Atlanta hoards $40 million as HIV housing crisis erupts

Over 90 HIV activists, doctors and researchers expressed a “total loss of faith and confidence” in the City of Atlanta's ability to manage an HIV housing program as millions in federal funds for the program sit unspent. 

Some $40.1 million provided by the U.S. Department of Housing & Urban Development for the city’s Housing Opportunities for People With AIDS (HOPWA) program is waiting to be spent, according to information provided by city officials at a July 9 meeting of the Human Services Committee of the Atlanta City Council.

That includes $2.2 million left of a $14.2 million grant in 2014, $720,000 left of an $18.1 million grant in 2015, $4.9 million left of a $22.9 million grant in 2016, $11.1 million left of a $23.1 million grant in 2017 and $21.2 million left of a $23.1 million grant in 2018.

The city’s inability to distribute the money to housing organizations is one reason that HIV activists and HOPWA-funded agencies sent a letter to Mayor Keisha Lance Bottoms (photo) on Monday requesting a “complete overhaul” of HOPWA grant administration. 

The group also criticized the city’s poor housing and service quality, lack of a plan for impending HOPWA funding cuts, lack of transparency and inconsistent monitoring and oversight of HOPWA recipients.

“Advocates have repeatedly asked for an audit of the processes that led to these issues; we have asked for reimbursement delays to be remedied; we have asked to be included in our city’s plans for HOPWA modernization, and we have asked for regular communication from city leaders involved in HOPWA administration,” the letter said. “None of these requests have been granted.”

The letter comes in the wake of a dispute between the city and Living Room, a housing organization for people living with HIV. Living Room said the city is months late on paying it some $500,000 in HOPWA funding. The city said Living Room failed to follow the program’s rules. Some 250 city residents are caught in the middle, with over 70 of them facing evictions or losing gas services and electricity – or both.

A dozen of those people had their power shut off on Friday in 90-degree heat, according to Larry Lehman, CEO of Positive Impact Health Centers. Lehman is among the signatories of the letter to Bottoms.

“Clients are suffering due to the Bottoms administration’s mismanagement of this program,” he told Project Q Atlanta. “We are in an extreme crisis. These individuals are facing eviction every day.”

Several members of Bottoms’ LGBTQ Advisory Board are among the people who signed the letter. They are Jeff Graham, executive director of Georgia Equality; Tracee McDaniel, board member of Trans Housing Atlanta Program; Emily Halden Brown, director of community engagement at AbsoluteCARE Medical Center; Craig Washington, co-founder of the Southern Unity Movement; and Tori Cooper, executive director of Advocates for Better Care Atlanta.

Bottoms was scheduled to appear at a LGBTQ Advisory Board meeting on Monday, but the session was rescheduled last week. A new date has not been set.

Anxiety over impending grant cuts

 

HUD distributes HOPWA funding to the city, which is then responsible for distributing the money to housing organizations. Those groups use the money to pay for rent and other services for people living with HIV.

Problems with the city's HOPWA program go back years, issues chronicled by Project Q in August 2018. That's when housing advocates called the city's HOPWA grants management "a mess." City officials hoped at the time to address the issues to avoid the problems when the city's new fiscal year opened this summer.

The signers of Monday’s letter requested the city reimburse HOPWA agencies “immediately” for funds the agencies spent to house HOPWA clients. They also requested that management of the HOPWA program be removed from the purview of the Office of Grants Management and transferred to the city’s Continuum of Care department.  

The city’s Office of Human Services is also responsible for managing the HOPWA program, but that office’s director, Preston Brant, left in May. 

“We will not be satisfied with the city simply hiring a replacement for the previous OHS director, or with any similar, symbolic change,” the letter said. “The bifurcated system currently in place is dysfunctional because it requires financial management staff (the Office of Grants Management) to conduct programmatic planning and monitoring. This is considerably outside their area of expertise.”

“The Office of Human Services is an atrophied relic of a department with no expectation of human services expertise in its leadership, as evidenced by previous hires,” the letter continued.

Compounding the HOPWA issues faced by the city are coming funding changes to the program that could lead to a 40 percent cut in HOPWA funding by fiscal year 2022, according to activists.

“We implore you to understand the seriousness of our situation, and the grave consequences of allowing our broken system to remain in place,” the letter said. “We implore you to resist the temptation for a quick fix to this complex problem. Despite our deep disappointment at how things have unfolded, and our anxiety about a future with dramatically reduced resources, we remain ready to partner in support of those we all serve.”

