Housing as Healthcare
Policy, Program, Intervention or other types of research evaluation
Issues : Legal representation is a critical structural intervention in ending the HIV epidemic.
Description : For five years, the HOPWA program at Legal Aid Service of Broward County has provided free legal services to help low income clients maintain or acquire safe and affordable housing. Legal Aid has provided advice and/or representation in: evictions, lease reviews, habitability issues which jeopardize compromised immune systems and other root causes of poverty having a direct impact on housing stability: consumer issues (such as garnishments and debt collection), driver’s license restoration, and names changes for transgender persons. Additionally, our project is representing a nonprofit in the development of housing for LGBTQ seniors. We have adopted a multi-prong approach to fostering “Housing as Healthcare”.
The inclusion of legal services is an essential support service in “Housing First” models. It is imperative that specialized legal teams with an understanding of the unique set of social, economic and medical issues impacting the housing stability of PLWHA are available to protect basic housing rights. Protecting clean and stable housing is critical to viral suppression.
Lessons learned : Legal services are an integral component of an interdisciplinary team of professionals addressing issues facing PLWHA. At the 2017 HUD HOPWA Institute, the City of Fort Lauderdale, our HOPWA grantor, reported findings that clients who received only case management services (including legal) had the same rates of viral suppression when compared with those received both case management and a rental subsidy.
Legal Aid’s informal findings are consistent with a recent study in Los Angeles County conducted in response to the 2012 closure of the legal services provider dedicated solely to people living with HIV/AIDS. Similar to Legal Aid’s informal findings, this study found that of the 387 respondents, 98% reported they had a legal need in the year prior to the survey. The respondents averaged six distinct legal needs in four areas of law. Although this study is of Los Angeles County, when combined with the informal findings in Broward County, FL, it is reasonable to extrapolate its findings to other jurisdictions. The study noted that research studies focused on HIV legal services and the legal needs of PLWH are limited.
Legal interventions result in economic savings. The Florida Bar Foundation recently reported that for every dollar spent on legal services results in a $7 savings to the community. Further, protecting healthy housing for clients results in financial benefit to the clients (or programs supporting them) in the form of moving costs, work loss, and education impacts.
Recommendations : The provision of legal services is critical to the success of interdisciplinary continuums of care. PLWHA face a number of legal issues which directly impact their housing and physical health.
Funding for legal services has been significantly reduced nationwide. Other federally funded “Housing First” approaches recognize and value the need for a legal component and have included legal services in collaborative funding opportunities. For example, the Notice of Funding Availability for the Supportive Services for Veteran Families (SSVF) grant administered by the Department of Veteran Affairs encourages the inclusion of legal services to assure a collaborative and holistic approach to ending Veteran homelessness.
The presentation will address the impact of legal services in a holistic model to overcome social drivers of HIV including housing status, poverty and the root cause issues which impact housing so that PLWHA can achieve improved mental and physical health.