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entitled 'Elderly Housing: Federal Housing Programs That Offer 
Assistance for the Elderly' which was released on March 16, 2005. 

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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). 

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