Elderly Housing

Federal Housing Programs That Offer Assistance for the Elderly Gao ID: GAO-05-174 February 14, 2005

According to the 2003 American Housing Survey sponsored by the U.S. Department of Housing and Urban Development (HUD), nearly one-third of elderly households--those whose head was age 62 or older--were experiencing housing affordability problems. Further, a congressional commission reported in 2002 that investment in affordable housing is decreasing, although the elderly population is expected to increase. A number of federal housing programs provide assistance, including rent subsidies, mortgage insurance, and loans and grants for the purchase or repair of homes, to low-income renters and homeowners. These programs are administered primarily by HUD or the U.S. Department of Agriculture (USDA). GAO was asked to determine the extent to which federal housing programs provide benefits to elderly households, summarize information on the programs' effectiveness in assisting the elderly and supportive services, and determine how HUD and USDA avoid overlap and duplication in their programs.

A total of 23 federal housing programs target or have special features for the elderly. Specifically, one HUD and one USDA program target the elderly exclusively, while three HUD programs target the elderly and disabled. The remaining 18 programs serve a variety of household types but have special features for elderly households, such as income adjustments that reduce their rents. The 13 programs for which data were available provide about 943,000 housing units designated for occupancy by the elderly. However, many programs also serve the elderly in undesignated units. Available occupancy data show that the elderly occupied at least 1.3 million units under rental assistance, public, and multifamily housing programs as of spring 2004. Information on the effectiveness of housing programs that assist the elderly is limited. HUD has an overall goal related to elderly housing, but not all individual programs that assist the elderly are explicitly linked to this goal. USDA does not have specific goals related to elderly housing. Most of the 23 housing assistance programs we reviewed are not designed to provide supportive services for the elderly. Four programs require the owners of program properties to ensure that services such as meals or transportation are available to their residents. In addition, HUD administers four programs--for example, the Service Coordinator Program--that can be used in conjunction with various housing programs to help the elderly obtain supportive services. Supportive services are also available to elderly residents of subsidized housing through partnerships between individual properties and local organizations. To avoid overlap and duplication in the development of rural housing for the elderly, HUD and USDA have established policies and procedures that require field offices from both agencies to notify their counterparts of applications to build new housing and consider each other's input on local market conditions. GAO visits to selected HUD field offices and state USDA offices revealed that staff were not consistently following these policies and procedures but were analyzing markets to ensure the need for proposed housing. Overall, however, funding and geographic constraints limit the potential for overlap and duplication in the construction of rural housing for the elderly.



GAO-05-174, Elderly Housing: Federal Housing Programs That Offer Assistance for the Elderly This is the accessible text file for GAO report number GAO-05-174 entitled 'Elderly Housing: Federal Housing Programs That Offer Assistance for the Elderly' which was released on March 16, 2005. This text file was formatted by the U.S. Government Accountability Office (GAO) to be accessible to users with visual impairments, as part of a longer term project to improve GAO products' accessibility. Every attempt has been made to maintain the structural and data integrity of the original printed product. Accessibility features, such as text descriptions of tables, consecutively numbered footnotes placed at the end of the file, and the text of agency comment letters, are provided but may not exactly duplicate the presentation or format of the printed version. The portable document format (PDF) file is an exact electronic replica of the printed version. We welcome your feedback. Please E-mail your comments regarding the contents or accessibility features of this document to Webmaster@gao.gov. This is a work of the U.S. government and is not subject to copyright protection in the United States. It may be reproduced and distributed in its entirety without further permission from GAO. Because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately. Report to Congressional Requesters: February 2005: Elderly Housing: Federal Housing Programs That Offer Assistance for the Elderly: [Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-05-174]: GAO Highlights: Highlights of GAO-05-174, a report to congressional requesters Why GAO Did This Study: According to the 2003 American Housing Survey sponsored by the U.S. Department of Housing and Urban Development (HUD), nearly one-third of elderly households” those whose head was age 62 or older”were experiencing housing affordability problems. Further, a congressional commission reported in 2002 that investment in affordable housing is decreasing, although the elderly population is expected to increase. A number of federal housing programs provide assistance, including rent subsidies, mortgage insurance, and loans and grants for the purchase or repair of homes, to low-income renters and homeowners. These programs are administered primarily by HUD or the U.S. Department of Agriculture (USDA). GAO was asked to determine the extent to which federal housing programs provide benefits to elderly households, summarize information on the programs‘ effectiveness in assisting the elderly and supportive services, and determine how HUD and USDA avoid overlap and duplication in their programs. What GAO Found: A total of 23 federal housing programs target or have special features for the elderly. Specifically, one HUD and one USDA program target the elderly exclusively, while three HUD programs target the elderly and disabled. The remaining 18 programs serve a variety of household types but have special features for elderly households, such as income adjustments that reduce their rents. The 13 programs for which data were available provide about 943,000 housing units designated for occupancy by the elderly. However, many programs also serve the elderly in undesignated units. Available occupancy data show that the elderly occupied at least 1.3 million units under rental assistance, public, and multifamily housing programs as of spring 2004. Information on the effectiveness of housing programs that assist the elderly is limited. HUD has an overall goal related to elderly housing, but not all individual programs that assist the elderly are explicitly linked to this goal. USDA does not have specific goals related to elderly housing. Most of the 23 housing assistance programs we reviewed are not designed to provide supportive services for the elderly. Four programs require the owners of program properties to ensure that services such as meals or transportation are available to their residents. In addition, HUD administers four programs”for example, the Service Coordinator Program”that can be used in conjunction with various housing programs to help the elderly obtain supportive services. Supportive services are also available to elderly residents of subsidized housing through partnerships between individual properties and local organizations. To avoid overlap and duplication in the development of rural housing for the elderly, HUD and USDA have established policies and procedures that require field offices from both agencies to notify their counterparts of applications to build new housing and consider each other‘s input on local market conditions. GAO visits to selected HUD field offices and state USDA offices revealed that staff were not consistently following these policies and procedures but were analyzing markets to ensure the need for proposed housing. Overall, however, funding and geographic constraints limit the potential for overlap and duplication in the construction of rural housing for the elderly. Units Designated for the Elderly in Selected HUD and USDA Programs, 2004: [See PDF for image] [End of figure] www.gao.gov/cgi-bin/getrpt?GAO-05-174. To view the full product, including the scope and methodology, click on the link above. For more information, contact David G. Wood at (202) 512-8678 or woodd@gao.gov. [End of section] Contents: Letter: Results in Brief: Background: Many Housing Programs Offer Assistance for the Elderly, but Information on Their Effectiveness Is Limited: Most Federal Housing Assistance Programs Are Not Required To Provide Supportive Services for the Elderly: HUD and USDA Have Policies in Place to Avoid Duplicating Programs: Agency Comments: Appendixes: Appendix I: Objectives, Scope, and Methodology: Appendix II: Status of HUD's Efforts to Improve Administration of the Section 202 Program: Appendix III: Summaries of Federal Housing Programs That Serve the Elderly: Programs Targeted to the Elderly: Programs Targeted to the Elderly and Disabled: Programs with Special Features for the Elderly: Appendix IV: Additional Housing Programs: Department of Agriculture: Department of Health and Human Services: Department of Housing and Urban Development: Department of Veterans Affairs: Federal Home Loan Banks: Internal Revenue Service: Appendix V: Comments from the Department of Housing and Urban Development: Appendix VI: GAO Contacts and Staff Acknowledgments: GAO Contacts: Staff Acknowledgments: Tables: Table 1: OMB PART Assessment Ratings on Selected Housing Programs: Table 2: Housing Assistance Programs That Require Supportive Services: Figures: Figure 1: Housing Programs Targeted to or with Special Features for the Elderly: Figure 2: Number of Units Designated for the Elderly in HUD and USDA Public and Multifamily Housing Programs, 2004: Figure 3: Occupancy in HUD and USDA Public and Multifamily Housing Programs, 2004: Figure 4: Active Loans or Grants to Elderly Recipients in USDA's Single- Family Programs, October 1995 through April 2004: Figure 5: Housing Assistance Programs That Can Use Federally Funded Supportive Services Programs: Figure 6: Section 504 Rural Housing Repair and Rehabilitation Grants Description: Figure 7: Section 202 Supportive Housing for the Elderly Description: Figure 8: Assisted Living Conversion Program Description: Figure 9: Section 231 Mortgage Insurance Description: Figure 10: Section 232 and 232/223(f) Mortgage Insurance Description: Figure 11: Section 502 Rural Housing Loan (Direct) Description: Figure 12: Section 502 Direct Housing Natural Disaster Loan Description: Figure 13: Section 502 Guaranteed Rural Housing Loan Description: Figure 14: Section 504 Rural Housing Repair and Rehabilitation Loan Description: Figure 15: Section 515 Rural Rental Housing Loan Description: Figure 16: Section 521 Rural Rental Assistance Description: Figure 17: Section 538 Guaranteed Rural Rental Housing Description: Figure 18: Housing Choice Voucher Description: Figure 19: Project-Based Rental Assistance Description: Figure 20: Public Housing Description: Figure 21: Section 8 Moderate Rehabilitation Description: Figure 22: Section 207 Mortgage Insurance for Manufactured Home Parks Description: Figure 23: Section 207/223(f) Mortgage Insurance Description: Figure 24: Section 213 Mortgage Insurance Description: Figure 25: Section 221(d)(3) Below-Market Interest Rate Description: Figure 26: Section 221(d)(3) and (d)(4) Mortgage Insurance Description: Figure 27: Section 236 Rental and Cooperative Housing Description: Figure 28: Section 542(b) and 542(c) Risk Sharing Programs Description: Abbreviations: ALCP: Assisted Living Conversion Program: HCBS: Home and Community-Based Services: HECM: Home Equity Conversion Mortgage: HHS: Department of Health and Human Services: HUD: Department of Housing and Urban Development: IRS: Internal Revenue Service: OIG: Office of Inspector General: OMB: Office of Management and Budget: PACE: Program of All-Inclusive Care for the Elderly: PART: Program Assessment Rating Tool: RHS: Rural Housing Service: ROSS: Resident Opportunities and Self Sufficiency: USDA: Department of Agriculture: VA: Department of Veterans Affairs: Letter February 14, 2005: The Honorable Gordon H. Smith: Chairman: The Honorable Herb Kohl: Ranking Minority Member: Special Committee on Aging: United States Senate: The Honorable Larry E. Craig: United States Senate: According to the 2003 American Housing Survey sponsored by the U.S. Department of Housing and Urban Development (HUD), nearly one-third of elderly households--generally those whose head is aged 62 or older-- were experiencing housing affordability problems. Whether homeowners or renters, these households were spending more than 30 percent of their incomes on housing. Further, according to a Congressionally-established bipartisan commission, decreased investment in affordable housing and a burgeoning elderly population that is projected to grow from about 12 percent of the population in 2002 to 20 percent by 2030 are likely to increase the number of elderly who must spend large portions of their incomes on housing.[Footnote 1] Housing affordability is an even greater problem for low-income elderly households--those with incomes of less than 80 percent of area median income. The 2003 American Housing Survey estimated that 66 percent of low-income elderly renters spent more than 30 percent of their income on housing. Like these renters, low-income elderly homeowners also have affordability problems. While approximately 80 percent of the elderly own their homes, about two-thirds of these households are considered low income. In 2003, about 40 percent of these low-income homeowners were spending more than 30 percent of their income on housing. Since the 1930s, a number of federal housing programs have provided assistance to low-income renters and homeowners, including rent subsidies, mortgage insurance, and loans and grants for the purchase or repair of homes. These programs are administered primarily by HUD or the U.S. Department of Agriculture (USDA). However, these programs do not reach all needy households, and waiting lists for many types of subsidized housing, including housing for the elderly, are often long. You requested that we review federal housing assistance programs that can benefit the elderly. This report discusses (1) the extent to which federal housing assistance programs provide benefits to elderly households and what is known about the effectiveness of these programs in assisting the elderly, (2) the types of supportive services that these programs provide for the elderly, and (3) how HUD and USDA avoid overlap and duplication in programs that offer similar types of housing assistance to the elderly. As requested, we also obtained information on the status of HUD's efforts to implement GAO's earlier recommendations to improve the timeliness and oversight of the Section 202 Supportive Housing for the Elderly (Section 202) program, which subsidizes the development of rental housing and provides rental assistance for elderly households with very low incomes.