Housing is key to ending the HIV epidemic. Yet as many as 2,800 extremely low-income New Yorkers living with HIV remain homeless or in precarious housing situations, according to estimates from the state Office of Temporary and Disability Assistance. That is unacceptable, especially because there is a long-standing state public assistance program to help these New Yorkers obtain safe housing .

While the program is available in New York City, homeless residents in Long Island and Upstate do not have access to these critical housing supports. This inequity is a matter of life and death.

Scientific advancements in treatment have transformed HIV from a death sentence into a manageable condition, and medications can prevent transmission of HIV to others.  But research and experience show that without housing, people do not have the stability to access and adhere to these treatments. People with HIV who are experiencing homelessness face a staggering 27-fold higher rate of premature death.

 This disparity is not only unjust; it is a public health threat.  A recent report from the New York State AIDS Institute shows that while New York City has reduced new HIV diagnoses by 32% since 2014, the rest of the state has seen only a 17% decline. Rochester has the highest rate of new HIV diagnoses outside of New York City and HIV is increasingly concentrated in communities already burdened by poverty, disproportionately impacting Black, Latino, and LGBTQ+ New Yorkers.

In New York City, more than 20,000 who are eligible for public assistance and live with HIV rely on the New York State HIV Emergency Shelter Allowances sufficient to secure housing and the state enacted HIV 30% rent cap for those who contribute a portion of disability benefits towards rental costs. These supports enable recipients maintain stable housing, achieve viral load suppression, and prevent further transmission. These supports don’t just save lives. They reduce costly emergency care and prevent new infections, saving millions of dollars in Medicaid spending.

Yet communities outside New York City are effectively shut out of providing this lifesaving assistance to their residents because local governments cannot afford the standard 71% local share required to provide these benefits.

There is a simple, voluntary, and cost-effective fix for this inequity.  By providing 100% state reimbursement to any municipality outside of New York City that opts in to provide meaningful HIV Emergency Shelter Allowances, we can make this essential public assistance program accessible throughout the state.

This investment would pay for itself and save New Yorkers’ lives.  Improved health outcomes and fewer new infections would generate Medicaid savings projected to exceed the additional New York State cost for this housing assistance.

This is not a new mandate on local communities. Rather, this fix would make it fiscally possible for local social service districts to opt to provide safe, permanent housing for residents with HIV, rather than the expensive and inappropriate shelter they are currently required to provide.

And local leaders are ready. Five heavily impacted Upstate counties have already written to Governor Hochul that they are ready and willing to provide this HIV housing support. Gov Hochul has rightly acknowledged that all New York communities need additional support from the State in the face of rising costs, increasing homelessness, and federal threats to critical social support systems.

Including this long-overdue fix to the HIV Emergency Shelter Allowance program in the Fiscal Year 2027 budget will save lives, support local communities, and continue New York State’s longstanding leadership in ending the HIV epidemic.

Hon. April N.M. Baskin
NYS Senator
63rd District

Hon. Harry Bronson
NYS Assembly
138th District