Aging in Place: Facilitating Choice

HUD Programs Support Aging in Place

HUD’s Section 202 Supportive Housing for the Elderly (Section 202) program has supported the construction of approximately 263,000 units in 8,000 properties that are currently serving low-income elderly households (defined as those with at least one member over age 62 and earning no more than 50 percent of the area median income). Demand for Section 202 housing is very high, with wait list times averaging a year or longer.1 Although eligibility for the Section 202 program is age specific, other HUD initiatives also serve seniors, including approximately 440,000 elderly families who receive housing choice vouchers, 492,000 elderly families who participate in the Project-Based Rental Assistance (Section 8) program, and 325,000 elderly individuals who live in public housing.2 In addition, in 2006 an estimated 30 percent of properties receiving low-income housing tax credits primarily served older residents, including 14 percent that were explicitly restricted to residents over age 55.3

HUD also stimulates the supply of assisted living units through the Assisted Living Conversion Program, which provides grants to private, nonprofit owners to convert some or all of a multifamily building into assisted or service-enriched housing. The exact level of assistance can vary from state to state, but HUD sets minimum standards for construction (requiring accessible bathrooms and a community kitchen and lounge or recreational facilities) and programming (requiring 24-hour crisis response staffing and the provision of three meals per day).4 In 2012, HUD awarded $26 million to 11 conversion projects in 9 states.5 Similarly, Section 231 of the National Housing Act allows HUD to insure mortgage loans for construction or rehabilitation of rental housing for elderly and disabled renters.6 Other Federal Housing Administration programs such as Mortgage Insurance for Rental and Cooperative Housing may also increase the supply of housing for seniors, although these are not age-specific programs.

A number of programs facilitate the coordination of services for residents of HUD-subsidized housing. The first of these programs, beginning in 1978, was the Congregate Housing Services Program (CHSP), which provided meals, transportation, and other services to frail residents of participating Section 202 and public housing developments. Legislation passed in 1990 specifically authorized the use of CHSP funds to hire service coordinators. Although no new contracts have been awarded under this program since 1995, some existing funds continue. CHSP has been eclipsed by the Service Coordinator program, through which owners of HUD-subsidized multifamily housing can hire a service coordinator to connect residents with services such as meals, transportation, housekeeping, and medication management. Service coordinators can be funded through competitive grants or from the property’s excess income or residual receipts. A separate program, the Resident Opportunity and Self-Sufficiency (ROSS) Service Coordinator program, offers similar services.7 A study of ROSS programs in Seattle shows evidence of reduced social isolation, increased likelihood of treatment for chronic conditions, and longer tenure for residents compared with those without ROSS services.8

HUD is engaged in ongoing efforts to evaluate its programs’ effectiveness at using housing as a platform to improve quality of life. For example, HUD is collaborating with the National Center for Health Statistics to match HUD’s administrative records for assisted renters with data from the annual National Health Interview Survey. This effort will, for the first time, make available reliable, nationally representative health statistics about health outcomes and health care access for assisted renters as well as disparities relative to other populations. This evidence will inform policy about cost-effective health interventions for assisted renters, allowing policymakers to better employ housing as a platform to improve quality of life while conserving public resources.

1. Melisa Vandawalker, Gretchen Locke, and Ken Lam. 2012. “Evaluation of the Section 202 Demonstration Predevelopment Grant Program,” Abt Associates and U.S. Department of Housing and Urban Development, 2.
2. U.S. Department of Housing  and Urban Development. 2012. “Public and Indian Housing: Tenant-Based Rental Assistance, 2013 Summary Statement and Initiatives,” and “Housing: Project-Based Rental Assistance, 2013 Summary Statement and Initiatives;” Shaun Donovan. 2011. Remarks at Leading Age Annual Washington DC Conference, 13 April.
3. Andrew Kochera. 2006. “Developing Appropriate Rental Housing for Low-Income Older Persons: A Survey of Section 202 and LIHTC Property Managers,” AARP Public Policy Data Digest 2.
4. Libby Perl. 2010. “Section 202 and Other HUD Rental Housing Programs for Low-Income Elderly Residents,” Congressional Research Services, 18–9.
5. U.S. Department of Housing and Urban Development. 2012. “HUD Awards $26 Million to Convert Apartments into Assisted Living or Service-Enriched Senior Housing,” 20 December press release.
6. U.S. Department of Housing  and Urban Development. 2013. “Mortgage Insurance for Rental Housing  for the Elderly: Section 231.”
7. Perl, 16–7.
8. Collin Siu. 2009. “Impacts of Nutrition and Human Services Interventions on the Health of Elderly and Disabled Persons in Public Housing,” Congressional Hunger Center, 18.