Four Housing Assistance Programs Require That Supportive Services Be Made Available to Elderly Residents

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 target or include the elderly among potential beneficiaries,  only 4 require the owners of properties developed under the programs to  ensure that supportive services are available. Appendix II provides  summaries of the four programs, which include:    HUD’s Section 202 program, which subsidizes the development and  operating costs of multifamily properties for elderly households with very  low incomes. HUD’s Assisted Living Conversion Program, which provides private  nonprofit owners of eligible properties with grants to convert some or all  of their units into assisted living facilities for the frail elderly. All insured facilities  must provide supportive services, but these services vary according to the  type of facility. Other HUD Programs Can Assist the Elderly in Obtaining Supportive Services

HUD administers four service-related programs that can be used in  conjunction with subsidized housing programs: two programs that provide  supportive services to residents of public and multifamily properties  developed under HUD programs, and two that link residents to supportive  services. 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. The Neighborhood Networks program encourages property owners,  managers, and residents of HUD-insured and -assisted housing to develop  computer centers. The ROSS grant program links public housing residents with appropriate  services. 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 HHS. Although  GAO did not obtain data on the extent to which such services are made  available at all public and federally subsidized multifamily housing, 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. 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. In addition, eligible elderly residents of federally subsidized housing may  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. The Section 515 program’s Congregate Housing subprogram requires properties to provide  supportive services.
Why GAO Did This Study

According to a congressionally established bipartisan commission, decreased investment in affordable housing and an 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. Moreover, according to this commission, more than one-third of the elderly tenants of government-subsidized housing require assistance with some type of activity of daily living, such as making a meal or getting in and out of bed. This testimony, which is based on a report issued in February 2005, discusses (1) the federal housing assistance programs requiring that supportive services be made available to elderly residents, (2) other Department of Housing and Urban Development (HUD) programs that assist the elderly in obtaining supportive services, and (3) private partnerships and federal health care programs that may provide supportive services to elderly beneficiaries of federal housing assistance.

What GAO Found

Of the 23 housing assistance programs GAO reviewed, only 4 require the owners of participating properties to ensure that services such as meals or transportation are available to residents. Three are HUD programs: the Section 202 Supportive Housing for the Elderly Program, which subsidizes multifamily properties for elderly households with very low incomes; the Assisted Living Conversion Program, which subsidizes the conversion of HUD-subsidized multifamily properties into assisted living facilities; and the Section 232 Mortgage Insurance Program, which insures mortgages for licensed facilities that provide varying levels of skilled care and services. USDA's Section 515 Rural Rental Housing Loan program, which makes loans for the construction and rehabilitation of rural multifamily properties, has a Congregate Housing Services subprogram that requires the provision of supportive services. HUD administers four programs that can be used with various housing programs to help the elderly with supportive services: Congregate Housing Services Program, which provides grants for the delivery of meals and nonmedical supportive services to elderly and disabled residents of public and multifamily housing; Neighborhood Networks Program, which encourages the development of computer centers in HUD-supported housing; Resident Opportunities and Self Sufficiency (ROSS) Program, which links public housing residents with services; and Service Coordinator Program, which funds coordinators who help elderly residents access services such as transportation and health care at some multifamily properties. Supportive services may also be available to elderly residents of subsidized housing through partnerships between individual properties and local organizations and through Department of Health and Human Services (HHS) programs. For example, HHS's Public Housing Primary Care Program provides public housing residents with access to affordable primary and preventive health care through clinics that are located in or near the properties. GAO did not obtain data on the extent to which such services are made available.