CAN Community Health Partnership

Comprehensive Housing Support Program for PLWH

December 2024 - February 2025

Executive Summary

  • Program Scope: 3-month program serving 15-25 PLWH clients
  • Total Budget: $31,000
  • Key Outcomes: Housing stability, health outcomes improvement, self-sufficiency
  • Implementation: Phased approach with comprehensive support services
  • Language Access: Full program delivery in English and Spanish

Ruth's Retreat House: Housing Stability Program

At Ruth's Retreat House, we understand that housing stability is fundamental to achieving and maintaining optimal health outcomes. Our program is specifically designed to create an environment where medical adherence can thrive through stable housing and comprehensive support. We recognize that consistent healthcare engagement becomes possible when clients have a secure, stable place to call home.

Ruth's Retreat House (RRH) proposes a comprehensive three-month program (December 2024 - February 2025) designed to serve 15-25 clients through an innovative approach that integrates housing stability, medication adherence, and personal development. Our program is fully accessible to both English and Spanish-speaking clients, with bilingual staff and materials available in both languages. By combining practical housing support with health management strategies and the transformative 7 Habits framework, we create sustainable pathways to both housing stability and improved health outcomes for persons living with HIV.

Our structured approach prioritizes the vital connection between stable housing and healthcare engagement. Each component of our program reinforces medical adherence through:

  • Stable environments for medication storage and management
  • Consistent access to healthcare facilities
  • Integrated health outcome support systems
  • Routine-building for medication adherence

Program Scope

Target Population

  • 15-25 individuals living with HIV
  • Priority: Newly diagnosed (within 60 days)
  • At risk for falling out of care

Support Services

  • Housing deposits and rent assistance
  • Utility assistance
  • Move-in support coordination

Program Goals

Housing Stability

Secure safe, affordable housing for clients while building long-term stability skills

Health Outcomes

Improve medical adherence and reduce viral loads through stable living environments

Self-Sufficiency

Develop financial literacy and life skills for sustainable independence

The 7 Habits Framework: Our Foundation for Change

The 7 Habits framework provides a proven, systematic approach to personal development that aligns perfectly with housing stability goals. By integrating these universal principles with practical housing support, we empower clients to build both the mindset and skills needed for long-term independence. This evidence-based approach creates a strong foundation for sustainable change while respecting each client's unique journey.

Private Victory: Foundation Building

1. Be Proactive

Moving from reactive to proactive behavior is crucial for housing stability and health management. Instead of waiting for crises, we help clients take charge of their circumstances by creating systems and routines that prevent problems before they occur.

  • Setting up medication reminders and health appointment calendars
  • Building emergency savings plans
  • Creating bill payment schedules
  • Developing preventive maintenance routines

2. Begin with the End in Mind

Success starts with a clear vision. We guide clients in creating detailed pictures of their desired outcomes - from stable housing to viral suppression - and help them map the steps needed to achieve these goals. This habit builds hope and direction.

  • Creating health vision boards and viral suppression goals
  • Developing housing stability plans
  • Writing personal mission statements
  • Setting SMART goals for health and housing

3. Put First Things First

Effective prioritization is essential when managing both health and housing needs. This habit helps clients distinguish between urgent and important tasks, ensuring critical responsibilities like medication adherence and rent payments are never overlooked.

  • Prioritizing medical appointments and medication schedules
  • Creating monthly budgets and payment priorities
  • Planning healthy meals and wellness routines
  • Managing household tasks and maintenance

Public Victory: Building Relationships

4. Think Win-Win

Success in housing and health management requires strong relationships. This habit teaches clients to create mutually beneficial arrangements with landlords, healthcare providers, and support networks, leading to more stable and sustainable outcomes.

  • Developing positive landlord relationships
  • Working effectively with healthcare providers
  • Building community connections
  • Negotiating and conflict resolution

5. Seek First to Understand

Effective communication is vital for navigating housing and healthcare systems. By developing deep listening skills and empathy, clients build stronger relationships with providers, better understand their treatment plans, and more effectively advocate for their needs.

