Issue:  Vol. 48 / No. 12 / 22 March 2018

Solutions exist to end HIV homelessness


Paul Ernest Pingol-Eulalia sits in the Castro Country Club. Photo: Rick Gerharter
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At first Paul Ernest Pingol-Eulalia adjusted well to his moving from the Philippines to Los Angeles in 2003. But the graphic designer's life began to spiral out of control after he began abusing drugs and alcohol.

He soon found himself living out of cheap motels and turning to prostitution to ensure he would have a roof over his head for the night. In March 2008 Pingol-Eulalia, who is gay, learned he had contracted HIV.

"It is hard to deal with addiction if you are homeless," said Pingol-Eulalia.

Then one day six years ago he mentioned to his case manager at the Los Angeles LGBT Center that he was thinking of moving to San Francisco to seek a fresh start. They suggested if he did that he should make his way to the AIDS Housing Alliance, which recently changed its name to the Q Foundation.

So Pingol-Eulalia, whose nickname is Paoi, bought himself a Greyhound bus ticket and arrived in time to make it to the agency's Monday morning housing clinic.

"When I moved here I had a hunch whatever I was looking for was in San Francisco," said Pingol-Eulalia, 36, during an interview Monday with the Bay Area Reporter at the Castro Country Club, a sober meeting place and cafe in the city's gay district.

He couch-surfed with a female friend his first two weeks in town, then moved into an apartment owned by a man who had hired him to do some graphic design work back in Los Angeles. But when the man discovered Pingol-Eulalia was using meth again, he kicked him out.

Pingol-Eulalia then turned to the Asian and Pacific Islander Wellness Center, which offered him emergency housing in a "skanky hotel" in the city's Tenderloin for 28 days. There he tried to sober up and started attending meetings for people with alcohol and narcotics addictions, eventually moving to a live-in rehab facility for a month.

Once out, he cycled through several sober living situations before landing a room in the Sunset with three gay roommates. He has been there now for 30 months and has been clean and sober for four and a half years.

"It really boils down to having a safe space. A safe space to me is a place I can go to and have a key to turn the door open with," said Pingol-Eulalia, who owns his own graphic design business called Pepe Creative Solutions. "It was hard for me to stay sober until I could figure out my housing situation."

While he credits the various nonprofit agencies that have helped him over the years, Pingol-Eulalia nonetheless feels there aren't enough services to help other people living with HIV or AIDS struggling to remain housed in San Francisco.

"We spent a lot of money on the Super Bowl, when we could have built more facilities for the homeless," he said.

City and nonprofit leaders acknowledge San Francisco is not doing enough to house people living with HIV or AIDS. The city's most recent HIV/AIDS Housing Five-Year Plan, which was released in December 2014, concedes on the first page "that the level of housing need for PLWHA is far greater than the resources available to meet that need."

According to the report, which used data from the city's 2013 Homeless Point-in-Time Count and Survey, as well as 2014 numbers from the city's Human Services Agency, 6 percent of the estimated 29,400 homeless individuals in San Francisco were HIV-positive, or 1,764 people. The report also estimated that 14,320 HIV-positive, low-income city residents were at risk of being homeless.

Homelessness is a contributing factor to the continued transmission of HIV in San Francisco, as according to the HIV housing plan, between 9 and 14 percent of the individuals diagnosed as HIV positive in 2006 through 2012 were homeless.

Compounding the issue is the fact that HIV-positive individuals are living longer, with the majority of the city's HIV-positive community over the age of 50. The result is the need for assistance to cover people's housing costs far outstrips the amount of subsidies the city is providing.

Between 2002 and 2014, the number of people receiving subsidies declined roughly 16 percent, from 1,190 slots down to 998. According to the HIV housing plan, in 2014 the city was providing "targeted housing assistance" – meaning housing or subsidy programs limited to people living with HIV or AIDS – "at any point in time to 1,462 households impacted by HIV/AIDS."

Bill Hirsh, the executive director of the AIDS Legal Referral Panel and a co-chair of the HIV/AIDS Provider Network, noted, "About 76 percent of the people living with HIV are at risk of homelessness because they pay so much of their income to rent. That I think is the scarier figure, even scarier than the number of people who are homeless. That is a lot of people."

Added Brian Basinger, Q Foundation's founder and executive director, "In what crazy world are we living in where we are not running to City Hall with pitchforks and demanding that this situation is addressed?"

He has proposed that local leaders convene a group of stakeholders tasked with conducting "a very deliberate and evidence-based analysis" to determine what is driving LGBT homelessness and homelessness among people with HIV and AIDS.

"It is not an accident that 30 percent of the city's homeless population comes from the LGBT community. That is not just a statistical anomaly; there is a reason why we have such great disparities in homelessness," Basinger said. "We need to find out what is driving the homelessness, where are the supports lacking, where are people falling through the cracks and ending on the street. Also, the deeper questions are why is our city, and why as a community, are we accepting that?"

