Resolution approving Amendment No. 1 to the agreement between City, acting by and through, the Department of Public Health (DPH), and Catholic Charities, to provide HIV health services rental subsidies services, to extend the term by five years from June 30, 2026, for a total term of July 1, 2021, through June 30, 2031, and to increase the amount by $7,317,206 for a total not to exceed amount of $13,426,414; and to authorize DPH to enter into amendments or modifications to the agreement that do not materially increase the obligations or liabilities to the City and are necessary to effectuate the purposes of the agreement or this Resolution.

This resolution approves Amendment No. 1 to an existing grant agreement between the City's Department of Public Health (DPH) and Catholic Charities for HIV health services rental subsidies. The amendment extends the contract term by five years, from June 30, 2026, to June 30, 2031, making the total term July 1, 2021, through June 30, 2031. It also increases the funding by $7,317,206, bringing the total not-to-exceed amount to $13,426,414. The program, known as the Assisted Housing and Health Program (AHHP), provides partial rent subsidies and short-term housing advocacy to low-income San Francisco residents living with HIV/AIDS, including seniors and those with co-occurring conditions like Hepatitis C, mental health, and substance use issues.

The total amended contract amount is $13,426,414, with $12,475,185 allocated for the program budget and a $951,229 (12%) contingency. Annually, for FY2026-27 through FY2030-31, the budget is $1,324,199. This includes $852,110 for direct assistance (rental subsidies, basic needs, back rent), $255,725 for personnel (2.83 FTE), $43,642 for other operating expenses, and $172,722 for indirect costs (15% of the total budget, including direct assistance). The program is funded by the City's General Fund.

Effective September 1, 2025, monthly subsidies will increase to $450 for households without dependents and $550 for households with dependents. To accommodate these increases, the target number of unduplicated clients (UDC) has been reduced from 240 to 154 per year, starting in FY2023-24. Client eligibility now requires an income of ≤ 600% of the Federal Poverty Level (up from 500%) and ≤ 30% of HUD median income to qualify for subsidies. Services are provided at 990 Eddy Street, San Francisco, and other satellite offices, Monday through Friday, 8:30 AM to 5:00 PM, with drop-in hours and appointments. Key services include intake, assessment, annual eligibility recertification, and the development of individual housing stability plans. The program also transitioned its client management database from ARIES to HIV Care Connect (HCC) in April 2025.

The Budget and Legislative Analyst (BLA) report noted that performance data for FY2023-24 was unreliable due to Catholic Charities' misinterpretation of metrics, though DPH believes the program is performing well and confirmed client eligibility for a sample. The BLA recommends DPH clarify performance metric definitions and consider adjusting the indirect cost recovery to exclude rental subsidies, which could free up $127,817 annually to serve an additional 10-15 individuals.

This amendment secures housing stability for low-income San Francisco residents living with HIV/AIDS by extending rental subsidies and support services through June 30, 2031. While individual monthly subsidies have increased to $450-$550, the program will serve fewer clients annually (154 instead of 240) to accommodate the higher per-client cost. There is a potential to serve more individuals if the DPH adjusts how indirect costs are calculated, as recommended by the BLA report.

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