[Footnote 2] This information is included in Appendix II. To address these objectives, we consulted with HUD and USDA officials to identify housing assistance programs that benefit the elderly. We reviewed laws and regulations to categorize the programs as either targeted exclusively to the elderly, targeted at the elderly and disabled, or not targeted but with special features for the elderly. We included housing assistance programs that (1) subsidize mortgage interest rates, rent, or housing repair or rehabilitation; (2) provide mortgage insurance, loan guarantees, or direct loans for single-family or multifamily housing; or (3) support the construction, rehabilitation, or purchase of multifamily housing or assisted living facilities. Appendix III summarizes each of the programs we include, and Appendix IV describes other housing-related programs that can benefit the elderly but do not fit our three categories. We also analyzed data from HUD and USDA databases to determine the number of units designated for or occupied by the elderly in federally subsidized or insured housing. We reviewed studies and reports by federal agencies, including the HUD and USDA Offices of Inspector General; research institutions; and others for information on the effectiveness of these programs. These reports included the HUD and USDA fiscal year 2003 Performance and Accountability Reports.[Footnote 3] We obtained information about supportive services from program descriptions and agency officials. We also reviewed agreements, policies, and procedures HUD and USDA have established to coordinate the development of subsidized housing in rural areas and visited selected HUD and USDA field offices to determine whether and how they coordinated with one another. Finally, we interviewed HUD officials and reviewed related documentation to obtain information on the status of GAO's earlier recommendations for the Section 202 program. Appendix I provides more detailed information on our scope and methodology. We conducted our work in Baltimore, Maryland; Greensboro and Raleigh, North Carolina; Columbus, Ohio; Oklahoma City and Stillwater, Oklahoma, and Washington, D.C., between December 2003 and December 2004, in accordance with generally accepted government auditing standards. Results in Brief: A variety of housing programs provide assistance for the elderly, but information on these programs' effectiveness is limited. Specifically, one HUD and one USDA program target the elderly exclusively, and three HUD programs target the elderly and disabled. Eighteen other HUD and USDA programs that do not target the elderly have special features for them, such as income adjustments that reduce the amount of rent they must pay for a subsidized unit. While comprehensive data on each of these 23 programs are not available, we found that 13 of the programs provide approximately 943,000 housing units designated for occupancy by the elderly. However, many programs also serve the elderly in undesignated units; available occupancy data show that the elderly occupied at least 1.3 million units under rental assistance, public, and multifamily housing programs as of spring 2004. Further, at least 69,650 elderly households have received loans or grants under USDA single-family programs since fiscal year 1996. Information on the effectiveness of these housing programs in assisting the elderly is limited. While HUD has established an overall goal related to elderly housing, not all individual programs that assist the elderly are explicitly linked to this goal, and USDA does not have goals specifically targeting housing for the elderly. Most of the housing assistance programs we reviewed were not required to provide supportive services to the elderly. Of the 23 programs, 4 require the owners of properties developed under these programs to ensure that services such as meals or transportation are available to their residents. For example, property owners who receive funding through HUD's Assisted Living Conversion Program (ALCP) are required to provide supportive services, including meals. In addition, HUD administers four programs that can be used in conjunction with various housing programs to assist the elderly in obtaining supportive services. HUD's Service Coordinator Program, for instance, funds on- site coordinators who help elderly residents access services such as transportation and healthcare. Supportive services are also available to elderly residents of subsidized housing through partnerships between individual properties and local organizations. HUD and USDA have established policies and procedures to avoid overlap and duplication in the development of rural housing assistance for the elderly. These procedures require HUD field offices and USDA state offices to notify each other when they receive applications for construction of new housing units, and to consider each other's input on the markets in which new construction is proposed. In addition, both HUD and USDA independently analyze the market conditions in locations where new developments are proposed. GAO site visits to selected HUD field offices and state USDA offices revealed that these offices were not consistently following coordination policies and procedures. However, each office was analyzing the markets where new construction was proposed to ensure that the housing was needed. Finally, program funding levels and certain geographic restrictions limit the potential for overlap and duplication among HUD and USDA rural rental housing. Background: The federal government has helped provide affordable housing to low- income households since the 1930s. Since then, a number of federal housing programs have subsidized the construction of housing for the poor, provided rental assistance to tenants in existing privately owned housing, and insured mortgages for both single-and multifamily properties. Today, HUD administers the majority of federal housing assistance programs in urban areas, and USDA's Rural Housing Service (RHS) implements housing programs in rural areas. In general, both HUD and USDA programs target families at lower income levels. HUD programs target families with incomes that are: extremely low (no more than 30 percent of an area's median), very low (no more than 50 percent of an area's median), and low (no more than 80 percent of an area's median). USDA programs also target families with incomes that are very low and low. In addition, some USDA programs target families with moderate incomes (no more than 115 percent of an area's median). HUD and USDA provide many types of housing assistance programs, including single-family programs, multifamily programs, rental assistance programs, and public housing. Housing developments can be assisted by multiple programs. For example, a loan or mortgage on a multifamily property may be insured through a HUD or USDA program, and the property may have tenants that receive rental assistance from these agencies. Federal housing assistance can generally be categorized as follows: * Single-family programs that provide mortgage insurance, loan guarantees, or direct loans for homeowners and grants or loans for home repairs or modifications; * Multifamily programs that provide loans, subsidies, mortgage insurance or loan guarantees, or a combination of these to support the development and rehabilitation of rental properties, including: * Production programs that provide federal funds to construct or substantially rehabilitate units for households with extremely low to moderate incomes; and: * Mortgage insurance/loan guarantee programs that provide incentives for lenders to finance rental housing by reducing risk;[Footnote 4] * Rental assistance programs, which can be used for multifamily and some single-family housing and generally pay property owners the difference between 30 percent of a household's adjusted income and its rent, including: * Tenant-based rental assistance that provides vouchers for eligible tenants to rent privately owned apartments or single-family homes and that tenants can use in new residences if they move; and: * Project-based rental assistance that is attached to specific properties and is available to tenants only when they are living in units at these properties; and: * Public housing, which is provided through HUD and offers units for eligible tenants in properties administered by public housing authorities. The RHS implements all of the USDA programs we reviewed. Two offices administer the HUD programs covered in this report: * The Office of Housing, which administers multifamily subsidy and mortgage insurance programs, multifamily production programs, and a variety of single-family programs; and: * The Office of Public and Indian Housing, which administers the Public Housing, Housing Choice Voucher, and Section 8 Moderate Rehabilitation Programs. HUD has specific goals for increasing housing opportunities for the elderly. As outlined in its fiscal year 2004 Annual Performance Plan, these goals include (1) increasing the availability of affordable housing for the elderly, (2) increasing the number of assisted-living units, (3) increasing the number of elderly households living in privately owned, federally assisted multifamily housing served by a service coordinator, and (4) increasing elderly families' satisfaction with their Section 202 units. USDA does not have specific goals related to the elderly in its fiscal year 2004 Annual Performance Plan. However, USDA does have the broad objective of improving the quality of life of rural families by financing, among other things, quality housing. To reach this objective, USDA has established two housing-related goals: (1) to increase financial assistance to rural households to buy a home, and (2) to increase the number of minority homeowners. Many Housing Programs Offer Assistance for the Elderly, but Information on Their Effectiveness Is Limited: We identified a total of 23 federal housing programs that are targeted at or have special features for the elderly: 2 that are intended for the elderly only, 3 that are targeted to the elderly and disabled, and another 18 that have special features, such as properties designated for elderly occupants and income adjustments that lower elderly households' rental payments. Some or all units in many multifamily and public housing properties are designated for the elderly. Data on the number of elderly served are not available for each program; however, analysis of available data shows that the elderly occupied at least 1.3 million units provided through several of these programs. Limited information is available about the effectiveness of most housing programs in assisting elderly households. A Variety of Programs Target the Elderly or Have Special Features for Them: HUD and USDA offer 23 housing programs that either target or have special features for the elderly. Two programs--HUD's multifamily Section 202 program and USDA's single-family Section 504 Rural Housing Repair and Rehabilitation Grants program--are currently intended for elderly beneficiaries only.[Footnote 5] Three multifamily programs target the elderly and the disabled: HUD's ALCP and two mortgage insurance programs (Section 231 and Section 232). Although not targeted to the elderly, another 18 programs have special features for them. For example, public housing and some multifamily programs allow properties to be wholly or partially designated for occupancy by the elderly. Also, rental assistance programs and USDA single-family programs make adjustments to elderly households' incomes when determining program eligibility or calculating benefits. These programs are briefly described in Figure 1, and in more detail in Appendix III. Although most of the 23 programs are intended for households with low, very low, or extremely low incomes, 7 of the multifamily insurance programs may provide benefits for households of all income levels (that is, there are no income restrictions or limits).[Footnote 6] Figure 1: Housing Programs Targeted to or with Special Features for the Elderly: [See PDF for image] [A] Before fiscal year 1992, the Section 202 program also supported the development of housing for the disabled. [B] Inactive programs no longer provide assistance or insurance to new properties, but existing properties continue to operate under the programs. [C] The Section 515 program's Congregate Housing subprogram requires properties to provide supportive services. [End of figure] Among these 23 programs, 13 have approximately 943,000 units designated for the elderly, based on available data (fig. 2). Some public and multifamily housing programs may designate properties wholly or partially for the elderly, but the number of units set aside varies across programs.[Footnote 7] As figure 2 shows, the Section 202 and Section 231 programs have designated most of their units for the elderly (84 percent and 90 percent, respectively), consistent with these programs' targeting of the elderly or the elderly and disabled.[Footnote 8] The Section 202 program designates the most units for the elderly--about 268,000 units. Figure 2: Number of Units Designated for the Elderly in HUD and USDA Public and Multifamily Housing Programs, 2004: [See PDF for image] Notes: For the HUD programs, except public housing, the total unit counts are from HUD's Multifamily Portfolio Reporting Database as of April 1, 2004. In 32 cases, HUD provided corrected unit counts in August 2004. We reported the number of units designated for the elderly for HUD programs except public housing from HUD's Multifamily Housing Inventory Survey completed in January 2003; we also included units in properties that were not included in the Multifamily Housing Inventory Survey but that HUD's Multifamily Portfolio Reporting Database identified as serving the elderly or as assisted living facilities. These two sources did not include data on the number of Section 207 Manufactured Home Park spaces for the elderly. The data on the Section 515 program are from USDA's Multi-Family Integrated System as of April 30, 2004. The data on the Section 538 program are from USDA's Guaranteed Loan System and a USDA internal report as of June 2004. "NA" means data were not available. [A] Although the Section 202 program currently targets the elderly only, not all of its units are designated for the elderly because the program also produced housing for the disabled until fiscal year 1992. [B] Unit counts were not available for 42 percent of the Section 207 Manufactured Home Parks properties, 57 percent of Section 232 properties, and 23 percent of Section 542(b) and (c) properties, so we could not produce a reliable count of the total number of units. For each of the other HUD multifamily programs, fewer than 5 percent of the properties were missing unit counts, so we considered the data sufficient for our purposes. [C] The unit counts for HUD multifamily insurance programs and Section 515 include units in properties receiving Section 8 or Rent Supplement project-based rental assistance. To avoid double-counting units, the row for project-based rental assistance counts only units not included in other program counts. [D] The total number of public housing units is an estimate from HUD's 2003 Performance and Accountability Report; an exact count was unavailable. Because the total number of public housing units is an estimate, the percentage of units designated for the elderly is also an estimate. [E] The number of public housing units designated for the elderly is the number of units that HUD had approved under designated housing plans as of July 14, 2004. An additional 6,004 units were designated for occupancy by a mixed population of the elderly and the disabled. [F] Units designated for the elderly under the Section 515 program may also be occupied by nonelderly disabled households. [G] The total number of units and units designated for the elderly represents a minimum number because data on total units were not available for three programs, and data on units designated for the elderly were not available for one program. [End of figure] HUD, USDA, and other agencies also administer other housing programs for which the elderly are eligible, but which do not have special features for the elderly. For example, under the Low-Income Housing Tax Credit program, the largest active multifamily housing production program, states receive annual allocations of tax credits and distribute them at their discretion. In their guidelines for the distribution of tax credits, some states have established preferences for properties intended for the elderly, but the federal government does not require such preferences. Similarly, HUD's single-family mortgage insurance program does not have features that apply only to elderly borrowers. HUD's Home Equity Conversion Mortgage program, which targets only elderly homeowners, did not meet our definition of housing assistance for this review. This program allows elderly homeowners to borrow against the equity in their homes and defer repayment for as long as they occupy their homes, but the money can be used for any purpose, not just housing. Appendix I explains our methodology for determining which programs to include, and Appendix IV provides brief descriptions of some programs that were excluded from this review. The Elderly Occupied At Least 1.3 Million Units Provided under Federal Housing Programs, but Complete Data on Elderly Occupancy Are Lacking: Elderly households occupied at least 1.3 million units provided through HUD and USDA rental assistance, public, and multifamily housing programs for which data on occupancy were available between April and June 2004 (fig. 3). The household counts by program do not match the unit counts presented in figure 2 and Appendix III, because some units may have been vacant or current data on tenants may have been incomplete.