Supervisor Scott Wiener, a gay man who represents the city's District 8, which includes the gay Castro district, told the B.A.R. the city has been making strides to keep HIV-positive people housed. It is a main goal of the city's Getting to Zero plan, noted Wiener, which not only aims to reduce HIV infections by 90 percent come 2020 but also end HIV deaths, as well as HIV stigma. After a fight over the program's budget last week, the Board of Supervisors voted to allocate $3.1 million toward it in the fiscal year that starts July 1.

"Part of keeping HIV-positive people healthy is keeping them housed," said Wiener. "Housing is a key part of Getting to Zero."



The HIV housing plan set out five main goals, three of which were squarely focused on addressing the city's housing supply. The first called for maintaining the current supply of housing and facilities dedicated to people living with HIV or AIDS.

It runs the gamut from residential care facilities for chronically ill people to the federal housing subsidy program known as HOPWA, which stands for Housing Opportunities for Persons with AIDS.

"The first thing we have to do is stop the bleeding," argued Basinger. "So we have to stop every single eviction that is within our powers to stop. That is first, otherwise the boat is going to sink."

To reduce the city's HIV-positive homeless count by 5 percent over the next five years, Hirsh estimated the cost would be nearly $2.9 million per year, which would provide 160 people an ongoing monthly subsidy of $1,500.

The city has budgeted $3 million in the Fiscal Year 2016-2017 budget for housing subsidies for seniors and people with disabilities, which includes people living with HIV or AIDS.

"I don't know how the money will be allocated and spent. But it was a good victory," said Hirsh. "There has been some progress made since the plan's release."

The HIV housing plan also called for adding 50 new affordable rental units designated for HIV-positive individuals by 2019 and funding an additional 25 rental subsidies through the HOPWA program so it totaled 265.

"This is a problem we can solve," said Wiener. "We just have to have the political will to make the investment and we are doing that."

Wiener secured $500,000 in the budget for the next fiscal year to assist those HIV-positive individuals in their early 60s who are aging out of their long-term private disability insurance that they got through their employer over to Social Security. Doing so often means a significant drop in their income, which is compounded by the fact many of the people didn't plan for their retirement years as they doubted they would live that long.

"It is not enough, but it is a good, very strong first step in terms of showing our commitment as a city to support our long-term HIV survivors," said Wiener. "I think the city has been doing more, but we need to do even more."

Earlier this month the supervisors unanimously passed Wiener's legislation to extend rent control to HIV-positive people living in HOPWA units. The legislation, co-sponsored by gay District 9 Supervisor David Campos and board President London Breed, who represents District 5, will benefit 240 HOPWA recipients.

And the city over the last two years has backfilled $4,340,000 in federal cuts to its HOPWA program.

"The city has done a great job of stepping up to fill those federal cuts," acknowledged Hirsh. "But the problem is there is actually a great unmet need for many, many people still in need of affordable housing. Simply backfilling and maintaining what we have is not going to help us move the needle."


HIV senior housing

This fall the city will open its first affordable housing development aimed at LGBT seniors that includes rooms dedicated to HIV-positive seniors at risk for homelessness. Known as the 55 Laguna project, and overseen by LGBT senior services provider Openhouse and affordable housing developer Mercy Housing, the first building to be completed will have eight rooms set aside for HIV-positive seniors. When the second building opens, sometime in 2018, there will be an additional 14 rooms for HIV-positive seniors.

Another step the city can take, which Wiener argues would benefit low-income HIV-positive people, is to give people who live or work in San Francisco preference for any new below-market-rate units built in the city. The board this summer is expected to adopt legislation Wiener has introduced that would make such a preference city policy.

"We are working so hard to build more affordable housing. We need to make sure our own residents have a fair shot to get into that housing," he said.

HIV housing advocates, along with Wiener, are also eyeing the two city-owned parking lots in the Castro as potential sites where affordable housing could be built, with all or some of the units dedicated to people living with HIV or AIDS. The San Francisco Municipal Transportation Agency is currently studying the two sites' development potential.

Yet Hirsh cautioned, "without a deep, ongoing operating subsidy, it will be very hard, if not impossible, to create new housing that is affordable to folks at the very lowest income levels."

With federal funding on the decline, he predicted the city would have to fund the housing subsidies residents of the new buildings would require.

"So if those lots in the Castro are developed with all shiny, wonderful new construction, unless there is some manna falling from heaven in the form of Section 8 vouchers from the federal government, the city will have to come up with a subsidy to make them affordable for our folks who are on SSI," said Hirsh.

To build support for funding housing assistance programs, Pingol-Eulalia believes the public needs to hear more stories about formerly homeless people who have "found redemption" once they were offered housing.

"I think people know the San Francisco homeless issue does exist. But people turn their back thinking it is a moral failure to be homeless," he said. "Homelessness is not a moral issue; addiction is not a moral issue. It is a disease that needs to be cured."


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