  • Understanding lease terms and responsibilities
  • Communicating effectively with healthcare team
  • Active listening in support groups
  • Cultural competency and empathy building

6. Synergize

No one succeeds alone. This habit teaches clients to combine their strengths with community resources and support systems. Through collaboration, clients discover creative solutions to challenges and build lasting support networks for long-term success.

  • Coordinating care teams and support services
  • Accessing community resources effectively
  • Building wellness networks
  • Creative problem-solving in groups

7. Sharpen the Saw

Maintaining stability requires ongoing self-renewal. This foundational habit ensures clients develop sustainable practices for physical health, mental wellness, social connection, and personal growth. It's about creating balance while continuously improving in all areas of life.

Physical & Mental
  • Health maintenance and medication adherence
  • Stress management and resilience building
  • Self-care routines and wellness practices
Social & Spiritual
  • Community engagement and support networks
  • Personal growth and purpose development
  • Building lasting support systems

Program Calendar: December 2024 - February 2025

Our program structure provides a comprehensive journey through housing stability, health management, and personal development. While we currently plan evening sessions from 7:00 PM - 9:00 PM to accommodate working clients, final scheduling will be tailored to participant needs following intake assessments.

Note: This calendar represents our program framework. Session times and specific activities will be adjusted based on client availability and needs, ensuring maximum participation and impact for all participants.

Month 1: Foundation Building

Focus on establishing stability basics and core habits while beginning housing search

Weeks 1-2

  • Program Orientation

    Introduction to support systems and resources

  • Expert Session: Financial Literacy

    Budgeting and financial foundations

  • Habits 1-2 Workshop

    Being Proactive & Beginning with the End in Mind

Weeks 3-4

  • Expert Session: Medical Adherence

    Healthcare management strategies

  • Habit 3 Workshop

    Put First Things First - Priorities

Month 2: Skill Building

Developing practical skills while implementing housing plans

Weeks 5-6

  • Expert Session: Credit Building

    Understanding and improving credit

  • Habits 4-5 Workshop

    Win-Win Thinking & Understanding Others

Weeks 7-8

  • Expert Session: Mental Health Support

    Building resilience and coping strategies

  • Habit 6 Workshop

    Synergize - Community Resources

Month 3: Sustainability Planning

Establishing long-term success strategies and support systems

Weeks 9-10

  • Expert Session: Housing Navigation

    Long-term housing strategies

  • Habit 7 Workshop

    Sharpen the Saw - Self-Renewal

Weeks 11-12

  • Expert Session: Wellness Planning

    Comprehensive health and wellness strategies

  • Graduation & Next Steps

    Celebration and transition planning

Weekly Program Elements

Core Sessions

  • • Group workshops
  • • Skills training
  • • Peer support

Individual Support

  • • One-on-one coaching
  • • Housing navigation
  • • Progress reviews

Resources

  • • Support materials
  • • Community referrals
  • • Crisis assistance

Program Materials & Resources

Core Program Materials

Core Workbooks

  • 7 Habits of Highly Effective People Workbook

    Personalized workbook for tracking progress through the 7 Habits framework

  • Financial Literacy Workbook

    Comprehensive guide covering budgeting, saving, and credit building

  • Housing Stability Guide

    Resource for maintaining stable housing and tenant responsibilities

  • Personal Development Journal

    Weekly reflection and goal-setting workbook

  • Bilingual Program Materials

    All program materials and workbooks available in English and Spanish

Assessment Tools

  • Housing Needs Assessment Package

    Forms for evaluating housing requirements and preferences

  • Financial Assessment Tools

    Budget worksheets and financial planning templates

  • Goal Setting Worksheets

    Structured templates for setting and tracking personal goals

Educational Materials

  • Housing Rights & Responsibilities Guide

    Comprehensive overview of tenant rights and obligations

  • Health Management Toolkit

    Resources for managing health appointments and medication

  • Community Resource Directory

    Local services and support organization listings

Support Resources

Digital Resources

  • Online budget tracking tools and templates
  • Virtual group session materials and handouts
  • Digital appointment reminder system
  • Mobile-friendly resource library
  • Video tutorials for financial literacy topics
  • Interactive goal-tracking dashboard