A city spokesperson did not respond to Project Q’s questions about the unspent HOPWA funds, a plan to address the evictions resulting from the Living Room dispute and a response to the HIV activists’ letter.

Atlanta City Councilmember Antonio Brown, the council’s sole LGBTQ member, is leading a new task force to address the HOPWA crisis. Some $1.5 million in emergency aid for eight HOPWA agencies is under consideration by the council, but it wouldn’t get final approval until August at the earliest.

Atlanta has the third-highest rate of new HIV infections of any city in the U.S., according to the Atlanta-based Centers for Disease Control & Prevention.

The full letter: 

Monday, July 15, 2019
The Honorable Keisha Lance Bottoms
Mayor, City of Atlanta
Atlanta City Hall
55 Trinity Avenue 
Atlanta, GA 30301

Dear Mayor Bottoms:

We, the undersigned HIV advocates, HOPWA-funded service providers and people living with HIV, are writing to express our total loss of faith and confidence in the City of Atlanta’s administration of its federal HOPWA grant. With acknowledgement of the gravity of the problems we face, but in a spirit of partnership, we posit that nothing short of a complete overhaul of HOPWA grant administration will provide people living with HIV the housing and life-saving programs they deserve and desperately need. 

Over the past two years, an organized group of advocates has clearly communicated our serious concerns to city officials in a variety of ways. We have documented critical problems, including (but certainly not limited to):

• Poor housing quality, inconsistent service quality and interruptions in services
• Massive, crippling annual reimbursement delays to agencies that serve HOPWA clients
• Lack of a plan for HOPWA modernization funding cuts expected to take effect in FY22
• Lack of transparency in RFP process and scoring criteria, as well as a lack of community inclusion
• Inconsistent monitoring and oversight of the HOPWA subrecipients by program leaders

These issues have led directly to homelessness and hopelessness among people who need HOPWA funds to survive. Indirectly, they have fueled our region’s HIV epidemic. 

Advocates have repeatedly asked for an audit of the processes that led to these issues; we have asked for reimbursement delays to be remedied; we have asked to be included in our city’s plans for HOPWA modernization, and we have asked for regular communication from city leaders involved in HOPWA administration. None of these requests have been granted. It is now too late to perform the audit we have asked for in the past. It would be futile to investigate how we got here and how we could fit HOPWA into the broken two-department system in place. People living with HIV are being evicted as we speak.

We therefore have two requests from the city: First, the monies that have already been spent by subcontractors to house HOPWA clients must be reimbursed to those subcontractors immediately. Failure of the City to honor these past due obligations will result in more people living with HIV being evicted from their homes, which not only hurts their health and ability to acquire housing in the future, but increases our community viral load and makes it harder for us to end our epidemic.

Second, we request that the HOPWA program be immediately removed from the purview of the Office of Grants Management and sub-awarded to an entity that is capable of programmatically and financially managing it. We are aware that a number of entities could program and manage finances for our city’s HOPWA grant, and our consensus is that the City of Atlanta’s Continuum of Care (Partners for HOME) would provide a reasonable backdrop to modernization planning, RFP management and scoring, and potentially provide access to resources to house people living with HIV beyond the HOPWA grant. 

As advocates, we see this subaward as an interim step that will get us to HOPWA modernization, until we eventually reach consensus on a longer-term solution, and a step toward integrating people with HIV into the landscape of housing resources and wraparound services others have access to. We do not, however, see this as an easy fix for the problems that plague HOPWA, and we offer the following caveats to accompany our request:

People living with HIV and HIV and HOPWA subject matter experts must be meaningfully brought to the table during this transition. The HOPWA Advisory Council in its current format is inadequate for this purpose; a transitional working group must be formed. This working group must participate in:

• The development of a plan for unspent and obligated HOPWA funds.
• The process of mapping the landscape of the Atlanta MSA, assessing need and conducting a review of current HOPWA and non-HOPWA housing stock.
• Assisting the subrecipient in preparation for staffing, program and other changes that need to occur as a result of taking on the HOPWA grant. This may include formation of a CoC HOPWA committee or establishment of another working group beyond the purview of the transitional working group.
• A communication strategy to inform the community, HOPWA-funded service providers, (and potentially, non-HOPWA-funded CoC members) of the implications of this change. 