[Footnote 9] The data include households in units designated for the elderly as well as other elderly households receiving assistance through the programs.[Footnote 10] Overall, elderly households comprised approximately 30 percent of the households participating in programs for which data were available.[Footnote 11] Figure 3: Occupancy in HUD and USDA Public and Multifamily Housing Programs, 2004: [See PDF for image] Notes: The data for Housing Choice Vouchers, Public Housing, and Section 8 Moderate Rehabilitation are from HUD's Public and Indian Housing Information Center as of June 3, 2004. The data for Section 515 are from USDA's Multi-Family Integrated System as of April 30, 2004. The data for the remaining programs (Section 202 and HUD multifamily insurance and project-based rental assistance programs) are from HUD's Tenant Rental Assistance Certification System as of May 25, 2004, and Multifamily Portfolio Reporting Database as of April 1, 2004. Submission dates for occupancy data vary, so the available data do not provide a precise count of households on a particular date. "NA" means data were not available. [A] Elderly households include those in which the head of household, co- head, or spouse was elderly as of the most recent reporting date. Housing assistance programs can also benefit households that have other members age 62 and older. [B] The household counts for HUD's multifamily insurance programs include only units receiving project-based rental assistance. [C] HUD does not maintain data on occupants of properties funded through ALCP. However, because only multifamily properties subsidized by HUD are eligible for this program, a household count for ALCP would likely overlap with the counts for other programs. [D] The household counts for HUD's multifamily insurance programs and Section 515 include households receiving Section 8, Rent Supplement, or Section 521 project-based rental assistance. To avoid double-counting households, the row for project-based rental assistance counts only households not included in other program counts. Appendix III provides additional data on the number of households receiving project-based rental assistance. [E] The total number of households and elderly households represents a minimum number because data on households were not available for five programs and were only available for units receiving project-based rental assistance for seven programs. [End of figure] In addition to the elderly households in public and multifamily housing programs, at least 69,650 elderly households received loans or grants through 4 USDA single-family programs from October 1995 through April 2004, the time period for which we were able to obtain data (fig. 4). Specifically, USDA's Section 504 grants program, which provides home repair grants to elderly homeowners, made at least 40,697 grants to elderly recipients during that period.[Footnote 12] Also, the Section 502 Rural Housing Loans (Direct), Section 502 Direct Housing Natural Disaster Loans, and Section 504 Rural Housing Repair and Rehabilitation Loans programs, which offer loans for home purchase or repair, had at least 28,953 elderly borrowers. USDA generally did not have data on the age of borrowers in its Section 502 guaranteed loan program, which had more than 167,500 active loans as of April 2004. Figure 4: Active Loans or Grants to Elderly Recipients in USDA's Single- Family Programs, October 1995 through April 2004: [See PDF for image] Notes: We used data from USDA's Dedicated Loan Origination and Servicing System and Guaranteed Loan System as of April 30, 2004. USDA has not always required staff to record the age of the primary and secondary borrowers or grantees in these systems, so data on age were incomplete. The Guaranteed Loan System only had the primary or secondary borrower age for about 2 percent of the 502 Guaranteed Loans, which was insufficient for our purposes. We considered a loan or grant to have an elderly recipient if the primary or secondary borrower or grantee was elderly at the time of the loan or grant application. "NA" means data were not available. [A] The percent of elderly recipients is derived only from those recipients whose age was available. [B] The RHS Administrator has the authority to allow Section 504 grants for nonelderly households, but we could not determine whether the 150 Section 504 grants that the USDA data showed as having nonelderly recipients were exceptions or data errors. [End of figure] Limited Information Is Available About the Effectiveness of Housing Programs in Assisting the Elderly: Program effectiveness can be assessed in a number of ways--for example, by evaluating the extent to which programs reach or serve intended beneficiaries or examining the efficiency with which they serve those that they do reach. In evaluation research, "effectiveness" is often defined in terms of the achievement of program goals or outcomes. While HUD and USDA have not established specific goals for each housing program that offers assistance for the elderly in their annual Performance and Accountability Reports, these reports contain limited information on some programs' performance--that is, the extent to which a program met specific goals and objectives or contributed to the attainment of larger overarching goals. The Office of Management and Budget (OMB), has used its standardized Program Assessment Rating Tool (PART) to assess five of the programs, finding that three had not demonstrated results, one was ineffective, and one was moderately effective. While we also identified academic studies of some programs we reviewed, they generally did not evaluate the effectiveness of a program in terms of the extent to which it reached its goals. For example, some academic studies analyzed the impact of the public housing and housing choice voucher programs upon property values. However, affecting property values is not a goal of these programs. Finally, we also identified information on how effectively some of the housing programs are implemented. Information on the Effectiveness of Programs Targeted to the Elderly: Of the two programs that are targeted to the elderly, only HUD's Section 202 program is included in the agencies' fiscal year 2003 Performance and Accountability Reports. HUD addresses this program under its overall goal of improving housing options for the elderly. According to HUD's Performance and Accountability Report, HUD exceeded its goal of approving 250 Section 202 and Section 811 projects to start construction during fiscal year 2003, approving 334 projects.[Footnote 13] While HUD exceeded this goal, the number of projects approved for construction is a limited measure of the effectiveness of the Section 202 program. USDA's fiscal year 2003 Performance and Accountability Report did not address the effectiveness of the Section 504 program. OMB rated the Section 202 program in its fiscal year 2004 PART assessment. PART is designed to assess the effectiveness of federal programs through a series of diagnostic questions intended to provide a consistent approach to rating federal programs. Drawing on available performance and evaluation information, the questionnaire attempts to determine the strengths and weaknesses of federal programs with a particular focus on individual program results. According to this assessment, the results of the Section 202 program had not been demonstrated, and: * The program lacked evidence showing the overall level of impact that the program had on poor elderly individuals; * HUD had not established quantifiable long-term performance goals with outcomes for this program, so progress could not be measured; * The program had produced about 6,000 units per year, yet there is a need for over a million units for the elderly. We also have reported specifically on how effectively the Section 202 program has been managed. Our 2003 report on the Section 202 program outlined several factors that prevented efficient and effective implementation.[Footnote 14] Appendix II contains an update on HUD's efforts to improve these deficiencies. Information on the Effectiveness of Programs Targeted to the Elderly and Disabled: HUD's fiscal year 2003 Performance and Accountability Report also provides information on two of the three HUD programs targeted to the elderly and disabled--the Assisted Living Conversion Program and the Section 232 mortgage insurance program. According to this report, HUD: * Met its goal for increasing the number of assisted living units for the elderly by adding 2,618 units or beds to the estimated 18,000 already in place in 325 properties insured by the Section 232 mortgage insurance program; * Exceeded its goal of converting 10 properties through the ALCP by converting 13 properties, adding an additional 407 assisted living units. Information on the Effectiveness of Programs That Have Special Features for the Elderly: While performance and accountability information does not directly address the extent to which programs that have special features for the elderly--such as HUD's public housing, project-based rental assistance, and housing choice voucher programs--are effective in assisting the elderly, it does provide additional context. For example, HUD's fiscal year 2003 Performance and Accountability Report has an indicator to track the share of units receiving assistance through these programs that are occupied by the elderly, but HUD has not established goals for this indicator because housing providers have discretion regarding admissions policies.[Footnote 15] USDA's Office of Inspector General (OIG) has reported on how effectively USDA's multifamily housing programs are implemented. For example: * In 2004, the OIG reported that USDA's Rural Housing Service missed by three projects its target of having no more than 140 multifamily housing projects with accounts more than 180 days past due. According to the report, this indicator is a measure of how effectively and efficiently the multifamily housing loan portfolio is being managed.[Footnote 16] * Also in 2004, the OIG reported that RHS had not implemented all of the policy changes that it had agreed to implement to better monitor the owners of Section 515 developments. As a result, according to the OIG, rural rental housing funds remained vulnerable to theft and abuse.[Footnote 17] In addition, we identified two studies that provided information related to the effectiveness of housing choice vouchers in assisting the elderly and the effectiveness of the Section 502 Rural Housing Loans (Direct) Program in helping the elderly become homeowners and obtain better quality housing: * A 2001 study on the Housing Choice Voucher Program showed that the elderly had less success finding and leasing a unit than other household types, possibly because elderly renters may have difficulty looking at multiple units.[Footnote 18] * A 1999 study of USDA's Section 502 Rural Housing Loans (Direct) Program, which provides loans to very-low and low-income rural residents for the purchase or repair of single-family homes, reported the results of a 1998 survey and found that of respondents with at least one elderly person on the mortgage, 30 percent were first-time homebuyers, and almost 90 percent reported that their current home was of better quality than their previous home.[Footnote 19] Finally, OMB's fiscal year 2004 PART assessments included information about the effectiveness of 4 of the 18 programs that provide special features for the elderly--the Housing Choice Voucher Program, project- based rental assistance, and the Sections 515 and 521 programs (table 1). Table 1: OMB PART Assessment Ratings on Selected Housing Programs: Agency: USDA; Program: Section 515 Rural Rental Housing Loans/Section; 521 Rural Rental Assistance; PART rating: Results not demonstrated; OMB comments on effectiveness evaluations: While reviews are not regularly scheduled, USDA's Office of Inspector General routinely reviews the program's performance. Agency: HUD; Program: Housing Choice Vouchers; PART rating: Moderately effective; OMB comments on effectiveness evaluations: A variety of work shows vouchers to be a cost-effective means of delivering housing. A number of studies of this program are underway that will provide useful information on the program's effectiveness. Agency: HUD; Program: Project-Based Rental Assistance; PART rating: Ineffective; OMB comments on effectiveness evaluations: No comprehensive evaluation of the effects of this program on low-income residents has ever been conducted. Source: OMB's fiscal year 2004 PART Assessments of HUD and USDA Programs. [End of table] Limitations of Available Information on Effectiveness: While Performance and Accountability Reports can be helpful in assessing program effectiveness, their usefulness is limited. For example, USDA's fiscal year 2003 report provides little useful information on the effectiveness of USDA's housing programs in assisting the elderly because of the lack of specific goals and objectives related to improving housing options for the elderly. Similarly, HUD's fiscal year 2003 report identifies such goals for only 3 of the 23 programs we reviewed. Further, HUD's goals are not necessarily specific; for example, although information was available on HUD's Section 232 program, targeted goals were not established for this program, such as increasing the number of assisted-living units through Section 232 insurance by a specific percentage. Without such specific criteria, HUD management and outside evaluators lack the essential information needed to assess this aspect of the program's effectiveness. In addition, GAO has previously reported that the usefulness of PART assessments is limited, for the following reasons: * Many PART questions contained subjective terms that were open to interpretation. We noted that such subjective terminology could influence program ratings by permitting OMB staff's views about a program's purpose to affect assessments. * OMB assigned overall program ratings and individual section scores. Overall ratings encourage a determination of the effectiveness of a program even when performance data are unavailable, the quality of those data is uneven, or they convey a mixed message on performance. * OMB inconsistently defined appropriate measures--outcomes versus outputs--for programs.[Footnote 20] Most other studies we identified on various aspects of the programs we reviewed did not evaluate either the programs' overall effectiveness, or their specific effect on the elderly. We also found some academic studies that provided information related to effectiveness but that were based on a prohibitively small sample of elderly program participants or did not use reasonably current data. The overall lack of information on the effectiveness of the programs we reviewed in assisting the elderly may be due to the fact that, as GAO has previously reported, many agencies lack the capacity to undertake program evaluations to assess a federal program's contributions to results. Agencies' capability to gather and use performance information has posed a persistent challenge.