The Atlanta HIV Housing Crisis Rages On

Atlanta voters decided in late November that city council member Andre Dickens will be their next mayor. Dickens will have a lot on his plate, including ongoing issues with the city’s HOPWA (Housing Opportunities for Persons With AIDS) program. Managing and disbursing HOPWA funds has become a thorn in the city of Atlanta’s side over the years, and a resolution to the problem still seems distant.

Providing subsidies for housing and related services for low-income people with HIV, HOPWA — a program of the U.S. Department of Housing and Urban Development— serves 29 metro Atlanta counties and works with approximately 20 organizations there. The city of Atlanta, through HOPWA funding, reimburses participating organizations after they cover fees for their clients. Jeff Graham (picture above, center), executive director of the advocacy group Georgia Equality, calls it a vital program. “Housing is a critical need for people living with HIV [and] AIDS,” he says. “The role stable housing provides in setting an environment where people can be successful living a long full life with an HIV diagnosis is oftentimes overlooked.”

Atlanta has one of the highest rates of new HIV infections among U.S. cities, according to the Centers for Disease Control and Prevention. HOPWA currently serves more than 1,800 individuals in Georgia, but problems with the program in Atlanta have been persistent over the years and have become more high-profile during the administration of Mayor Keisha Lance Bottoms, who was elected in 2017 and did not seek reelection last year.

Many participating organizations have complained about the time it takes to get reimbursed. Living Room, an Atlanta-based organization that received HOPWA funding, sued the city in 2019, saying it had wrongfully withheld payments. Later that year Living Room declared bankruptcy with more than $1 million in debt and shut down. Daniel Driffin, who was deputy executive director of Living Room at the time, says the situation put many in the program on the brink of eviction.

When HUD investigated the situation in 2019, it found mismanagement in the program. The city vowed to restructure.

This September, though, the board of Positive Impact Health Centers — which also provides housing for people with HIV in Atlanta — voted to end its 28-year relationship with the city and threatened legal action.

“As a nonprofit AIDS Service Organization that serves over 20 counties, Positive Impact Health Centers, Inc. spent out-of-pocket approximately $1,302,307.81 to provide housing services for individuals living with HIV from January to September 2021,” Positive Impact CEO and President Larry Lehman said in a press release at the time. “Although the City of Atlanta currently has more than $70 million in federal HOPWA dollars sitting in their account, as a pass-through entity, the City of Atlanta has failed to timely process reimbursement requests for PIHC and other nonprofit organizations preventing desperately needed funds for housing services from getting into the community.” Lehman has since said the city is more current with its payments and is working with his group on a transition plan.

 The city of Atlanta sees HOPWA matters differently. Addressing the long-standing issues with HOPWA has remained a priority for the Bottoms administration, says spokesman Michael Smith. He adds that the mayor created the Department of Grants and Community Development as well as other measures to improve the services provided, and that project sponsors are receiving their reimbursements in a more timely manner under her administration.

 The city will continue to work with current project sponsors and community partners to place all of Positive Impact’s HOPWA clients in housing and ensure that supportive services are not interrupted, Smith says.

“The City has worked diligently with Positive Impact over the years and DGCD has provided dozens of hours of technical assistance to [its] staff on how to properly substantiate monthly expenditures, while also making more than a million dollars in pre-payments to Positive Impact to assist the agency,” Smith said in an email.

Graham of Georgia Equality is encouraged by the incoming mayor’s commitment to HOPWA. Dickens has acknowledged problems with the program and vowed to try to fix it.

For now, the situation remains a complicated, divisive one. No one can pinpoint exactly why delays in reimbursements persist. Graham agrees problems with HOPWA have been ongoing and says there are structural issues in the city’s grantmaking and procurement processes. “Because it is a complex issue, there has been a lack of political will to focus in on it,” he says. “I honestly believe there is a bias against people living with HIV [and] AIDS, that they are not as important a constituency in reality as people talk about in their words.”

“What really matters is that the program is incredibly broken and people who are vulnerable are suffering as a result of it,” he continues. “All we are seeing now from city leadership is finger-pointing and denial.”

William Ramirez, an Ending the Epidemic fellow with Georgia Equality, focuses on HIV housing equity and has been closely following the situation. He’s also worked to establish relationships with providers to build a coalition. He fears that other organizations besides Positive Impact might eventually end their HOPWA agreements with the city.

Driffin, formerly of Living Room, shares Ramirez’s concerns but says the city is attempting to improve the situation. However, it’s a bit too early to tell if it’s working. He holds out hope that all those needing assistance will still be able to get it.

“Even from the time I was with Living Room, there were fewer and fewer options for individuals on government programs to secure habitable and safe housing,” he says. “We are getting such an influx of people moving into Atlanta that have a higher income. Landlords and organizations that own housing complexes can just lease to those people. I really don’t want to see people who rely on HOPWA funding get pushed out of the city limits.”