H U D   S E C T I O N   8 1 1   P R A

Project Rental Assistance Program

Six Case Studies on

the Implementation

Experience of the

2012 Grantees

U.S. Department of Housing and Urban Development | Office of Policy Development and Research

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H U D   S E C T I O N   8 1 1   P R A

Project Rental Assistance Program

Six Case Studies on

the Implementation

Experience of the

2012 Grantees

Prepared for

U.S. Department of Housing and Urban Development

Prepared by

Rebecca Northrop

Christopher Jones

Dalton Laluces

La Tonya Green

Kenya Crumel

BCT Partners

Melissa Vandawalker

Meghan Henry

Claudia Solari

Gretchen Locke

Jill Khadduri

Abt Associates

January 2018

Acknowledgments

Acknowledgments

This case study report is one of two major deliverables of the first phase of the evaluation of the Section 811 Project Rental Assistance program. We acknowledge the talented efforts of

many individuals who and organizations that have assisted in carrying out this work. These

organizations include the U.S. Department of Housing and Development, Technical Assistance

Col aborative, and Centers for Medicare and Medicaid Services.

We also acknowledge the assistance of the 811 Project Rental Assistance program grantees.

•  California Grantee Partnership—California Housing Finance Agency, California Department of Health Care Services, California Department of Housing and Community Development,

California Tax Credit Al ocation Committee, and California Department of Developmental

Services.

•  Louisiana Grantee Partnership—Louisiana Housing Corporation, Louisiana Housing

Authority, and Louisiana Department of Health.

•  Maryland Grantee Partnership—Maryland Department of Housing and Community

Development, Maryland Department of Health and Mental Hygiene, and Maryland

Department of Disabilities.

•  Minnesota Grantee Partnership—Minnesota Housing Finance Agency and Minnesota

Department of Human Services.

•  Pennsylvania Grantee—Pennsylvania Housing Finance Agency and Pennsylvania

Department of Human Services.

•  Washington Grantee Partnership—Washington Department of Commerce and Washington

State Department of Social and Health Services.

Disclaimer

The contents of this report represent the views of the authors and do not necessarily reflect the views or policies of the U.S.

Department of Housing and Urban Development or the U.S. government.

Contents

Contents

Executive Summary .............................................................................................................................ix

Background of the Section 811 Project Rental Assistance Program  ................................................ 1

The Section 811 and PRA Programs ................................................................................................................................ 1

Evaluation of the Section 811 PRA Program .................................................................................................................. 2

A Descriptive Overview of the Six Case Study States  ................................................................................................. 3

811 Program Designs ......................................................................................................................................................... 3

Housing Context ................................................................................................................................................................. 3

Services Context ................................................................................................................................................................. 7

How Does the Section 811 PRA Model Fit?  ................................................................................................................... 8

California Section 811 Project Rental Assistance Program...............................................................11

Introduction ........................................................................................................................................................................11

Grantee Partnership, Organizational Structure, and Management  .........................................................................11

Background Leading to the 2012 811 PRA Application .................................................................................................................12

Program Financial Structure  ..........................................................................................................................................................13

State Context: Housing Programs ................................................................................................................................. 13

Housing ............................................................................................................................................................................................13

Existing Programs  ..........................................................................................................................................................................14

How the 811 PRA Program Fits With Other State Programs .........................................................................................................15

How Major Housing Assistance Programs Are Used To Assist the Target Population ...............................................................15

Local Issues—Housing Affordability and the Rental Market ........................................................................................................15

Service Provision and Healthcare .................................................................................................................................. 16

Current Status of Service and Healthcare Programs That Support Community Living ..............................................................16

Recent Changes in Programs That Support Integrated Community Living  ................................................................................17

How the 811 PRA Program Fits With the Service and Healthcare Programs That Support Community Living .........................18

California’s Olmstead Plan ..............................................................................................................................................................18

Population Served ............................................................................................................................................................ 18

Comparison of Target Populations: Planned Versus Actual .........................................................................................................18

Skilled Nursing Facilities .................................................................................................................................................................18

Regional Centers .............................................................................................................................................................................18

Developmental Centers ...................................................................................................................................................................19

Outreach, Referral, and Application .............................................................................................................................. 19

Outreach, Referral, and Application Process .................................................................................................................................19

Target Population Screening and Eligibility ....................................................................................................................................19

Implications of Target Population and Outreach and Referral Methods ..................................................................................... 20

Housing Strategies ........................................................................................................................................................... 20

