This case study features the Issan House, which provides 35 units of permanent housing for people living with HIV/AIDS and mental illness or chemical dependency. The developer, the Greyston Foundation, won a third-place award in the 2004 MetLife Foundation Awards for Excellence in Affordable Housing. Issan House, located on an historic site in Yonkers, N.Y., integrates housing, healthcare, psycho-social support and intensive case management to provide residents with a sense of security, community and a level of service necessary to engage an often difficult-to-reach population. Residents occupy the top two floors of the building, and the Maitri Adult Day Health Program, a community health program for people with HIV/AIDS, occupies the lower two floors, assuring residents of around-the-clock access to a health and crisis counselor whenever needed. The distinctive design and adaptive reuse of the site along with the innovative services designed to meet the needs of an extremely vulnerable population make Issan House a very successful model program. This case study discusses the project, the organization, the supportive housing program, the physical features of the project, resident involvement and community impact.