Oregon Balance of State HIV/AIDS Housing & Services Systems ...

Oregon HIV/AIDS Housing and Services Systems Integration Plan 19
driven to assist people with limited assets, and may be willing to provide support, services, or even
housing. Another opportunity may be the six USDA Rural Development offices in the balance of
state, which provide rental assistance to low-income residents in rural areas. However, nationally
this assistance has been greatly reduced in recent years, and these offices in Oregon currently assist
with only 700 rental units statewide.
Health Care (including HIV Care)
People living with HIV/AIDS have a range of health care needs, including treatment for HIV
disease itself, treatment for other chronic health conditions, supportive services, and in some cases
care in an assisted living environment. In Oregon, the primary responsibility for meeting the health
care needs of people living with HIV/AIDS falls to the Oregon Department of Human Services,
Public Health, HIV/STD/TB Section, HIV Care and Treatment Program, known in brief as “HIV
Care and Treatment.” HIV Care and Treatment is also the administrator of the OHOP program. At
least in part because of this structural connection, as well as because all recipients of HIV housing
assistance are eligible for some health services as a result of their HIV diagnosis, integration
between these two systems (health care and HIV/AIDS housing) is particularly extensive and well
developed.
HIV Care and Treatment administers HIV case management services throughout the Oregon
balance of state and provides an array of other types of statewide medical assistance, with a
program-wide budget of approximately $14 million that includes both federal Ryan White
Comprehensive AIDS Resources Emergency (CARE) Act funds and state general and other funds.
Federal Ryan White CARE Act funds are awarded to all states by formula to provide primary
healthcare and support services, including AIDS Drug Assistance Programs (ADAPs), which
enhance access to care for people living with HIV/AIDS and their families. HIV Care and
Treatment activities are therefore commonly referred to as “Ryan White” services, although state
and other program funding for HIV Care and Treatment roughly equal the federal funding share.
HIV Care and Treatment program services are provided in the balance of state by a network of 19
AIDS service providers (15 county health departments, two community-based organizations, and
two independent contractors) with a total of 42 HIV case managers serving more than 800 people
living with HIV/AIDS and their families each year. 52 Approximately $1.5 million of services are
annually targeted to individuals in the balance of state, along with $2.5 to 3 million in ADAP
funding. Oregon’s ADAP, known locally as CAREAssist, represents the HIV Care and Treatment
Program’s largest program element by expenditure, and roughly 75 percent of ADAP funds are
expended in the Portland metropolitan area.
As part of its CAREAssist portfolio, Oregon HIV Care and Treatment is able to provide access to
health insurance (as described in the section on Health Insurance above) for low-income people
living with HIV/AIDS in Oregon who are not covered by the Oregon Health Plan (OHP). Between
these two programs, any income-eligible Oregonian living with HIV/AIDS who presents with a
need for health insurance coverage can receive it. HIV Care and Treatment administrators estimate
that approximately 20 percent of Oregonians living with HIV/AIDS receive medical service
52 Oregon Department of Human Services, HIV Care and Treatment Program, 2007 HOPWA NOFA Proposal for the Oregon
Housing and Behavioral Health Initiative (OHBHI).