Property and Unit Characteristics  ................................................................................................................................................ 20

Property Selection Methods and Financing .................................................................................................................................. 21

Implementation Schedule .............................................................................................................................................................. 21

Rent and Subsidy Levels ................................................................................................................................................................ 21

Unit and Tenant Turnover ............................................................................................................................................................... 22

Service Provision and Coordination .............................................................................................................................. 22

Ongoing Services ........................................................................................................................................................................... 22

Coordination of Services and Housing ......................................................................................................................................... 22

Gaps in Services ............................................................................................................................................................................ 22

2013 811 PRA Application ................................................................................................................................................ 23

Leveraging ......................................................................................................................................................................... 23

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 23

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Successes and Challenges ............................................................................................................................................. 23

Factors Contributing to Program Success .................................................................................................................................... 23

811 PRA Program Challenges .........................................................................................................................................................24

Louisiana Section 811 Project Rental Assistance Program .............................................................. 27

Introduction ....................................................................................................................................................................... 27

Grantee Partnership, Organizational Structure, and Management ......................................................................... 27

Background .................................................................................................................................................................................... 27

Partnerships and Organizational Structure ................................................................................................................................... 27

Program Financial Structure .......................................................................................................................................................... 28

State Context: Housing Programs ................................................................................................................................. 29

Housing Policy ................................................................................................................................................................................ 29

Existing Programs .......................................................................................................................................................................... 29

Rental Housing Market ................................................................................................................................................................... 30

Service Provision and Healthcare .................................................................................................................................. 30

Policy ............................................................................................................................................................................................... 30

Recent Changes Supporting Community Living .......................................................................................................................... 30

Expansion of Medicaid 1915(c) HCBS Waivers .............................................................................................................................31

Olmstead Plans, Settlements, Consent Decrees ..........................................................................................................................31

Population Served ............................................................................................................................................................ 31

Outreach, Referral, and Application .............................................................................................................................. 32

Outreach, Referral, and Application Methods .............................................................................................................................. 32

Target Population Eligibility ............................................................................................................................................................ 32

Implications of Outreach, Referral, and Application Methods on Individuals Referred and Placed .......................................... 32

Housing Strategies ........................................................................................................................................................... 32

Property and Unit Characteristics ................................................................................................................................................. 32

Property Selection Methods and Financing .................................................................................................................................. 32

Property Selection Process ........................................................................................................................................................... 33

Implementation Schedule .............................................................................................................................................................. 33

Rent and Subsidy Levels ................................................................................................................................................................ 33

Unit Offers and Tenant Turnover .................................................................................................................................................... 33

Service Provision and Coordination .............................................................................................................................. 34

Service Models ............................................................................................................................................................................... 34

Coordination of Services and Housing ......................................................................................................................................... 34

Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps) .................................................................. 35

2013 811 PRA Application ................................................................................................................................................ 36

Leveraging ......................................................................................................................................................................... 36

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 36

Successes and Challenges ............................................................................................................................................. 36

Successes ...................................................................................................................................................................................... 36

Challenges ...................................................................................................................................................................................... 37

Maryland Section 811 Project Rental Assistance Program .............................................................. 39

Introduction ....................................................................................................................................................................... 39

Grantee Partnership, Organizational Structure, and Management ......................................................................... 39

Overview ......................................................................................................................................................................................... 39

Maryland Department of Housing and Community Development ............................................................................................... 39

Maryland Department of Health and Mental Hygiene .................................................................................................................. 39

Maryland Department of Disabilities ............................................................................................................................................. 40

Partnership ..................................................................................................................................................................................... 40

Design and Structure of Maryland’s 811 PRA Program ............................................................................................................... 40

811 PRA Roles and Responsibilities ...............................................................................................................................................41

Program Staffing ............................................................................................................................................................................ 42

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ntents

State Context: Housing Programs ................................................................................................................................. 42

Financing......................................................................................................................................................................................... 42

Supportive Housing Programs ...................................................................................................................................................... 43

Additional Federal Housing Programs .......................................................................................................................................... 44

Service Provision and Healthcare.................................................................................................................................................. 44

Funding ........................................................................................................................................................................................... 46

Olmstead Settlement ..................................................................................................................................................................... 46

Population Served ............................................................................................................................................................ 46

Outreach, Referral, and Application .............................................................................................................................. 47

Outreach ..........................................................................................................................................................................................47

Referral and Application ..................................................................................................................................................................47

Implications ..................................................................................................................................................................................... 48

