-08; 8:45 am]
BILLING CODE 4165-15-P