[Footnote 21] Finally, we did not evaluate the extent to which the programs we reviewed addressed the needs of eligible elderly households because (1) complete data on the number of elderly households occupying units provided by federal housing programs were not available, and (2) eligibility criteria for each program varied, making it difficult to establish the number of eligible elderly households. Most Federal Housing Assistance Programs Are Not Required To Provide Supportive Services for the Elderly: Generally, HUD and USDA's housing assistance programs are not required to provide supportive services to the elderly. Of the 23 housing assistance programs that we reviewed, 4 required the owners of properties developed under the programs to ensure that supportive services were available. HUD has programs that link the elderly to or provide them with supportive services. Two of these programs, the Service Coordinator and the Resident Opportunities and Self Sufficiency (ROSS) programs, link residents with appropriate supportive services that are available in the community. In addition, the Congregate Housing Services Program funds meals and other needed services in public and multifamily housing properties, and the Neighborhood Networks program provides resources for establishing computer centers at such sites. Owners of public and multifamily housing may also provide supportive services by establishing partnerships with public and private organizations in the community. Four Housing Assistance Programs Require That Supportive Services Be Made Available to Elderly Residents: HUD's Section 202 program, the ALCP, and Section 232 Mortgage Insurance, and USDA's Section 515 Congregate Housing Program, which is a sub-program of the Section 515 program (see Appendix III) require property owners to make supportive services available to their residents. Generally, HUD and USDA do not provide funding for these services.[Footnote 22] The property owners typically obtain other funds to provide supportive services or must ensure that appropriate services are available in the community (see table 2). Table 2: Housing Assistance Programs That Require Supportive Services: Agency: USDA; Program: Section 515 Rural Rental Housing Loans (Congregate Housing subprogram); Supportive service requirements: Properties must include central dining facilities and provide meals, transportation, housekeeping, personal services, and recreational and social activities. Agency: HUD; Program: Assisted Living Conversion Program; Supportive service requirements: Assisted living facilities must provide personal care, transportation, meals, housekeeping, and laundry services. Agency: HUD; Program: Section 202 Supportive Housing for the Elderly; Supportive service requirements: Applicants for Section 202 funding must demonstrate that services will be available at the development or in the community where new construction is proposed. Agency: HUD; Program: Section 232 Mortgage Insurance; Supportive service requirements: All insured facilities must provide supportive services that vary according to the type of facility. Source: GAO analysis of program requirements. [End of table] HUD Has Other Programs that Assist the Elderly in Obtaining Supportive Services: While USDA does not generally provide funding for supportive services for residents of federally assisted housing, HUD has two programs that link residents of public and multifamily properties developed under HUD programs to supportive services, and two that provide supportive services. None of these four programs is just for the elderly, but they either can be used in properties designated for the elderly or have funding specifically for the elderly. The Service Coordinator Program, for example, provides funding for managers of multifamily properties designated for the elderly and disabled to hire coordinators to assist residents in obtaining supportive services from community agencies. These services, which may include personal assistance, transportation, counseling, meal delivery, and healthcare, are intended to help the elderly live independently and to prevent premature and inappropriate institutionalization. Service coordinators can be funded through competitive grant funds, residual receipts (excess income from a property), or rent increases. According to HUD's fiscal year 2003 Performance and Accountability Report, service coordinators were serving more than 111,000 units in elderly properties. Similarly, HUD's ROSS grant program links residents with appropriate services. This program differs from the Service Coordinator Program in that it is designed specifically for public housing residents. The ROSS program has five funding categories, including the Resident Service Delivery Models for the Elderly and Persons with Disabilities (Resident Services) and the Elderly/Disabled Service Coordinator Program. Resident Services funds can be used to hire a project coordinator; assess residents' needs for supportive services and link residents to federal, state, and local assistance programs; provide wellness programs; and coordinate and set up meal and transportation services. The Elderly/Disabled Service Coordinator Program has not provided new grants since 1995 but still services existing grants.[Footnote 23] The Congregate Housing Services Program provides grants for the delivery of meals and nonmedical supportive services to elderly and disabled residents of public and multifamily housing, including USDA's Section 515 housing. While HUD provides up to 40 percent of the cost of supportive services, grantees must pay at least 50 percent of the costs, and program participants pay fees to cover at least 10 percent.[Footnote 24] Like the Elderly/Disabled Services Coordinator Program under ROSS, the Congregate Housing Services Program has provided no new grants since 1995, but Congress has provided funds to extend expiring grants on an annual basis. In addition, the Neighborhood Networks program encourages property owners, managers, and residents of HUD-insured and -assisted housing to develop computer centers. Although computer accessibility is not a traditional supportive service for the elderly, a senior HUD official told us that having computers available enhances elderly residents' quality of life. HUD does not fund each center's planned costs, but encourages property owners to seek cash grants, in-kind support, and donations from sources such as state and local governments, educational institutions, private foundations, and corporations.[Footnote 25] Private Partnerships and Federal Health Care Programs May Provide Some Supportive Services: Elderly residents of public and federally subsidized multifamily housing can also receive supportive services through partnerships between property owners and local organizations and through programs provided by the Department of Health and Human Services (HHS). For example, property owners can establish relationships with local nonprofit organizations, including churches, to ensure that residents have access to the services that they need. At their discretion, property owners may establish relationships that give the elderly access to meals, transportation, and housekeeping and personal care services. In site visits to HUD and USDA multifamily properties, we found several examples of such partnerships: * In Greensboro, North Carolina, Dolan Manor, a Section 202 housing development, has established a relationship with a volunteer group from a local church. The volunteer group provides a variety of services for the residents, such as transportation. * In Plain City, Ohio, residents of Pleasant Valley Garden, a Section 515 property, receive meals five times a week in the community's senior center (a $2 donation is suggested). A local hospital donates the food and a nursing home facility prepares it. Volunteers, including residents, serve the meals. The senior center uses the funds collected from the lunch for its activities. In addition, local grocery stores donate bread products to the senior center daily. The United Way provides most of the funding for the senior center. * In Guthrie, Oklahoma, Guthrie Properties, a Section 515 property, has established a relationship with the local Area Agency on Aging. The agency assists residents of Guthrie Properties in obtaining a variety of services, including meals and transportation to a senior center. Some elderly residents of public and federally subsidized housing may also obtain health-related services through programs run by HHS. For example, HHS's Public Housing Primary Care Program provides public housing residents with access to affordable comprehensive primary and preventive health care through clinics that are located either within public housing properties or in immediately accessible locations. The program awards grants to public and nonprofit private entities to establish the clinics. The organizations must work with public housing authorities to obtain the physical space for the clinics and to establish relationships with residents. Currently, there are 35 grantees, 3 of which are in rural areas. According to a program administrator, although clinics are not specifically geared toward elderly-designated public housing, they can be established at such properties. Elderly residents of federally subsidized housing may also be eligible for the Medicaid Home and Community-Based Services (HCBS) Waiver Program, which is administered by HHS's Centers for Medicare and Medicaid Services. Through this waiver program, individuals eligible for Medicaid can receive needed health care without having to live in an institutional setting.[Footnote 26] HUD has identified the use of these waivers as an innovative model for assisting the frail elderly in public housing. In addition, eligible elderly residents of federally subsidized housing may also receive health care through the Program of All-Inclusive Care for the Elderly (PACE), which is also administered by the Centers for Medicare and Medicaid Services.[Footnote 27] Like the HCBS waiver program, this program enables eligible elderly individuals to obtain needed services without having to live in an institutional setting. The program integrates Medicare and Medicaid financing to provide comprehensive, coordinated care to older adults eligible for nursing homes. Figure 5 provides information on the housing assistance programs that can use federally funded supportive services programs that assist the elderly. Figure 5: Housing Assistance Programs That Can Use Federally Funded Supportive Services Programs: [See PDF for image] Notes: Congregate Housing Services Program grants cannot be awarded to Section 221(d)(4) housing. Information on the extent to which elderly residents actually utilized these supportive services was generally not available at the federal level. [End of figure] HUD and USDA Have Policies in Place to Avoid Duplicating Programs: Although the potential for duplication exists, HUD and USDA have established policies and procedures to guide the development of multifamily housing for the elderly in rural areas. A 1991 agreement between the agencies and subsequent guidance to HUD and USDA field offices established a framework for coordinating efforts to provide housing assistance to low-income rural households. As noted, HUD develops rental housing for the elderly in rural areas through its Section 202 program, and USDA can develop such housing through its Section 515 program. In addition to obtaining one another's input on proposed developments, HUD field office and state USDA office staffs assess the markets in areas where a new development is proposed. Site visits to HUD and USDA field offices in three states revealed that while staff did not consistently follow coordination procedures, each office did analyze market conditions in the proposed locations. In addition, the potential for unnecessary overlap and duplication between these programs has been limited by funding levels and the geographic areas in which HUD and USDA develop new housing. Policies are in Place to Guide the Coordination of Rural Housing Development: Policies and procedures designed to coordinate HUD and USDA efforts to develop rental housing in rural areas have been in place since the early 1990s.[Footnote 28] In 1991 HUD and USDA signed a Memorandum of Understanding and agreed to maintain an on-going working relationship to address issues related to providing housing assistance to rural areas in a cooperative, cost effective, and nonduplicative manner. As a result of this agreement, HUD and USDA issued guidance, in 1991 and 1992 respectively, specifying how the agencies should coordinate. Specifically, the guidance outlined coordination procedures that each agency should follow when reviewing applications for funds to develop rental units. For HUD, this policy applied to several programs, including the Section 202 program. For USDA, this policy applied specifically to the Section 515 program, which can be used to develop properties for families or the elderly. Among the programs we included, HUD's Section 202 program and USDA's Section 515 program are the only two that actively produce rental units for the elderly in rural areas.[Footnote 29] While neither the original agreement between HUD and USDA nor the resulting guidance has been updated since the early 1990s, the Section 515 program instructions and the Section 202 program's annual Notice of Funding Availability, which announces the availability of funding as well as program requirements, describe current procedures. According to the Section 515 program instructions, the purpose of the coordination effort is to (1) foster better communication, (2) obtain additional documentation to determine market feasibility, (3) prevent overdevelopment of subsidized housing, and (4) prevent adverse effects on proposed or existing units that provide similar types of rental housing. The program instructions also state that state USDA offices will forward basic loan information on Section 515 loan applications that are selected for further processing to the applicable HUD field office. HUD field office staff will identify any pending, authorized, or existing units in the market area and provide comments, positive or negative, on the proposed market area to USDA within 2 weeks. When HUD staff have concerns about market feasibility or the impact of a proposed project on existing or authorized HUD units, they also provide documentation to support their concerns. HUD has established a similar process for notifying USDA of proposed developments. HUD's fiscal year 2004 Notice of Funding Availability for the Section 202 program requires HUD to seek USDA's input on Section 202 applications, giving USDA the opportunity to respond if it has concerns about the demand for additional assisted housing or possible harm to existing housing in the same market area. In addition to seeking input from one another on the markets in which new rural rental housing is proposed, both HUD and USDA assess market conditions when they evaluate applications for Section 202 and Section 515 funds. For example, HUD's guidance instructs HUD's economists to evaluate the markets in which all Section 202 applications propose development to determine if sufficient demand for the units exists and to assure that any new units will not have a long-term adverse impact on existing assisted housing for the elderly. If this analysis shows that sufficient demand for the units proposed in an application does not exist, then the application cannot be funded. Similarly, according to USDA officials, USDA state office staffs analyze market data to determine need and demand for the units proposed in Section 515 applications. Applications are not approved if: * another rural rental housing loan has already been selected for further processing in the same market; * a previously authorized USDA, HUD, Low-Income Housing Tax Credit, or similar type of project in the same market area has not been completed, has not reached its projected occupancy level, or is experiencing high vacancies; or: * the need in the market area is for additional rental assistance and not for additional housing units. We visited HUD field offices and USDA state offices in North Carolina, Ohio, and Oklahoma to determine whether and how these offices were following these policies and procedures. We chose these states because they had the largest numbers of approved Section 202 grants in rural areas and Section 515 loan awards in fiscal years 2002 and 2003 (see Appendix I). Our observations from the site visits are not necessarily representative of all field offices. Overall, the HUD and USDA field offices in the three states we visited did not consistently follow the policies and procedures designed to facilitate coordination in fiscal years 2002 or 2003. For example, while local USDA officials in North Carolina and Oklahoma obtained input from HUD on Section 515 loan applications in fiscal years 2002 and 2003, USDA officials in Ohio did not. According to a senior official from USDA's Ohio state office, the agency did not seek HUD's input on the sites funded in fiscal years 2002 or 2003 because USDA determined that market demand existed for the units. Moreover, this official stated that they had sought HUD's input on Ohio's list of "designated places"--cities, towns, and communities for which USDA could approve new Section 515 development.