Housing Strategies ........................................................................................................................................................... 48

Property and Unit Characteristics ................................................................................................................................................. 48

Rent and Subsidy Levels ................................................................................................................................................................ 49

Unit and Tenant Turnover ............................................................................................................................................................... 50

Service Provision and Coordination .............................................................................................................................. 50

Service Provision ............................................................................................................................................................................ 50

Coordination ................................................................................................................................................................................... 50

2013 811 PRA Application ................................................................................................................................................ 50

Leveraging ......................................................................................................................................................................... 51

Housing Choice Vouchers...............................................................................................................................................................51

Other Sources Leveraged ...............................................................................................................................................................51

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 51

Program Administration ..................................................................................................................................................................51

Financial Management ................................................................................................................................................................... 52

Information Systems ...................................................................................................................................................................... 52

Successes and Challenges ............................................................................................................................................. 52

Challenges ...................................................................................................................................................................................... 52

Successes ...................................................................................................................................................................................... 53

Minnesota Section 811 Project Rental Assistance Program  ........................................................... 55

Introduction ....................................................................................................................................................................... 55

Grantee Partnership, Organizational Structure, and Management ......................................................................... 55

Overview ......................................................................................................................................................................................... 55

Minnesota Housing Finance Agency ............................................................................................................................................. 55

Minnesota Department of Human Services .................................................................................................................................. 55

Minnesota Housing and Department of Human Services Partnership ....................................................................................... 56

Design and Structure of Minnesota’s 811 PRA Program .............................................................................................................. 56

811 PRA Roles and Responsibilities .............................................................................................................................................. 57

Program Funding ............................................................................................................................................................................ 58

State Context: Housing Programs ................................................................................................................................. 59

Housing Programs .......................................................................................................................................................................... 59

Rental Housing Market ................................................................................................................................................................... 60

Service Provision and Healthcare .................................................................................................................................. 61

Changes in Medicaid Resources ................................................................................................................................................... 62

Olmstead Settlement ..................................................................................................................................................................... 62

Population Served ............................................................................................................................................................ 62

Outreach, Referral, and Application .............................................................................................................................. 63

Outreach ......................................................................................................................................................................................... 63

MFP Outreach................................................................................................................................................................................. 63

PATH Long-Term Homelessness Outreach ................................................................................................................................... 64

Referral and Application ................................................................................................................................................................. 64

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ntents

Implications ..................................................................................................................................................................................... 64

Housing Strategies ........................................................................................................................................................... 65

Property and Unit Characteristics ................................................................................................................................................. 65

Determining the Initial Rent Level .................................................................................................................................................. 66

Unit and Tenant Turnover ............................................................................................................................................................... 67

Service Provision and Coordination .............................................................................................................................. 67

Service Provision ............................................................................................................................................................................ 67

Coordination of Services................................................................................................................................................................ 67

2013 811 PRA Application ................................................................................................................................................ 68

Leveraging ......................................................................................................................................................................... 68

Housing Choice Vouchers.............................................................................................................................................................. 68

Other Sources Leveraged .............................................................................................................................................................. 68

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 69

Program Administration ................................................................................................................................................................. 69

Financial Management ................................................................................................................................................................... 69

Information Systems ...................................................................................................................................................................... 69

Successes and Challenges ............................................................................................................................................. 70

Successes ...................................................................................................................................................................................... 70

Challenges .......................................................................................................................................................................................71

Pennsylvania Section 811 Project Rental Assistance Program  ....................................................... 73

Introduction ....................................................................................................................................................................... 73

Grantee Partnership, Organizational Structure, and Management ......................................................................... 73

Partnerships and Organizational Structure ................................................................................................................................... 73

Partnership Between PHFA and DHS ............................................................................................................................................74

State Context: Housing Programs ................................................................................................................................. 75

Housing ........................................................................................................................................................................................... 75

Service Provision and Healthcare .................................................................................................................................. 77

Policy and Funding: Prioritization of Medicaid Resources Toward Home- and Community-based Services .......................... 77

Existing Efforts ............................................................................................................................................................................... 78

Olmstead Plan and Settlements .................................................................................................................................................... 78

Population Served ............................................................................................................................................................ 79

Outreach, Referral, and Application .............................................................................................................................. 80

Housing Strategies ........................................................................................................................................................... 81

Property and Unit Characteristics  ................................................................................................................................................ 82

Property Selection Methods and Financing .................................................................................................................................. 82

Implementation Schedule  ............................................................................................................................................................. 82

