The ultrasound in February that found a mass growing in her uterus and abnormally thick uterine lining brought Jonell Anderson more than anxiety over diagnosis and treatment.

For Anderson and other patients in the rural community of Sandpoint, Idaho who need gynecological care, stress over discovering an illness is compounded by the challenges they face getting to a doctor.

After that initial ultrasound, Anderson’s primary care provider referred her to an OB-GYN nearly an hour’s drive away in Coeur d’Alene for more testing.

Getting care for more serious gynecological issues, like a hysteroscopy, endometriosis, or polycystic ovary syndrome, has become much more difficult in Sandpoint, a town of about 10,000 people in Idaho’s panhandle region. A state law criminalizing abortions drove multiple OB-GYNs to leave town about a year ago.

The effects have been far-reaching. The OB-GYNs who left Sandpoint were also providing care to patients in nearby outlying areas, like Bonners Ferry, a roughly 40-minute drive into Idaho’s northernmost county. Doctors have spoken out about not feeling safe practicing medicine where they could face criminal charges for providing care to their patients. Republican lawmakers in Idaho contend doctors are being used in an effort to roll back the ban, and they declined to amend the law this year.

According to the Idaho Coalition for Safe Healthcare, a group advocating for a rollback of the state’s strict abortion ban, at least two hospitals, including Bonner General Health in Sandpoint, ended labor and delivery services in the 15 months after the state criminalized abortion in 2022. During that same time period, the number of OB-GYNs practicing in Idaho dropped by 22%. The report’s authors noted that many rural residents rely on consultations from medical specialists in urban parts of the state that are already struggling to provide care.

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New Guidance Will—For the First Time—Enable Ryan White HIV/AIDS Program Recipients to Use Funds for Housing Security Deposits for Eligible Patients

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced new policy action to facilitate access to housing for people with HIV served by the Ryan White HIV/AIDS Program recipients. The new guidance enables—for the first time—the use of Ryan White HIV/AIDS Program funds to cover housing security deposits for eligible clients. This guidance advances critical elements of the National HIV/AIDS Strategy (PDF – 1 MB) announced by President Biden and the Ending the HIV Epidemic in the U.S. Initiative and addresses a key barrier that has been raised by patients and advocates.

HRSA Deputy Administrator Jordan Grossman announced this guidance during the Advancing Housing, Health, and Social Care Partnerships Conference, which is bringing together federal agencies, states, and housing and services organizations across the country participating in the HRSA-supported Health and Housing Initiative, the U.S. Interagency Council on Homelessness ALL INside Initiative, and the HHS and HUD-supported Housing and Services Partnership Accelerator.

“We know that lack of access to stable housing impacts health outcomes for individuals living with HIV,” said Carole Johnson, HRSA Administrator. “This new action will help individuals with HIV by addressing one of the barriers to remaining engaged in care. We look forward to this action helping to facilitate more housing opportunities which will support better health outcomes.”

The Ryan White HIV/AIDS Program provides care and treatment services to more than 560,000 low-income people with HIV, with a strong focus on tailoring approaches to best meet the needs of high-need communities and addressing factors like access to housing and transportation that directly affect clients’ ability to enter and stay in care. In 2022, 77.9% of Ryan White HIV/AIDS Program clients with unstable housing who received medical care reached viral suppression—meaning they cannot sexually transmit HIV to other people and can live a long, healthy life—compared to 90.6% of those with stable housing.

Current program guidelines have been viewed as an obstacle to assisting clients with security deposits. The guidance issued today explains how recipient can use Ryan White Program funds for security deposits for their clients provided that they ensure the deposits are returned to the program, not the client, at the end of the lease.

The National HIV/AIDS Strategy, developed by the White House Office of National AIDS Policy (ONAP) in collaboration with federal partners and with input from the HIV community across the country, outlines a vision for ending the HIV epidemic in the United States through goals, objectives, and strategies to prevent new infections, treat people with HIV to improve health outcomes, reduce HIV-related disparities, and better integrate and coordinate the efforts of all partners.

The Ending the HIV Epidemic in the U.S. initiative builds upon the foundational efforts of the Ryan White HIV/AIDS Program to reach people newly diagnosed with HIV and those who are disconnected from care by enhancing linkage to and engagement in care, decreasing disparities, and improving viral suppression.

HRSA thanks the HIV community for its invaluable contributions in advancing health outcomes for individuals at risk of or experiencing housing instability and homelessness and for sharing insights which have been instrumental in shaping this new guidance.

To access the Security Deposit guidance, please see the Housing Security Deposits in the Ryan White HIV/AIDS Program letter (PDF – 81 KB).

See News & Announcements on HRSA.gov.

CMS posted updated FAQs on the Hospital Price Transparency website with additional information to help hospitals understand and meet new compliance requirements taking effect on July 1, 2024.

The FAQs also provide additional information for hospitals, consumers, and other stakeholders.