Additional Support Materials

  • Welcome packet with program overview and expectations
  • Monthly progress tracking forms
  • Emergency contact cards and resource lists
  • Transportation planning worksheets
  • Medication adherence tracking tools
  • Housing search documentation package
  • Success story templates for peer support
  • Crisis intervention protocol guides

Housing Procurement Process

Step-by-Step Housing Support

1

Initial Housing Assessment

Comprehensive evaluation of client's housing needs, preferences, and barriers

  • Current housing situation assessment
  • Income and budget review
  • Location preferences and requirements
  • Transportation needs
  • Documentation readiness check
2

Housing Search & Options

Active search for suitable housing options using our network of resources

  • Property database screening
  • Partner landlord outreach
  • Affordable housing applications
  • Section 8/Housing Choice Voucher support
  • Emergency housing coordination if needed
3

Application Support

Assistance with housing applications and required documentation

  • Application completion assistance
  • Document gathering and organization
  • Credit report review and explanation
  • Reference letters when needed
  • Application fee assistance coordination
4

Move-In Coordination

Support through the move-in process and initial stabilization

  • Lease review and explanation
  • Deposit and rent assistance processing
  • Utility connection support
  • Move-in kit coordination
  • Initial home setup assistance
5

Housing Stability Support

Ongoing support to maintain housing stability

  • Regular check-ins and support
  • Tenant rights education
  • Budgeting and payment planning
  • Maintenance request guidance
  • Crisis intervention if needed

Housing Resources

Property Partnerships

  • Network of supportive landlords
  • Pre-screened affordable properties
  • Second chance housing options
  • Emergency shelter partnerships
  • Transitional housing connections

Financial Resources

  • Security deposit assistance
  • First month's rent support
  • Utility assistance programs
  • Emergency rental assistance
  • Moving cost support options

Support Services

  • Housing navigation assistance
  • Transportation support
  • Furniture assistance referrals
  • Legal aid connections
  • Credit repair resources

Quality Assurance

  • Regular property inspections for safety and habitability
  • Fair housing compliance monitoring
  • Client satisfaction surveys
  • Landlord relationship management
  • Housing stability tracking
  • Regular case review and progress monitoring

Measurable Outcomes

Health Outcomes

Viral Load Suppression90%
Medical Appointment Adherence95%
Medication Adherence95%
Retention in Care90%

Program Milestones

Housing Stability Achievement85%
Program Completion Rate90%
Service Engagement95%
Self-Sufficiency Progress80%

Our outcome targets align with EHE goals and are based on evidence showing the positive impact of housing stability on HIV health outcomes. Research indicates that stable housing can lead to 90%+ viral suppression rates and significantly improved medication adherence.

Strategic Budget Allocation

Staff Support ($27,000)

Program Lead (1.0 FTE - 60% allocated to project)

Annual Salary

$95K

Project Hours

24 hrs/week

Hourly Rate

$45.67

The Program Lead serves as the primary architect and supervisor of the housing stability program, ensuring quality service delivery while managing staff and partner relationships. This role combines strategic oversight with direct service through evening group facilitation, making certain our program maintains high standards while remaining responsive to client needs.

• Program oversight and quality assurance
• Curriculum development and program planning
• Lead facilitator for evening support groups
• Staff supervision and training
• Partner relationship management
• Program evaluation and outcome tracking

Monthly Cost Breakdown (Fringe Estimates):

Base Salary (24 hrs/week): $4,384.32

FICA (7.65%): $335.40

Insurance: $250

Workers Comp (1%): $43.84

Unemployment (2%): $87.69

Retirement (3%): $131.53

Monthly Total with Est. Fringe: $5,182.78

Weekly Breakdown:

Weekly Base (24 hrs): $1,096.08

Weekly with Fringe: $1,295.70

*Fringe benefits are estimated and subject to adjustment based on final program requirements

Program Support 1 (1.0 FTE - 50% allocated to project)

Annual Salary

$39.5K

Project Hours

20 hrs/week

Hourly Rate

$19.00

This position specializes in housing stability, serving as the primary housing navigator for the program. They manage relationships with landlords and property managers while providing direct support to clients in their housing search and placement process. The role includes both individual case management and group facilitation, supporting clients through every step of their housing journey.