[Footnote 30] Based on input from HUD and USDA field offices, USDA state offices can remove places from the list if a market for additional rental housing does not exist. Since HUD officials had not raised concerns about the two places on Ohio's list for which Section 515 housing was proposed in fiscal years 2002 and 2003 and funds were ultimately allocated, USDA officials did not think that it was necessary to request their input again. Only one of the HUD offices visited sought USDA's input on Section 202 grant applications in fiscal year 2002, and none sought USDA's input in fiscal year 2003. According to HUD officials in the field offices we visited, HUD offices did not seek input for various reasons. For example, in North Carolina and Oklahoma there were staffing changes. In Ohio, funds were awarded to a site that had been funded in fiscal year 2002. Since contact was made with USDA officials in fiscal year 2002 regarding this site, HUD officials did not see a need to contact them again in fiscal year 2003. Although coordination between the HUD and USDA offices we visited was inconsistent in fiscal years 2002 and 2003, we found that these offices based their funding decisions on market analyses. For example, HUD economists evaluated the markets in which all Section 202 applications proposed development. If the economists determined that a sufficient market for development did not exist, the application was not funded. Similarly, in each state USDA office we visited, officials explained that if they determined that the market for Section 515 development was insufficient in a place where development was proposed, they would not fund the application. Possibly as a result of these market analyses, we did not identify any examples of HUD and USDA providing unnecessarily duplicative housing assistance for the elderly. The Potential for Unnecessary Overlap and Duplication between Section 515 and Section 202 Developments Is Limited: Several factors limit the potential for unnecessarily duplicative Section 202 and Section 515 housing for the elderly in rural areas: funding constraints, geographic restrictions, and, in some areas, demand for additional rental units. First, the way that Section 202 funding is allocated and the amount of Section 515 funding limit the number of units these programs produce in rural areas. HUD generally allocates only a portion of Section 202 funds to nonmetropolitan areas, which are more likely than metropolitan areas to be considered rural and thus eligible for USDA funds.[Footnote 31] In fiscal years 2002 through 2004, for example, HUD set aside enough funds for each of its local offices to fund a minimum of five units in nonmetropolitan areas and allocated 15 percent of all funds appropriated for the Section 202 program to these areas. And although the Section 515 program provides funding exclusively in rural areas, funding for this program has fallen sharply since its peak in 1979. During the peak funding years, the program produced more than 20,000 new units annually. Since 2000, fewer than 2,000 new units have been produced annually. Also, not all new Section 515 units are for the elderly, further reducing the potential for overdevelopment of elderly housing in rural areas. Second, geographic restrictions on areas where Section 515 funds can be used limit the extent to which the Section 515 and Section 202 programs can overlap. Section 202 properties can be developed anywhere in the United States. In contrast, not only must Section 515 properties be in rural areas, but also new development can occur only in designated places. State USDA offices develop lists of places with a need for multifamily rental housing, and invite Section 515 applications for these places. According to the USDA officials we interviewed, this list can be refined through input from HUD and USDA field offices. As a result, new Section 515 properties could potentially be developed and overlap with new Section 202 development only in a small number of areas. Finally, officials at the HUD field offices and state USDA offices we visited told us that oversaturating a market with both HUD and USDA units for the elderly was not a concern for several reasons, including a high demand for such units. In some cases, they said, existing elderly properties had waiting lists, and new properties generally rented quickly. According to other officials, given the limited number of elderly units that could be constructed with available funding, overlap and duplication between HUD and USDA housing for the elderly was not a concern. Agency Comments: We provided a draft of this report to USDA and HUD for their review and comment. USDA had no comments on the report. HUD provided comments in a letter from the Assistant Secretary for Housing - Federal Housing Commissioner (see Appendix V). The letter stated that the report does not give HUD's programs full credit for their contributions in assisting the elderly. HUD's specific comments in this regard, and our responses, are as follows: * HUD commented that the report should include more detail on partnership arrangements and overall supportive services provided to the elderly. We believe that the report covers these issues at a level of detail appropriate to our objective. The report includes information on the four federal housing assistance programs that require that supportive services be made available to elderly residents, and four programs that can be used to either link residents to supportive services or provide services directly. In addition, it includes examples of private partnerships and health care programs to convey a broader sense of the supportive services that can be available to the elderly. * HUD noted that the draft did not include data on units designated for a mixed population of the elderly and disabled. We initially determined that the 6,004 units that fall into this category were not significant enough to merit inclusion. However, in response to HUD's comment, we have included this data as a note to Figure 2. * HUD stated that the report fails to give Home Equity Conversion Mortgages (HECM) sufficient credit. As detailed in the Objectives, Scope, and Methodology (see Appendix I), this report focuses upon programs that met our definition of housing assistance. While the HECM program did not meet this definition, both the body of the report and Appendix IV acknowledge HECM as a program that assists elderly families. * HUD agreed that GAO used the appropriate definition of elderly households, but stated that the report should acknowledge that other households may have members aged 62 or older (that are not the head, co- head, or spouse). While we did not initially provide data on such households because they are not, by definition, elderly households, we did add a note to Figure 3 to acknowledge that housing assistance programs can also benefit this group. As agreed with your office, unless you publicly announce its contents earlier, we plan no further distribution of this report until 30 days from the report date. At that time, we will send copies to the Secretaries of Agriculture and Housing and Urban Development. We will make copies available to others upon request. This report will also be available at no charge on GAO's Web site at [Hyperlink, http://www.gao.gov]. Please call me at (202) 512-8678 if you or your staff have any questions about this report. Key contributors to this report are listed in Appendix VI. Signed by: David G. Wood: Director, Financial Markets and Community Investment: [End of section] Appendixes: Appendix I: Objectives, Scope, and Methodology: To determine the extent to which federal housing assistance programs provide benefits to elderly households, we first identified the relevant programs through a literature search, review of the Catalog of Federal Domestic Assistance, and consultation with Department of Housing and Urban Development (HUD) and Department of Agriculture (USDA) officials.[Footnote 32] As used in this report, housing assistance programs are those that: * subsidize mortgage interest rates, rent, or housing repair or rehabilitation; * provide mortgage insurance, loan guarantees, or direct loans for single-family or multifamily housing; and: * support the construction, rehabilitation, or purchase of multifamily housing or assisted living facilities. We excluded programs that are administered by government-sponsored enterprises such as Fannie Mae, Freddie Mac, and Federal Home Loan Banks; are used exclusively to fund nursing homes or supportive housing for the homeless; are not used exclusively to provide housing assistance; or lack special features that apply to the elderly. We then reviewed laws and regulations to determine which housing assistance programs were (1) targeted to the elderly as the only beneficiaries, (2) targeted to the elderly and disabled only, and (3) were not targeted to the elderly but had special features for them. Appendix III describes the programs we included, and Appendix IV describes some programs we excluded, even though they can benefit elderly households. For each of the programs we included, we interviewed agency officials and reviewed laws, regulations, handbooks, and other documentation to describe the programs and how they benefit the elderly. We used various HUD and USDA databases to analyze the extent to which the programs within our scope either designated units for the elderly or were occupied by elderly households. Specifically: * To determine the number of units under HUD's multifamily programs, we used data from HUD's Multifamily Portfolio Reporting Database as of April 1, 2004. HUD provided corrected unit counts for 32 properties in August 2004. Unit counts were not available for 42 percent of the Section 207 Manufactured Home Parks properties, 57 percent of Section 232 properties, and 23 percent of Section 542(b) and (c) properties, so we could not produce a reliable count of the total number of units for these programs. For the other HUD multifamily programs, fewer than 2 percent of the properties were missing unit counts (except that 4.5 percent of Section 207/223(f) properties were missing unit counts), so we considered the data sufficient for our purposes. We combined these data with the results of HUD's Multifamily Housing Inventory Survey, conducted between June 2002 and January 2003, to determine the number of multifamily units designated for the elderly under each program.[Footnote 33] * To determine the number of elderly households living in properties under HUD's multifamily programs, we used data from HUD's Tenant Rental Assistance Certification System as of May 25, 2004. However, we were only able to determine the number of households receiving project-based rental assistance. Not all units under HUD's multifamily program receive project-based rental assistance, and occupancy data on these unassisted units were not available. As a result, the numbers that we report for these programs do not reflect the total number of elderly households in these programs but only the number of elderly households receiving project-based rental assistance.[Footnote 34] * To determine the number of elderly households living in public housing or receiving rental assistance through the Housing Choice Voucher or Section 8 Moderate Rehabilitation programs, we used data from HUD's Public and Indian Housing Information Center as of June 3, 2004. We excluded outdated data (29 percent of the records) by including in our analysis only households whose records had been updated within the last 15 months.[Footnote 35] To determine the number of public housing units designated for the elderly, we used a July 14, 2004, Designated Housing Plan Status Report--a spreadsheet that HUD uses to track public housing authorities that have requested or been approved to formally designate units for the elderly. * For USDA's Section 515 program, we used data from USDA's Multi-Family Integrated System as of April 30, 2004, and July 13, 2004, to determine the number of units, units designated for the elderly, and units occupied by elderly households (including households receiving Section 521 rental assistance).[Footnote 36] * To determine the number of Section 538 units, we used (1) a report from USDA's Guaranteed Loan System as of June 3, 2004, covering Section 538 properties guaranteed beginning in fiscal year 2000 and (2) a June 16, 2004, report listing data on Section 538 properties guaranteed through fiscal year 1999 but not maintained in USDA's central data systems. Data on the occupants of Section 538 properties were not available. * For USDA's Section 502 and 504 single-family programs, we used data from USDA's Dedicated Loan Origination and Servicing System and Guaranteed Loan System as of April 30, 2004, to determine the total number of loans and grants and the number of borrowers or grantees who were elderly at the time they applied for a loan or grant. However, the Guaranteed Loan System only had the primary or secondary borrower age for about 2 percent of the Section 502 Guaranteed Loans, a percentage that was insufficient for our purposes. In order to assess the reliability of the program data described above, we reviewed related documentation and interviewed agency officials and contractors who worked with these databases. In addition, we performed internal checks to determine the extent to which the data fields were populated and the reasonableness of the values contained in the data fields. During our internal checks, for household counts based on the age of household members, we identified 0.01 percent of cases where the age appeared to be erroneous due to unreasonably high values. We concluded that the data we used were reliable for purposes of this report. To provide information on the effectiveness of the programs within our scope in assisting the elderly, we reviewed studies and reports by federal agencies, research institutions, and the HUD and USDA Offices of Inspector General. We reviewed the methodologies used in relevant studies to ensure that the results reported were reasonable. We excluded studies that did not focus on the effectiveness of a program in assisting the elderly, were more than 15 years old, or were not focused upon the goals of the program. We also reviewed the Office of Management and Budget's Program Assessment Rating Tool assessments for programs within our scope. In addition, we used HUD and USDA fiscal year 2003 Performance and Accountability Reports to determine if program goals or performance measures specific to the elderly had been established for these programs. For those programs with such goals, we provided information on whether the goal was reached. For those programs that did not have these goals, we summarized available