The subrecipient must be provided with adequate resources and staff to take on the large HOPWA grant and to account for the specific subject matter expertise of serving people living with HIV. Under-resourcing this transition in its inception would be a serious mistake. We will be watching with particular attention to the ability of the subrecipient to execute contracts and deliver reimbursements in a timely manner.

No interruptions or changes in current contracts, funding or services may result from this transition, but we ask that the current (FY 20-22) RFP process, which has been mired in serious transparency problems, be restarted and that a transparent RFP and scoring process be initiated with the involvement of the subrecipient.

We will not be satisfied with the city simply hiring a replacement for the previous OHS director, or with any similar, symbolic change. The bifurcated system currently in place is dysfunctional because it requires financial management staff (the Office of Grants Management) to conduct programmatic planning and monitoring. This is considerably outside their area of expertise. The Office of Human Services is an atrophied relic of a department with no expectation of human services expertise in its leadership, as evidenced by previous hires.

We implore you to understand the seriousness of our situation, and the grave consequences of allowing our broken system to remain in place. We implore you to resist the temptation for a quick fix to this complex problem. Despite our deep disappointment at how things have unfolded, and our anxiety about a future with dramatically reduced resources, we remain ready to partner in support of those we all serve.

Sincerely, 

The Undersigned:

Tracee McDaniel
Board of Directors 
Trans Housing Atlanta Program

Matthew Pieper
Executive Director
Open Hand Atlanta

Nicole Roebuck,  MSW 
Executive Director 
AID Atlanta

Neena K. Smith-Bankhead

Terrance Cooley
Veteren's Permanent Supportive Housing Case Manager
Quest Communities

Dr Reggie Dunbar II 
Founder-CEO
Poz Military Veterans USA INTL 
Atlanta GA 

Steven Igarashi-Ball,
Assistant Event Manager, AID Atlanta

John Stanton, MPH, MSN, APRN-BC
Nurse Practitioner | Positive Impact Health Centers
Clinical Faculty | Emory University School of Nursing
President | Association of Nurses in AIDS Care, Georgia Chapter

Christopher Bostick 

Travis Miller

Markus A Jones

Renard Prather
THRIVE SS 

Leroy Braxton
Housing Committee Planning Council

Emily Halden Brown
Director, Community Engagement
AbsoluteCARE Medical Center 

Devin Barrington-Ward
Managing Director 
Black Futurists Group

Jeff Graham
Executive Director
Georgia Equality

Alex Ortiz
Chair, Board of Directors
Living Room

MarQuail Broadnax 
THRIVE SS

Ronald Brown
Retired Library Branch Manager
Fulton County Library (GA)

Daniel D. Driffin, MPH
Deputy Executive Director & Person Living with HIV
Living Room 

Jon Gabriel Ortiz
Director of Digital Marketing
THRIVE SS
Person Living With HIV

Jamaan Parker
Public Policy Committee 
Vice-Chair
HIV Health Services Planning Council

Richard Hutchinson Jr. 
Executive Director, Person Living With HIV 
He Is Valuable, Inc. 

Ashton J. Reynolds
Operations Director, Person Living With HIV
He Is Valuable, Inc.

Joe Robinson
Program Coordinator/Silver Lining Project
THRIVE SS

John Patton
Social Media Ambassador 
THRIVE SS
Person living with HIV

Dana Mitchell

Marcus D. McPherson, MPPA

Gregory McKelvey
Living Room
[email protected]

Malcolm Reid
THRIVE SS 
Program Manager - The Silver Lining Project 

Cary D. Brassfield 
THRIVE SS Member
Person Living with HIV

Darriyhan Edmond
Linkage Coordinator
THRIVE SS

Ashton P. Woods
Organizer - Black Lives Matter Houston
Candidate for Houston City Council At-Large 5

Derek Canas 
Creator - #EndTheStigma Campaign

Tracee McDaniel
Executive Director/Founder
Juxtaposed Center for Transformation Inc.

Shyronn Jones
Positive Women's Network - USA
WLHIV | Georgia State Lead |
Policy Fellow 
 
Evany Turk’
Positive Women's Network-USA 
Membership Engagement Coordinator
Women Living w. HIV

Jeremy Sims
HOPWA  Advisory Committee 
2017 YHPA: Alumni 
HIV/Homlessness Advocate

Lisa Britt
Butterfly Girls, LLC

Veronica Brisco
AIDS Healthcare Foundation (AHF)
Advocacy Mobilizer-Independent Contractor

Brandon Dykes 
National President 
Nu Phi Zeta Fraternity Inc. 

