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Kitsap HIV case management describes client housing and support work; staff warn HOPWA funding is at risk
Summary
HIV medical case management staff told the board they serve clients across multiple counties, maintain high rates of antiretroviral coverage and viral suppression, and rely on federal HOPWA housing funds that could be at immediate risk if HUD funding is reduced.
Kitsap Public Health District’s HIV medical case management program told the board April 3 that it provides comprehensive case management and peer navigation to people living with HIV across several counties, achieves high antiretroviral coverage and viral‑suppression rates among enrolled clients, and relies on federal housing funds that district staff said are directly at risk from broader federal funding uncertainty.
"The immediate risk is housing through HOPWA, because HOPWA is housed under HUD. And so because HUD is at risk, HOPWA is at risk," said Ashley Duran, program supervisor for HIV Medical Case Management. She said tenant‑based rental assistance and other housing supports funded through HOPWA would be the most vulnerable services if federal HUD funding were reduced.
Duran said the program currently serves about 84 clients on its caseload at any given time, with case managers carrying 40–50 clients each; the program also serves clients in Kitsap, North Mason, Jefferson and Clallam counties and accepts referrals from elsewhere in Washington. She said 98 percent of current clients are prescribed antiretroviral therapy and 95 of the current clients had achieved an undetectable viral load as of March 2025 (the state DOH goal is 90 percent).
The program is primarily funded by Ryan White Part B grants and HOPWA (Housing Opportunities for Persons With AIDS), and it also bills Medicaid and participates in Medicaid match. Duran said the board’s approved local budget dollars helped the program and thanked the board for that support.
Duran described the program’s services: housing assistance (short‑term rent/mortgage/utility support, tenant‑based rental assistance vouchers, permanent housing move‑in costs), food assistance (grocery cards, Meals on Wheels), transportation support (gas cards, ferry passes, bus tokens) and intensive insurance, benefits and legal navigation when needed. She gave client examples: one client diagnosed late in illness was stabilized on ARVs and returned to work; another client who experienced prolonged housing instability was placed into stable housing using a Bremerton Housing Authority voucher the program helped secure.
When asked what would be cut first if funding drops, Duran said supportive services — food assistance, medical transportation, and Ryan White housing assistance — would be the first to go. Staff said case management itself might be preserved in part to maintain continuity of care and medication access, but supportive services that directly prevent homelessness and help medication adherence would be reduced.
Ending: Duran said preserving housing funds is essential to maintain clients’ stability and viral‑suppression outcomes; staff asked the board to consider funding risks when evaluating future budget choices and advocacy efforts.
