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Alameda Countywide Homeless and Special Needs Housing Plan 43 The Ryan White CARE Act represents the largest dollar investment made by the federal government specifically for the provision of services for people living with HIV/ AIDS. The CARE Act is intended to help communities and states increase the availability of primary health care and support services, in order to reduce utilization of more costly inpatient care, increase access to care for underserved populations, and improve the quality oflife of those affected by the epidemic. Federal guidelines require that the use of CARE Act Title 1 funds locally be guided by a Ryan White planning council comprised of consumers, providers, and advocates. CARE Act programs are required to complete regular needs assessments to determine the current needs of the community, and the planning council must set priorities and allocate resources based on the needs assessment and Ryan White guidelines.9In Alameda County, the Collaborative Community Planning Council (CCPC)IO is the body that determines priorities and allocations for CARE Act Title 1, and the Alameda County Public Health Department Office of AIDS Administration (OAA) supports the Oakland EMA HIV Services Planning Council (HSPC) and administers the funding. In program year 2004-2005, Alameda County received $6.6 million in Ryan White Title I funds. Recent Chanaes in the ResDonse to HIV/AIDS Housina and Services Several changes at the national level influence the current context for HIV I AIDS housing and services in Alameda County. These include: · Changes in Uses of Ryan White and HOPWA. In 1999, HRSA clarified that Ryan White funds could be used for housing referral services, and short-term or emergency housing that is necessary to gaining access to medical care, but not permanent rental or ownership housing. HOPW A funds may be used for a range of housing activities, but HUD has indicated that the use of HOPW A for services should be limited to 35 percent of the total grant amount. · Integration of Planning Efforts. In recognition of the similarity in issues and programs between various federal programs, including HOPW A, Consolidated Plans, Continuum of Care, and Ryan White, HUD has placed a renewed emphasis on integrating local planning efforts. The 1996 Alameda County Multi- Year HIV/ AIDS Housing Plan was a success in terms of reorienting and increasing AIDS housing resources, However, some of the systems change that it contemplated for cross-departmental cooperation between related branches of local government has not yet been achieved, especially the coordination of housing resources. Housing funding continues to be handled separately in both OAA and HCD, though progress has been made in sharing information and developing common monitoring protocols. In addition, the HIV/AIDS housing and service system in Alameda County, like other communities in the country, faces a growing population with stable or declining resources. Since the introduction of anti-retroviral medications in 1996, people living with HIV/AIDS are leading longer and healthier lives. As new infections continue, though, lengthening life spans mean there are greater numbers of people living with HIV/AIDS than ever before. Other complicating factors affecting people living with HIV/AIDS locally as well as nationally include the co-occurrence of 9 mv/ AIDS Bureau (HAB), Health Resources and Services Administration (HRSA), Ryan White CARE Act Needs Assessment Guide, p. 1.16, Fall 1999. Funded by HRSA HIV/AIDS Bureau with John Snow, Inc. and assistance provided by MOSAICA under contract #240-96-0037. 10 ccpe is a new name starting in 2005. The CCPC combined the Health Services Planning Council, which had addressed service categories including housing, with the HIV Prevention Planning Council.