Jerome Brooks 
Executive Director 
Living Room 

Robert Cheek
Community Health Outreach & PLWA
Nationz Foundation, Inc.

Roshod Murphy
THRIVE SS 

Hunter Drake, M.A.
Adjunct Professor
University of South Florida Saint Petersburg, 
USF Health, Department of Pediatric Infectious Disease

Justina Hall
Youth Peer Navigator/HIV Test Counselor
Nationz Foundation, Inc 

Nakeisa Jackson
Aniyah’s Space Incorporated

Vincent Marconi
Infectious Disease Research Program Director, Atlanta VA Medical Center
Staff Provider, Grady Health System Infectious Disease Program

Larry Scott-Walker
Executive Director
THRIVE SS 

Michael Lamb/Miss Mikey 
Certified Tester 
THRIVE SS 

Vincent Roberts, MSW
Positive Impact Health Centers

Walter Royal, III, MD
Professor and Chair, Department of Neurobiology
Director, Neuroscience Institute
Morehouse School of Medicine

Shelia Neal
Peer Advocate/Community Health Worker
Aids Outreach Center

Darryl Branch 

Bishop Hartsel Clifton Shirley
National & International Director of Social Action
New Direction Overcomers Intl. Fellowship

Thomas Davis
Founder and project Lead
The Catharsis Project

Jai McNeill
THRIVE SS 

Keith DeAndre
THRIVE SS

Nicole Becton-Odum
Nicole Odum Ministries

Laura N. Broyles, MD
Adjunct Assistant Professor, Emory University Division of Infectious Diseases
Global Health Consultant, Global Health Impact Group

Dont’e Davis
THRIVE SS 

Donna J. Smith
Faculty, GSU School of Public Health

Claudia E. Ordóñez
Anthropologist, M.A.I.R.
Adjunct Faculty Instructor | Hubert Department of Global Health
Rollins School of Public Health | Emory University 

Kenneth Chandler 
THRIVE SS

Roderick Alexander 
THRIVE SS Culture Ambassador 

Christopher Jones
Founder/CEO
Feed The People Atlanta Inc

Kenneth G. Castro, MD
Professor of Global Health and Epidemiology
Rollins School of Public Health
Emory University

Melanie Thompson, MD
Principal Investigator
AIDS Research Consortium of Atlanta

Torrian L Baskerville
Founder & Managing Partner
Mounted Wings Group, LLC

Patricia E. Parsons
Manager, ID Services
Mercy Care

Maria E. Sundaram, MSPH, PhD
Postdoctoral Research Fellow
Hubert Department of Global Health
Emory University

Quintin R. Robinson, M.D
Staff Physician -HIV
AbsoluteCARE Medical Center

Brandon Rozier 
Engagement Ambassador- THRIVE SS
Ryan White Case Manager & Peer Support
Aniz,Inc.

Tristian Sparks

K.M Venkat Narayan
Professor, Emory University

Virgo Avedore Olano-Harvell
Founder/ CEO of Virgos Specialties Animal Walking and Boarding

Lisa Diane White
Deputy Director
SisterLove, Incorporated

Zina Age
CEO/Founder
Aniz, Incorporated 

Wanona Thomas
Founder/CEO of LIVE IN YOUR TRUTH
Person Living with HIV

Roger Rochat M.D.
Professor, Emory University 

Jane Kelly, M.D.
Epidemiologist, Georgia Department of Public Health
 

Charles Stephens 
Executive Director 
Counter Narrative Project

Craig Washington
Co-Founder/Board Vice President
Southern Unity Movement

Marie Sutton, CEO
Imagine Hope Inc

Ameeta Kalokhe, MD 
Emory Infectious Diseases Ryan White Program

Carlos Del Río, MD
Rollins School of Public Health
Center for AIDS Research
Emory University

Keri Norris, PhD, JM, MPH, MCHES
Chief of Health Policy & Administration
The Fulton DeKalb Hospital Authority

Tori Cooper, BA
Executive Director
Advocates for Better Care Atlanta, LLC

Gwen Davies, PhD.
Positive Impact Health Centers

Nathaniel Thompson
#UAWorks

Karla Galaviz, PhD
Assistant Professor, Emory University