information related to the effectiveness of the programs in assisting the elderly. To describe the types of supportive services that federal housing assistance programs provide for the elderly, we first reviewed laws and regulations to determine which of the programs within our scope were required to ensure that supportive services were available. Next, we identified supportive services programs that could be used with various housing assistance programs, whether or not the housing assistance program required such services. For example, while public housing authorities that manage public housing are not required to provide supportive services, housing authorities may implement such services voluntarily. We identified supportive services programs by reviewing literature and descriptions of housing assistance programs and interviewing administrators of the housing assistance programs within our scope, as well as representatives of advocacy organizations and professional associations interested in elderly housing issues and supportive services. We obtained descriptions of these supportive services programs by interviewing officials from HUD, USDA, and the Department of Health and Human Services. We also reviewed program descriptions, notices of funding availability, and other documentation to develop descriptions of these supportive service programs. To determine how HUD and USDA avoid overlap and duplication in programs that offer similar types of housing assistance to the elderly, we first determined which programs were actively producing new units in the same areas. We found that both HUD and USDA were actively producing new multifamily rental units in rural areas through the Section 202 and Section 515 programs, respectively. While Section 202 units can be constructed in metropolitan areas, Section 515 units cannot. As a result, we focused our analysis upon rural areas. We reviewed agreements, policies, and procedures established by HUD and USDA to coordinate the development of subsidized housing in rural areas and interviewed HUD and USDA officials responsible for administering these programs. We also visited HUD and USDA field offices in Greensboro and Raleigh, North Carolina; Columbus, Ohio; and Oklahoma City and Stillwater, Oklahoma to determine whether and how the policies and procedures for coordinating were being followed. We identified these states as having received, when both programs are considered together, the most Section 202 grants in rural areas and the most Section 515 new construction loans made in fiscal years 2002 and 2003. To determine the status of HUD's efforts to improve administration of the Section 202 program (Appendix II), we interviewed HUD officials and reviewed related documentation to identify steps HUD had taken to implement the recommendations we made in our 2003 report on the Section 202 program. We also obtained a HUD report on the number of delayed Section 202 properties as of November 10, 2004, and compared this report with data we presented in our 2003 report. We conducted our work primarily in Baltimore, Maryland; Greensboro and Raleigh, North Carolina; Columbus, Ohio; Oklahoma City and Stillwater, Oklahoma, and Washington, D.C., between December 2003 and December 2004, in accordance with generally accepted government auditing standards. [End of section] Appendix II: Status of HUD's Efforts to Improve Administration of the Section 202 Program: Our May 2003 report to the Senate Special Committee on Aging noted the significance of the Department of Housing and Urban Development's (HUD) Section 202 Supportive Housing for the Elderly (Section 202) Program, which subsidizes the development of rental housing and provides rental assistance for elderly households with very low incomes.[Footnote 37] Among other things, the report found that many Section 202 properties encountered delays before beginning construction, and we made several recommendations to improve the program's timeliness and oversight. Specifically, we recommended that HUD: * Evaluate the effectiveness of the current methods for calculating the capital advances that project sponsors receive and make any necessary changes to these methods, based on this evaluation, so that capital advances adequately cover the development costs of Section 202 projects consistent with HUD's project design and cost standards; * Provide regular training to ensure that all field office staff are knowledgeable of and held accountable for following current processing procedures required to approve projects to begin construction; * Update the Section 202 program handbook to reflect current processing procedures; and: * Improve the accuracy and completeness of information that field staff enter in the program's database system and expand the system's capabilities to track key project processing stages. At the time we completed our work, HUD had made some progress but had not fully implemented these four recommendations. First, in our 2003 report, we found that construction of Section 202 properties was sometimes delayed, in part because HUD awarded inadequate capital advance amounts.[Footnote 38] As a result, sponsors had to put off construction while they sought additional funding. We recommended that HUD evaluate the effectiveness of its methods for calculating capital advances and make any changes necessary to cover the development costs of Section 202 projects. HUD commissioned a study to examine how the development cost limits used to calculate capital advance amounts compared with indicators of local construction costs and to recommend any needed changes in limits for high-cost areas. A HUD official said that the agency received the results of the study in the fall of 2004, but had not determined whether to make any changes in its methods for calculating capital advances. In addition, HUD had not implemented the two recommendations related to training field staff and updating the Section 202 program handbook. We concluded in our 2003 report that providing adequate formal training for field office staff responsible for reviewing Section 202 properties before approving them to begin construction and issuing an updated program handbook could reduce delays in approving projects for construction by ensuring that staff were accountable for applying and interpreting HUD policies and procedures consistently. HUD agreed with these recommendations. According to senior agency officials, HUD's goal at the time we completed our work was to provide formal training to field staff in fiscal year 2005 in the technical implementation of the agency's new rules for using Low-Income Housing Tax Credits or other mixed financing to help fund Section 202 properties. These officials also said that HUD's goal was to update its program handbooks in fiscal year 2005 to reflect these new rules and other updates to policies and procedures. Although HUD had not fully implemented our recommendations for improving the timeliness of the Section 202 program, the number of delayed Section 202 properties had declined. In our 2003 report, we found that construction on 169 properties that had received Section 202 capital advance awards had been delayed as of the end of fiscal year 2002. By November 2004, all but 18 of these properties had been approved for construction, according to our analysis of a report prepared by HUD. These 18 properties had been awarded capital advances in fiscal years 1998 through 2000. An additional 108 projects funded in fiscal years 2001 and 2002 had been delayed, for a total of 126 delayed projects as of November 10, 2004.[Footnote 39] Senior HUD officials said that management staff in headquarters were monitoring the progress of these delayed projects by meeting quarterly with field office managers to discuss steps that could be taken to help the projects proceed to construction. Finally, HUD had identified needed enhancements to its program database but had not implemented the improvements, as we suggested. To improve HUD's oversight of the Section 202 program, we recommended that HUD improve the accuracy and completeness of information entered into its program database and expand the system's capabilities to track key stages of the development process. Senior HUD officials said that the agency had hired a new contractor in the summer of 2004 to work on the program database and had developed a list of needed enhancements that would address our recommendation. The list included improving the system's ability to track properties' progress, correcting data errors, and automating reports. However, the officials did not have a timeline for when they expected the enhancements to be complete. [End of section] Appendix III: Summaries of Federal Housing Programs That Serve the Elderly: This appendix presents information on 23 federal programs we identified that provide housing assistance to the elderly. The programs, which are administered by the departments of Agriculture (USDA) and Housing and Urban Development (HUD), are organized alphabetically by agency into three categories. The first category includes programs that are targeted to the elderly, the second programs that are targeted to the elderly and disabled, and the third programs that are not targeted to the elderly or disabled but have special features for the elderly.[Footnote 40] This appendix includes active programs as well as programs that no longer actively produce or subsidize new units yet still fund existing units. In general, both HUD and USDA programs target families at lower income levels. HUD programs target families with incomes that are: extremely low (no more than 30 percent of an area's median), very low (no more than 50 percent of an area's median), and low (no more than 80 percent of an area's median). USDA programs also target families with incomes that are very low and low. In addition, some USDA programs target families with moderate incomes (no more than 115 percent of an area's median). According to HUD and USDA officials, the terms "family" and "household" are generally used interchangeably. HUD's definition of family specifically includes elderly families, which are families whose head, spouse, or sole member is a person who is at least 62 years of age. It may include two or more persons who are at least 62 years of age living together or one or more persons who are at least 62 years of age living with one or more live-in aides. In general, USDA's definition of an elderly household also includes the disabled--that is, the head, spouse, or sole member is at least 62 years old or is a disabled person of any age. However, for the Section 504 grants and Section 538 programs, nonelderly disabled households are not included in the definition of elderly. Project-based rental assistance provides subsidies for tenants in specific properties so that the subsidy is not portable if a tenant moves. Tenant-based rental assistance provides vouchers for eligible tenants to rent single or multifamily units. Through both project-based and tenant-based forms of rental assistance, the renter generally pays 30 percent of adjusted income towards rent. Service coordinators are individuals that can generally be hired to work in public or other federally subsidized multifamily housing to assist residents in obtaining supportive services. For each program, we identify the federal agency responsible for administering the program, the type of assistance provided, and the type of housing. We also provide brief descriptions of (1) the program's purpose and objectives; (2) how the program is administered; (3) eligibility requirements; (4) special features for the elderly; (5) supportive services provided; and (6) available data on the extent to which the program targets or serves the elderly. We obtained the information for the summaries from the Catalog of Federal Domestic Assistance, program fact sheets, program handbooks, various HUD and USDA databases, and agency officials.[Footnote 41] Programs Targeted to the Elderly: Figure 6: Section 504 Rural Housing Repair and Rehabilitation Grants Description: [See PDF for image] [End of figure] Figure 7: Section 202 Supportive Housing for the Elderly Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Programs Targeted to the Elderly and Disabled: Figure 8: Assisted Living Conversion Program Description: [See PDF for image] [A] Assisted living facilities are designed to accommodate the frail elderly and persons with disabilities who can live independently but need assistance with activities of daily living. These facilities must provide supportive services such as personal care, transportation, meals, housekeeping, and laundry. [End of figure] Figure 9: Section 231 Mortgage Insurance Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Figure 10: Section 232 and 232/223(f) Mortgage Insurance Description: [See PDF for image] [A] Combination refers to properties that featured multiple facility types. Unknown refers to properties where data on facility type were unavailable. HUD did not have sufficient data to determine the total number of beds or units in all properties. Approximately 16,972 units were designated for the elderly. [End of figure] Programs with Special Features for the Elderly: Figure 11: Section 502 Rural Housing Loan (Direct) Description: [See PDF for image] [End of figure] Figure 12: Section 502 Direct Housing Natural Disaster Loan Description: [See PDF for image] [End of figure] Figure 13: Section 502 Guaranteed Rural Housing Loan Description: [See PDF for image] [End of figure] Figure 14: Section 504 Rural Housing Repair and Rehabilitation Loan Description: [See PDF for image] [End of figure] Figure 15: Section 515 Rural Rental Housing Loan Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly or disabled. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. [End of figure] Figure 16: Section 521 Rural Rental Assistance Description: [See PDF for image] [A] Section 521 rental assistance can also be used in units financed by the Section 514 and 516 Farm Labor Housing Loan and Grant Program (see Appendix IV). [End of figure] Figure 17: Section 538 Guaranteed Rural Rental Housing Description: [See PDF for image] [End of figure] Figure 18: Housing Choice Voucher Description: [See PDF for image] [End of figure] Figure 19: Project-Based Rental Assistance Description: [See PDF for image] [End of figure] Figure 20: Public Housing Description: [See PDF for image] [A] Elderly units are those designated for occupancy by the elderly. The number of nonelderly units, which can be occupied by elderly or nonelderly households, is an estimate by HUD. Elderly households are those in which the head, cohead, or spouse was elderly. The number of households is less than the estimated number of units because some units may be vacant, HUD may not have current data on all households, or the estimated unit count may be inaccurate. [End of figure] Figure 21: Section 8 Moderate Rehabilitation Description: [See PDF for image] [End of figure] Figure 22: Section 207 Mortgage Insurance for Manufactured Home Parks Description: [See PDF for image] [End of figure] Figure 23: Section 207/223(f) Mortgage Insurance Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Figure 24: Section 213 Mortgage Insurance Description: [See PDF for image] [End of figure] Figure 25: Section 221(d)(3) Below-Market Interest Rate Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Figure 26: Section 221(d)(3) and (d)(4) Mortgage Insurance Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Figure 27: Section 236 Rental and Cooperative Housing Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. Elderly or nonelderly households may occupy nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households was less than the number of units because HUD only had occupancy data on households receiving project-based rental assistance. [End of figure] Figure 28: Section 542(b) and 542(c) Risk Sharing Programs Description: [See PDF for image] [A] Elderly units are designated for occupancy by the elderly. We did not have sufficient data to determine the number of nonelderly units. Elderly households had an elderly head, cohead, or spouse, regardless of whether the unit was designated for the elderly. The number of households includes only those receiving project-based rental assistance. [End of figure] [End of section] Appendix IV: Additional Housing Programs: This appendix describes some additional housing programs that can benefit the elderly but that either did not meet our definition of housing assistance or were not considered by agency officials to be "key" in assisting the elderly. The appendix does not include all of the housing assistance programs that serve the elderly. A variety of federal agencies are responsible for these programs, including the departments of Agriculture (USDA), Health and Human Services (HHS), Housing and Urban Development (HUD), and Veterans Affairs (VA). The programs are organized in alphabetical order according to their administering agency. Department of Agriculture: Community Facilities Direct Loan, Guaranteed Loan, and Grant Programs: These programs provide a direct loan, guaranteed loan, or project grant assistance to construct, enlarge, extend, or otherwise improve community facilities, such as medical clinics, schools, fire and rescue stations, and child care centers for public use in rural areas. These programs finance a range of service centers for the elderly, including nursing homes, boarding care, assisted care facilities, adult day care, and intergenerational care facilities. To be eligible, applicants must be entities such as city, county, and state agencies; private nonprofit corporations; or federally recognized tribal governments. Priority is given to projects that will enhance public safety or provide health care facilities. Section 514/516 Farm Labor Housing Loans and Grants: This program provides loans or project grants to provide decent, safe, and sanitary low-rent housing for domestic farm laborers. Loans are available to farmers, family farm partnerships, family farm corporations, or associations of farmers. Loans and grants are available to states, public or private nonprofit organizations, federally recognized Indian Tribes, and nonprofit corporations of farm workers. Grants are available to eligible applicants only when there is a pressing need and when such facilities cannot be obtained without grant assistance. Loans are usually for 33 years at 1 percent interest, and grants may cover up to 90 percent of development costs. Section 533 Rural Housing Preservation Grants: This program provides grants to sponsoring organizations for the repair or rehabilitation of housing for very low-and low-income rural residents. To be eligible, an applicant must be a state or political subdivision, public nonprofit corporation, Indian tribal corporation authorized to receive and administer housing preservation grants, private nonprofit corporation, or a consortium of such entities. Organizations may use less than 20 percent of the Housing Preservation Grant funds for program administration purposes, such as to hire personnel and pay necessary and reasonable administrative expenses. Eighty percent or more of the funds must be used for loans, grants, or other assistance on individual homes, homeowners, rental properties, or cooperatives to pay any part of the cost for repair or rehabilitation of structures. Department of Health and Human Services: Low-Income Home Energy Assistance Program: This federally funded program helps low-income households meet their home heating and cooling needs. The program provides funding to states, federally-or state-recognized Indian tribes and tribal organizations, and insular areas, such as Puerto Rico and Guam, in the form of block grants for home energy assistance, energy crisis intervention or assistance, and low-cost residential weatherization and other energy- related home repair. The program targets (1) households with a high energy burden (those households with the lowest incomes and highest home energy costs), and (2) vulnerable households, including those with frail older individuals, individuals with disabilities, and very young children. Department of Housing and Urban Development: Community Development Block Grant Program: According to the Congressional Research Service, this program is the largest source of federal financial assistance for state and local governments' community development and neighborhood revitalization activities. The program's objective is to develop viable urban communities by providing housing and expanding economic opportunities, principally for individuals with low to moderate incomes. For example, Community Development Block Grant funds have been used to rehabilitate affordable senior housing, construct senior centers, and provide services such as congregate meals and transportation. Home Equity Conversion Mortgages: This program enables elderly homeowners to withdraw some of the equity in their home in the form of monthly payments for life or a fixed term, or in a lump sum, or through a line of credit. This reverse mortgage program allows families to stay in their home while using some of its equity. The total income that an owner can receive through the program is the maximum claim amount, which is calculated with a formula including the age of the owner, the interest rate, and the value of the home. The borrower remains the owner of the home and may sell it and move at any time, keeping the sales proceeds that exceed the mortgage balance. No repayment is required until the borrower moves, sells, or dies. HOME Investment Partnerships Program: This program is a federal formula block grant to state and local governments designed to create affordable housing for low-income households. The program provides funds to states and localities to build, buy, and rehabilitate affordable housing for rent or homeownership. Also, funds can be used to provide direct rental assistance to low-income people. For rental housing, at least 90 percent of HOME funds must benefit low-and very low-income families at 60 percent of the area median income; the remaining ten percent must benefit families below 80 percent of the area median income. Assistance to homeowners and homebuyers must go to families below 80 percent of the area median. HOME gives grantees the flexibility to use a variety of mechanisms to fund housing projects that meet local priorities, and is routinely combined with other public and private financing for affordable housing such as Housing Choice Vouchers and the Low-Income Housing Tax Credit. Housing Counseling Assistance Program: This program provides counseling to consumers on seeking, financing, maintaining, renting, or owning a home. The Housing Counseling Assistance Program enables individuals wanting to rent or own housing- -whether through a HUD program, a Veterans Affairs program, other Federal programs, a State or local program, or the regular private market--to get the counseling needed to make their rent or mortgage payments and to be a responsible tenant or owner in other ways. The counseling is provided by HUD-approved housing counseling agencies. There are three strategic goals for the program: (1) to improve the quality of renter and homeowner education, (2) to develop a reliable stream of funding and resources for counseling agencies, and (3) to enhance coordination among local housing providers. Section 203(b) Mortgage Insurance: This program promotes homeownership among families with low to moderate incomes by providing mortgage insurance for the purchase or refinancing of a principal residence. This program provides mortgage insurance to protect lenders, such as mortgage companies, banks and savings and loan associations, against the risk of default on loans to qualified buyers. Insured loans may be used to purchase new or existing one-to four- family homes, as well as to refinance debt. The insurance allows homebuyers to finance up to 97 percent of the home's cost through their mortgage. Section 203(k) Rehabilitation Mortgage Insurance: This program enables homebuyers and homeowners to finance the purchase (or refinancing) of a house that is at least a year old and the cost of its rehabilitation through a single mortgage. The cost of rehabilitation must be at least $5000, but the total value of the property must still fall within the mortgage limit for the area. Section 220 Mortgage Insurance (Urban Renewal Mortgage Insurance): This program provides federal insurance for mortgage loans on multifamily rental projects located in urban renewal areas and areas where local governments have undertaken designated revitalization activities. The purpose of Section 220 is to encourage the development of quality rental housing in urban areas targeted for overall revitalization, and to insure lenders against loss on mortgage defaults. The maximum amount of the mortgage loan may not exceed 90 percent of the estimated replacement cost for new construction or 90 percent of the estimated cost of the repair and the estimated value of the property before the repair for substantial rehabilitation. Section 234(c) Mortgage Insurance-Purchase of Units in Condominiums: This program insures loans for terms of up to 30 years for the purchase of a unit in a condominium building. The building must contain at least four dwelling units and can be detached or semidetached, a rowhouse or walk-up, or an elevator structure. The insurance covers loans made by lending institutions such as mortgage companies, banks, and savings and loan associations. Section 811 Supportive Housing for Persons with Disabilities: This program is designed to allow very low-income adults with disabilities to live independently in the community by funding the development of rental housing with appropriate supportive services. HUD provides interest-free capital advances to nonprofit sponsors to help finance the development of supportive housing. The advance does not have to be repaid as long as the housing remains available for very low- income persons with disabilities for at least 40 years. The program also provides project rental assistance, which covers the difference between the operating costs of the development as approved by HUD and the tenants' contribution toward rent (usually 30 percent of adjusted income). Each project must have a supportive services plan. The services offered may vary with the target population but could include case management, training in independent living skills, and assistance in obtaining employment. Title I (Property Improvement Loan Insurance for Improving All Existing Structures and Building of New Nonresidential Structures): This program facilitates the financing of improvements to homes and other existing structures and the building of new nonresidential structures. The maximum loan amount is $25,000 for improving a single family home or for improving or building a nonresidential structure. For improving a multifamily structure, the maximum loan amount is $12,000 per family unit, not to exceed a total of $60,000 for the structure. HUD insures private lenders against losses of up to 90 percent of any single loan. Department of Veterans Affairs: VA Homeless Providers Grant and Per Diem Program: This program provides funding to community agencies providing services to homeless veterans. The program's purpose is to help homeless veterans achieve residential stability, increase their skill levels and income, and obtain greater self-determination by promoting the development of housing with supportive services. Only programs with supportive housing or service centers are eligible for the two levels of funding: grants and per diem. VA Home Loans: This program helps veterans, certain service personnel, and certain unmarried surviving spouses of veterans obtain credit for the purchase, construction, or improvement of homes on more liberal terms than are generally available to nonveterans. Lenders, such as mortgage companies, savings and loan associations, or banks, make the loans and VA provides the guarantee. The amount guaranteed varies with the amount of the loan and previous use of the program. With the current maximum guarantee, a veteran who has not previously used the benefit may be able to obtain a loan up to $240,000, depending on the borrower's income level and the appraised value of the property. Federal Home Loan Banks: Affordable Housing Program: This program subsidizes the purchase, construction, rehabilitation, or refinancing of (1) owner-occupied housing for very low-to moderate- income households, and (2) rental housing in which very-low-income households can afford and will occupy at least 20 percent of the units. The Federal Home Loan Banks offer both grants and loans with below-cost interest rates. Community Investment Program: This program provides a favorably priced source of wholesale funds for any member involved in lending for community and economic development. The funds can be used for development of commercial projects, infrastructure improvements, or business that creates jobs. The funds are available to finance home purchases by families whose income does not exceed moderate-income levels, for purchase or rehabilitation of housing for occupancy by families whose income does not exceed moderate- income levels, or for commercial and economic development activities that benefit low-and moderate-income families or neighborhoods. Internal Revenue Service (IRS): Low-Income Housing Tax Credit: This tax credit program, which IRS and the states administer jointly, is the principal federal program designed to support the development and rehabilitation of housing for low-income households. Under this program, states are authorized to allocate federal tax credits as an incentive to the private sector to develop low-income rental housing. In their guidelines for the distribution of tax credits, some states have established preferences for properties intended for the elderly, but such a preference is not a federal requirement. Annually, IRS allocates tax credits to each state. For 2005, the credit is equal to $1.85 per state resident. Investors that provided financing may take the tax credits annually for 10 years to offset federal taxes. At a minimum, the owner must agree to make (1) 20 percent of the property units affordable to households with incomes at or below 50 percent of the area median income or (2) 40 percent of the units affordable to households with incomes at or below 60 percent of the area median. [End of section] Appendix V: Comments from the Department of Housing and Urban Development: U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT: WASHINGTON, D.C. 20410-8000: OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER: Mr. David G. Wood, Director: Financial Markets and Community Investment: U.S. Government Accountability Office: 441 G Street, NW: Washington, DC 20548: Dear Mr. Wood: Thank you for the opportunity to provide comments on the Government Accountability Office (GAO) draft report: ELDERLY HOUSING: Federal Housing Programs That Offer Assistance for the Elderly (GAO-PUB No. 05- 174). The Department of Housing and Urban Development's (HUD) housing programs address the special needs of elderly households with strategies for maximizing independence both by promoting community- based living opportunities, and by making supporting services available to residents of rental housing. The draft report falls somewhat short of giving the Department's programs full credit for their contributions to assisting the elderly through these nuanced strategies. On page 5, the draft report states that "Generally, the housing assistance programs we reviewed are not designed to provide supportive services to the elderly." However, the concept of supportive services deals with how HUD projects generally, and public housing authorities (PHAs) in particular, can enrich and improve residents' physical, mental and social lives. Many PHAs as a general practice partner with local service agencies to provide on-site health services, transportation, day care, education, personal care assistance, meals, outreach, recreation and other supportive services. While supportive services may not be required under certain programs, overall