• Primary case management for assigned clients (12-13 clients)
• Housing search and placement coordination
• Landlord engagement and relationship building
• Co-facilitation of evening support groups
• Weekly client check-ins and documentation

Monthly Cost Breakdown (Fringe Estimates):

Base Salary (20 hrs/week): $1,645.40

FICA (7.65%): $125.87

Insurance: $150

Workers Comp (1%): $16.45

Unemployment (2%): $32.91

Retirement (3%): $49.36

Monthly Total with Est. Fringe: $1,977.48

Weekly Breakdown:

Weekly Base (20 hrs): $411.35

Weekly with Fringe: $494.37

*Fringe benefits are estimated and subject to adjustment based on final program requirements

Program Support 2 (1.0 FTE - 45% allocated to project)

Annual Salary

$39.5K

Project Hours

18 hrs/week

Hourly Rate

$19.00

This role focuses on the critical intersection of financial stability and health outcomes. They provide comprehensive financial literacy education while coordinating health-related support services. Working directly with clients, they ensure that financial planning aligns with healthcare needs, while helping clients navigate benefits and support systems for long-term stability.

• Primary case management for assigned clients (12-13 clients)
• Financial literacy education and coaching
• Health appointment coordination
• Benefits navigation and application support
• Weekly client check-ins and documentation

Monthly Cost Breakdown (Fringe Estimates):

Base Salary (18 hrs/week): $1,480.86

FICA (7.65%): $113.29

Insurance: $150

Workers Comp (1%): $14.81

Unemployment (2%): $29.62

Retirement (3%): $44.43

Monthly Total with Est. Fringe: $1,779.73

Weekly Breakdown:

Weekly Base (18 hrs): $370.21

Weekly with Fringe: $444.93

*Fringe benefits are estimated and subject to adjustment based on final program requirements

Total Program Cost (Including Est. Fringe)

Monthly Staff Costs:

Program Lead:$5,182.78
Support 1:$1,977.48
Support 2:$1,779.73
Monthly Staff Total:$8,939.99
Total 3-Month Staff Cost:$26,819.97
Program Support Cost:$4,150.00
Total Program Cost:$30,969.97

*All fringe benefit calculations are estimates and may be adjusted based on final program requirements and actual costs

Program Support ($4,000)

Specialized Evening Sessions$1,650
• 6 virtual expert speaker sessions @ $275/session, including:$1,650
Program Materials$1,800
• Workbooks & supplies (25 sets @ $72/set)$1,800
Client Engagement$700
• Evening refreshments & supplies$400
• Gift cards (12 @ $25 each)$300

Program Support Summary

Specialized Evening Sessions:$1,650
Program Materials:$1,800
Client Engagement:$700
Total Program Support:$4,150

Program Support & Resources

Transportation Support

  • Access to CAN's Lyft account for appointment transportation
  • Gas cards for personal vehicle use
  • Bus cards for public transportation access

Client Support Kits

  • Welcome Home Kit: Essential items for new housing setup
  • Kitchen Kit: Basic cooking and dining supplies
  • Bathroom Kit: Personal care and hygiene items
  • Laundry Kit: Detergent, supplies, and cleaning materials
  • Emergency Kit: Basic emergency supplies and resources

Documentation & Reporting

  • Monthly Service Reports

    Detailed tracking of referrals received and services provided

  • Client Documentation

    Progress notes, encounter logs, and plans of care

  • Staff Time Tracking

    Monthly staff time allocation reports

  • Incentive Distribution Logs

    Tracking of gift cards and support kit distribution

Partnership Implementation

Documentation Process

  • Monthly reporting structure
  • Client ID tracking spreadsheet
  • Progress notes format
  • Service verification records

Client Support Flow

  • Initial referral from CAN
  • Intake and needs assessment
  • Housing placement support
  • Ongoing program engagement

Timeline Milestones

  • December 2024: Program launch
  • January 2025: Mid-program review
  • February 2025: Final disbursements
  • February 28: Program completion

Program Contacts

Program Director

Monique Springer

m.springer@ruthsretreathouse.org