Good Works, Better Practices, Great Homes
An interactive guide to operating AIDS housing

Section II: FACILITY

The "facility" component of a supportive housing program comprises the physical environment in which clients live. The supportive housing model presumes that people need, first and foremost, to have safe and affordable housing before other barriers to independent living can be addressed. Therefore, the quality of the facility component of your program is fundamental to all other services.

For some programs, the facility takes the form of individual apartments. For others, the housing is some kind of congregate living structure. When you contemplate the "facility" of your program, you will want to consider everything from concrete structures, to safety, to the aesthetic feeling the facility gives to its inhabitants.

Place matters. Individual clients have individual housing needs and issues and the success of your program may be determined by geographic considerations. To the extent possible, providers should be aware of local resources and services, public transportation routes, and the proximity to family members and/or environmental triggers when placing residents in apartments.

On a practical level, there are several legal requirements that need to be met, such as compliance with fire, health, and building codes, and with laws governing accessibility for persons with disabilities. For supportive living programs, the selection of a building, maintenance and housekeeping are important issues. For programs that provide a housing subsidy and services, finding an appropriate apartment and landlord lays the foundation of the living environment as well as appropriate lease requirements. Once the apartment has been selected, you can be proactive about ongoing maintenance issues by knowing these basic regular maintenance facts. Further, the respective rights and responsibilities of the client, the program, and the third party landlord should be clearly communicated from the beginning. 

In addition to structural issues, programs will need to pay attention to the prevention of communicable diseases. This is particularly relevant for supportive housing environments where a variety of group interactions occur from shared housekeeping, to meals, to social interaction. Due to the susceptibility of all individuals living with HIV to other illnesses, it is essential for all programs to practice and educate participants and staff in basic hygiene and precautionary measures to remind them periodically.

The governing regulations in the area of communicable diseases are the model Occupational Safety and Health Administration's Blood-born Pathogen standards (Model Exposure Control Plan). These regulations require employers to protect employees and clients who may be exposed to blood or other infectious material. This includes practices aimed at preventing exposure, as well as guidelines to follow when someone has been exposed. The term "universal precautions" (also referred to as "standard precautions") refers to uniform practices used by public institutions to prevent the transmission of disease. Using universal precautions presumes that all blood and body fluid should be treated as potentially infectious, thereby preventing discriminatory treatment of only certain individuals. The use of these preventative measures should be explained to residents upon admission so that no one feels that they are being ostracized due to their HIV status. In addition to universal precautionary procedures, good hygiene practices, including hand washing, can be applied to further prevent illness. Care should be taken to insure that cleaning and washing supplies are available in bathrooms and kitchens at all times including maintaining soap and paper towels

Finally, you will want to pay attention to the atmosphere and ambiance of the physical environment of your program. AIDS housing programs strive to provide alternatives to institutionalization for people living with HIV. To this end, the décor of the facility should be as homelike and nurturing as possible, while also fostering independence and privacy.

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