Rent and Subsidy Levels ................................................................................................................................................................ 82

Unit and Tenant Turnover ............................................................................................................................................................... 83

Service Provision and Coordination .............................................................................................................................. 83

Service Models ............................................................................................................................................................................... 83

Coordination of Services and Housing ......................................................................................................................................... 83

Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps) .................................................................. 83

2013 811 PRA Application ................................................................................................................................................ 84

Leveraging ......................................................................................................................................................................... 84

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 84

PHFA Program Monitoring ............................................................................................................................................................. 84

DHS Program Monitoring ............................................................................................................................................................... 85

Successes  ......................................................................................................................................................................... 85

Strong Partnerships ....................................................................................................................................................................... 85

Leveraging Existing Programs ....................................................................................................................................................... 85

Challenges ......................................................................................................................................................................... 85

Securing One-Bedroom Units  ...................................................................................................................................................... 85

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ntents

Staff Turnover ................................................................................................................................................................................. 85

Breadth of Geographic Differences ............................................................................................................................................... 85

Shift in Housing Strategy ............................................................................................................................................................... 85

Washington Section 811 Project Rental Assistance Program  ......................................................... 87

Introduction ....................................................................................................................................................................... 87

Grantee Partnerships Organizational Structure, and Management ........................................................................ 87

Application Background  ................................................................................................................................................................ 87

Partnerships and Organizational Structure ................................................................................................................................... 87

Program Financial Structure  ......................................................................................................................................................... 88

State Context: Housing Programs ................................................................................................................................. 89

Housing Programs and Funding .................................................................................................................................................... 89

Existing Housing Programs That Serve People With Disabilities................................................................................................. 89

Additional Federal Housing Programs  ......................................................................................................................................... 91

How the 811 PRA Program Fits With Other State Housing Programs ......................................................................................... 91

Rental Housing Market ................................................................................................................................................................... 91

Service Provision and Healthcare .................................................................................................................................. 92

Current Status of Service and Healthcare Programs That Support Community Living ............................................................. 92

Washington’s Olmstead Plan ......................................................................................................................................................... 92

Local Issues: Homelessness ......................................................................................................................................................... 93

Population Served ............................................................................................................................................................ 93

Outreach, Referral, and Application .............................................................................................................................. 93

Participant Outreach and Referral Process .................................................................................................................................. 93

Participant Screening and Eligibility .............................................................................................................................................. 93

Referring 811 PRA Applicants to Available Units .......................................................................................................................... 94

Implications of Target Population and Outreach and Referral Methods ..................................................................................... 94

Housing Strategies ........................................................................................................................................................... 94

Property and Unit Characteristics  ................................................................................................................................................ 94

811 PRA Units at Channel Cove..................................................................................................................................................... 94

Property Selection Methods  ......................................................................................................................................................... 95

Implementation Schedule .............................................................................................................................................................. 96

Rent and Subsidy Levels ................................................................................................................................................................ 96

Unit and Tenant Turnover ............................................................................................................................................................... 96

Service Provision and Coordination .............................................................................................................................. 96

Transitional Services ...................................................................................................................................................................... 97

Gaps in Services ............................................................................................................................................................................ 97

2013 811 PRA Application ................................................................................................................................................ 97

Leveraging ......................................................................................................................................................................... 97

Program Administration, Assessment, Information Systems, and Data Infrastructure ....................................... 97

Successes and Challenges ............................................................................................................................................. 98

Program Successes and Replicable Innovations ......................................................................................................................... 98

Program Challenges ....................................................................................................................................................................... 98

References ......................................................................................................................................... 99

Additional Reading ........................................................................................................................... 101

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L

ist of Tables

List of Tables

Table 1.1:  Program Design in the Case Study States  ............................................................................................................... 4

Table 1.2:  Housing Context in the Case Study States ............................................................................................................... 5

Table 1.3:   Services Context in the Case Study States ............................................................................................................... 7

Table 2.1:   Agency Roles in the 811 PRA Program .....................................................................................................................12

Table 2.2:  California—Planned and Actual Time Spent on 811 PRA Program by Key Staff ....................................................13

Table 2.3:  California—Overview of Major Federal Housing Programs .....................................................................................16

Table 2.4:  Characteristics of Properties With 811 PRA Units ................................................................................................... 20

Table 3.1:   Louisiana Federal Housing Programs ...................................................................................................................... 30

Table 3.2:  Properties Under RAC or Application in Process .................................................................................................... 34