HUD housing assistance programs and funding mechanisms are designed to encourage partnerships between individual properties and local organizations. Although its capital fund may not be used to pay for supportive services, a PHA is permitted to use capital funds to provide community space in existing public housing developments that may be used for elderly related programs. Furthermore 100 percent of capital funding in PHAs of 250 units or less, and 20 percent of such funding in larger PHAs, can be used for pennitted operating fund uses including elderly supportive services. The operating fund may be used for appropriate supportive services as well as operating fund reserves. Housing Choice Vouchers may be used in assisted living facilities. Overall, the report should go into more detail on partnership arrangements and overall supportive services provided to the elderly. Figure 2, page 12 - This table's identification of 76,638 Public Housing units as designated for the elderly is based on the number of units that as of July 14, 2004, were designated for occupancy by elderly households under PHAs' designated housing plans. However, the draft does not appear to take into account units occupied by elderly that are not in a designated "elderly only" development. In particular, the report does not seem to incorporate units that are for a "mixed" population of both elderly and disabled households. On page 13, the draft indicates that HUD's Home Equity Conversion Mortgage program (HECM) does not meet the definition of housing assistance for the purpose of this review. The HECM program enables elderly homeowners to borrow against the equity in their homes and defer repayment for as long as they occupy their homes. However, because the elderly homeowner can use the equity for any purpose, not just for housing-related expenses, the program did not meet our definition of housing assistance." This formulation fails to give HECM mortgages sufficient credit as a source of housing affordability. The HECM program of the Department's Federal Housing Administration (FHA), commonly referred to by consumers as a reverse mortgage program, is designed to enable elderly homeowners to convert the equity in their homes into income that can be used to pay for home improvements, medical costs, living expenses, or other expenses. Clearly there will be many instances where this dynamic provides the elderly homeowner with the financial means for remaining in his or her home, thus occupying more desirable housing than would be the case otherwise. The utility of HECM financing in this regard is demonstrated by FHA's accounting for about 95 percent of the reverse mortgage market. Figure 3, page 15 - These occupancy data for elderly in HUD insured/ assisted projects are based on defining elderly households as including those in which "the head of household, co-head, or spouse was elderly as of the most recent reporting date." This is reasonably consistent with the provisions of 24 C.F.R. 5.403, which apply to the public housing and Section 8 programs and define "elderly family" as "a family whose head, spouse, or sole member is a person who is at least 62 years of age.' (such definition) may include two or more persons who are at least 62 years of age living together, or one or more persons who are at least 62 years of age living with one or more live-in aides." Nevertheless, it also should be noted that there are additional households which have members aged 62 or older that are not the head, co-head, or spouse. We hope the above comments will be helpful in finalizing the draft report, and assist your study's efforts toward determining the extent and effectiveness of federal assistance for housing the elderly and services supporting this population. If you have any questions regarding our comments, please contact Michael Wells of my staff at 202- 401-0450, extension 2423. Sincerely, Signed by: John C. Weicher: Assistant Secretary for Housing-Federal Housing Commissioner: [End of section] Appendix VI: GAO Contacts and Staff Acknowledgments: GAO Contacts: David Wood, (202) 512-8678, [Hyperlink, woodd@gao.gov]; Paul Schmidt, (312) 220-7681, [Hyperlink, schmidtpj@gao.gov]. Staff Acknowledgments: In addition to those named above, Emily Chalmers, Natasha Ewing, Alison Martin, John McGrail, Marc Molino, Lisa Moore, John Mingus, and Julianne Stephens made key contributions to this report. (250175): FOOTNOTES [1] Commission on Affordable Housing and Health Facility Needs for Seniors in the 21ST Century, A Quiet Crisis in America (Washington, D.C.: June 30, 2002). Available at http://www.seniorscommission.gov. [2] GAO, Elderly Housing: Project Funding and Other Factors Delay Assistance to Needy Households (GAO-03-512, May 30, 2003), 1. [3] Federal agencies are required under the Government Performance and Results Act of 1993 to submit Annual Performance and Accountability Reports to Congress. [4] Not all mortgage insurance programs are targeted exclusively to housing for lower-income households. [5] Prior to fiscal year 1992, the Section 202 program produced housing for the elderly and disabled. The Cranston-Gonzalez Affordable Housing Act (PL 101-625), enacted in 1990, changed the Section 202 program so that it targeted only the elderly beginning in fiscal year 1992. That act also created a separate HUD program, Section 811, to produce housing for people with disabilities. [6] Because these mortgage insurance programs have statutory limitations on the insurable mortgage amount per unit, higher cost properties intended for more affluent households would be unlikely to qualify for mortgage insurance under these programs. [7] Designating housing units for the elderly is not a feature of single-family programs. Data on single-family programs' loan and grant recipients are presented in figure 4. [8] Although the Section 202 program currently targets the elderly only, not all of its units are designated for the elderly because prior to 1992 the program also produced housing for the disabled. [9] For example, for HUD's Section 202 and multifamily mortgage insurance programs (Sections 207/223(f), 221(d)(3) Below-Market Interest Rate, 221(d)(3)/(d)(4), 231, 236, and 542(b)/(c)), occupancy data were available only for households receiving project-based rental assistance. Not all households under these programs receive such assistance. [10] Elderly households include those in which the head of household, co-head, or spouse was elderly as of the most recent reporting date. [11] Occupancy data were not available for single-family programs. Data on single-family programs' loan and grant recipients are presented in figure 4. [12] USDA did not have data on the age of another 8,704 Section 504 grant recipients. However, based on program requirements, nearly all of these recipients were probably elderly. Specifically, the RHS Administrator has the authority to allow Section 504 grants for nonelderly households in exceptional circumstances. A senior RHS official said that the agency has rarely exercised that authority and that USDA does not maintain statistics on the number of exceptions granted. [13] In HUD's fiscal year 2003 Performance and Accountability Report, data on the number of Section 202 projects approved to start construction was not available separately from data on the Section 811 program, which provides housing assistance to the disabled. [14] GAO, Elderly Housing: Project Funding and Other Factors Delay Assistance to Needy Households, GAO-03-512, (Washington, D.C.: May 30, 2003). [15] Public housing authorities can establish tenant selection preferences for public housing and housing choice vouchers. Public housing authorities and property owners can establish tenant selection preferences for project-based rental assistance. For example, preferences for the elderly can be established to ensure that they are given priority for assistance. [16] U.S. Department of Agriculture, Office of Inspector General, Financial and IT Operations, Audit Report: Rural Development's Financial Statements for Fiscal Years 2004 and 2003, 85401-11-FM (Washington, D.C.: Nov. 5, 2004), 9. [17] U.S. Department of Agriculture, Office of Inspector General, Midwest Region, Audit Report: Rural Housing Service Rural Rental Housing Project Management (Washington, D.C.: Sept. 30, 2004), 3. [18] Meryl Finkel and Larry Buron, Study on Section 8 Voucher Success Rates, vol. 1, "Quantitative Study of Success Rates in Metropolitan Areas," report prepared for the U.S. Department of Housing and Urban Development (Cambridge, Mass.: Abt Associates, Inc., 2001), 3-7. [19] James J. Mikesell and others, Meeting the Housing Needs of Rural Residents: Results of the 1998 Survey of USDA's Single Family Direct Loan Housing Program, Rural Development Research Report 91, Economic Research Service, U.S. Department of Agriculture (Washington, D.C.: 1999), 47. [20] GAO, Performance Budgeting: Observations on the Use of OMB's Program Assessment Rating Tool for the Fiscal Year 2004 Budget, GAO-04- 174 (Washington, D.C.: Jan. 30, 2004), 17, 20, 21. [21] GAO, Program Evaluation: Studies Helped Agencies Measure or Explain Program Performance, GAO/GGD-00-204 (Washington, D.C.: Sept. 29, 2000), 18. [22] Under the Section 202 capital advance program, if a sponsor indicates that at least 25 percent of tenants are expected to be frail elderly, HUD allows the sponsor to use funds from the project rental assistance contract to pay for a service coordinator. A portion of the funds (up to $15 per month per unit) may also be used to cover some of the cost of supportive services. [23] In fiscal year 2004, new grants for the program were funded through the Public Housing Operating Fund. [24] Fees cannot exceed 20 percent of an individual's adjusted income. [25] Grant funding for Neighborhood Networks centers can also be provided to public housing authorities through HUD's Office of Public and Indian Housing. [26] In order to be eligible for health care services through the HCBS waiver program, individuals must meet a "level of care" requirement that varies by state but that typically is measured by standards of care for either hospitals, nursing facilities or intermediate care facilities for persons with mental retardation. [27] PACE participants must be at least 55 years old, live in the service area, and be certified as eligible for nursing home care by the appropriate state agency. [28] A 2000 GAO study on duplication between HUD and USDA rural housing programs found that while some of USDA's housing programs are similar to programs offered by other federal agencies, other USDA housing programs and terms have no counterparts elsewhere. GAO, Rural Housing: Options for Optimizing the Federal Role in Rural Housing Development, GAO/RCED-00-241(Washington, D.C.: Sept. 15, 2000), 5-6. [29] Section 202 housing can be developed in metropolitan and nonmetropolitan areas, which may or may not include rural areas. Section 515 housing can be developed only in rural areas. [30] USDA officials in Oklahoma also sought input from a HUD field office on that state's list of designated places. [31] GAO conducted a study of USDA's definition of rural, which explored how changing the definition of rural could improve eligibility determinations. GAO, Rural Housing: Changing the Definition of Rural Could Improve Eligibility Determinations, GAO-05-110 (Washington, D.C.: December 3, 2004). [32] U.S. General Services Administration, Catalog of Federal Domestic Assistance (Washington, D.C.: August 2004). [33] HUD field office staff completed the Multifamily Housing Inventory Survey, reporting the number of units designated for the elderly or the disabled in insured or subsidized multifamily properties, excluding unassisted hospitals, nursing homes, intermediate care facilities, board and care facilities, and assisted living facilities. For properties that were not included in the Multifamily Housing Inventory Survey, if the Multifamily Portfolio Reporting Database indicated that the property was wholly for the elderly or was an assisted living facility, we included the property's units in our count of elderly- designated units. [34] The HUD multifamily programs for which occupancy data were available only on households receiving project-based rental assistance were Section 202, Section 207/223(f), Section 221(d)(3) Below-Market Interest Rate, Section 221(d)(3)/(d)(4), Section 231, Section 236, and Section 542(b)/(c). [35] Public housing authorities are supposed to certify data on tenants at least annually and submit the data to HUD. Allowing for the time it may take for public housing authorities to process and submit data to HUD, we considered data submitted within 15 months of the data extract to be current. [36] Combined, the data include Section 515 properties that had active loans as of April 30, 2004, that had not been paid off as of July 13, 2004. [37] GAO, Elderly Housing: Project Funding and Other Factors Delay Assistance to Needy Households (GAO-03-512, May 30, 2003), 1. [38] We considered a property to be delayed in beginning construction if it had not met HUD's guideline that projects should be approved to begin construction within 18 months of receiving a capital advance award. [39] As of the end of fiscal year 2002, less than 18 months had elapsed since HUD awarded capital advances to projects funded in fiscal year 2001, so none of these projects were considered delayed at that time. [40] Generally, the income adjustments for the elderly are also available to the disabled. [41] U.S. General Services Administration, Catalog of Federal Domestic Assistance (Washington, D.C.: August 2004). GAO's Mission: The Government Accountability Office, the investigative arm of Congress, exists to support Congress in meeting its constitutional responsibilities and to help improve the performance and accountability of the federal government for the American people. GAO examines the use of public funds; evaluates federal programs and policies; and provides analyses, recommendations, and other assistance to help Congress make informed oversight, policy, and funding decisions. GAO's commitment to good government is reflected in its core values of accountability, integrity, and reliability. Obtaining Copies of GAO Reports and Testimony: The fastest and easiest way to obtain copies of GAO documents at no cost is through the Internet. GAO's Web site ( www.gao.gov ) contains abstracts and full-text files of current reports and testimony and an expanding archive of older products. The Web site features a search engine to help you locate documents using key words and phrases. You can print these documents in their entirety, including charts and other graphics. Each day, GAO issues a list of newly released reports, testimony, and correspondence. GAO posts this list, known as "Today's Reports," on its Web site daily. The list contains links to the full-text document files. To have GAO e-mail this list to you every afternoon, go to www.gao.gov and select "Subscribe to e-mail alerts" under the "Order GAO Products" heading. Order by Mail or Phone: The first copy of each printed report is free. Additional copies are $2 each. A check or money order should be made out to the Superintendent of Documents. GAO also accepts VISA and Mastercard. Orders for 100 or more copies mailed to a single address are discounted 25 percent. Orders should be sent to: U.S. Government Accountability Office 441 G Street NW, Room LM Washington, D.C. 20548: To order by Phone: Voice: (202) 512-6000: TDD: (202) 512-2537: Fax: (202) 512-6061: To Report Fraud, Waste, and Abuse in Federal Programs: Contact: Web site: www.gao.gov/fraudnet/fraudnet.htm E-mail: fraudnet@gao.gov Automated answering system: (800) 424-5454 or (202) 512-7470: Public Affairs: Jeff Nelligan, managing director, NelliganJ@gao.gov (202) 512-4800 U.S. Government Accountability Office, 441 G Street NW, Room 7149 Washington, D.C. 20548:

The Justia Government Accountability Office site republishes public reports retrieved from the U.S. GAO These reports should not be considered official, and do not necessarily reflect the views of Justia.