Table 3.3:  Louisiana 1915(c) HCBS Waivers ............................................................................................................................. 35

Table 4.1:   Maryland 811 PRA Program Division of Responsibilities .........................................................................................41

Table 4.2:  Other Federal Housing Programs in Maryland ........................................................................................................ 44

Table 4.3:  1915(c) Waivers (Home- and Community-Based Services) ................................................................................... 45

Table 4.4:  Average Rents in Baltimore (2012 Versus 2015) ...................................................................................................... 49

Table 4.5:  Average Rents in Washington, D.C. (2012 Versus 2015) ......................................................................................... 49

Table 4.6:  Leveraged Housing Choice Vouchers .......................................................................................................................51

Table 5.1:   Minnesota—811 PRA Program Division of Responsibilities ................................................................................... 57

Table 5.2:  Minnesota—Other Federal Programs ...................................................................................................................... 60

Table 5.3:  Minnesota—Services Available to 811 Project Rental Assistance Participants .................................................... 62

Table 6.1:  Pennsylvania—811 PRA Program Roles and Responsibilities ................................................................................ 74

Table 6.2:  Pennsylvania—Responsibilities of Local Lead Agencies and Stakeholders........................................................... 81

Table 7.1:   Washington State—Agency Roles in the 811 PRA Program ................................................................................... 88

Table 7.2:   Washington State—Overview of Major Federal Housing Programs ...................................................................... 91

Table 7.3:   Washington State—Rental Housing Markets .......................................................................................................... 92

Table 7.4:   Washington State—Characteristics of Properties With 811 PRA Rental Assistance Contracts ........................... 95

List of Figures

Figure 5.1: Minnesota—Average Market Rents in Twin Cities (2010–2015) .............................................................................. 61

Figure 5.2: Minnesota—Rental Vacancy Rates in Twin Cities (2010–2015) .............................................................................. 61

Figure 5.3: Minnesota—811 Project Rental Assistance Outreach ............................................................................................ 63

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Executive Summary

Executive Summary

•  How are successful state and local partnerships

structured to carry out the 811 PRA program?

•  How are outreach and marketing efforts designed

to support fair housing objectives and compliance,

provide tenant choice, and ensure efficient

This report presents case studies of six states’ early

occupancy policies for housing owners and

experiences implementing the Section 811 Project Rental

managers?

Assistance (811 PRA) program, a new approach to

providing affordable rental housing for extremely low-

•  How is the 811 PRA integrated with and adapted to

income people with disabilities. Beginning in 1991, the

state housing and service delivery systems operating

U.S. Department of Housing and Urban Development’s

in varied political, fiscal, and housing market

(HUD’s) Section 811 Supportive Housing for Persons with

contexts?

Disabilities program began providing capital grants to

•  What are the preliminary outcomes of the initial

develop and operate affordable housing with available

funding round?

supportive services—known as “supportive housing”—

The Phase I evaluation produced two major reports.

designed to meet the needs of nonelderly people with

This case study report presents detailed descriptions

disabilities. The program was referred to as the Section

of the early implementation experiences of six states

811 Project Rental Assistance Contract (PRAC) program,

funded in the initial funding round, with a focus on (1)

for the project-based rental assistance contracts that

the housing and services context in each state, (2) the

provided the subsidy to make the housing affordable.

partnerships developed to implement the 811 PRA

Traditional y, Section 811 developments housed only

program, and (3) the way in which the new program fits

people with disabilities, mainly in group homes or small

within these contexts. In addition, a process evaluation

apartment buildings in community-based settings.

report provides an aggregate summary of 811 PRA

In recent years, interest has increased in developing

implementation in all the states funded in the initial round

broader housing options for people with disabilities. This

of grants.

broader set of housing options includes opportunities

This case study report begins with a descriptive overview

for affordable units in housing that is not exclusively for

of the findings from the six states, fol owed by the six

people with disabilities. The Section 811 PRA program

case studies.

was created in 2010 and provides funding directly to

state housing finance agencies working in partnership

with state human services and Medicaid agencies to

test a different approach to the capital grants provided

under the Section 811 PRAC program. Instead of building

new housing specifical y for people with disabilities, the

811 PRA program provides subsidies for scattered-site

units in affordable housing developments (existing or

newly built) that are financed by other public or private

funding sources and occupied by a mix of people with

and without disabilities. Section 811 PRA-assisted units

are targeted to nonelderly people with disabilities who

are eligible for Medicaid’s home- and community-based

services or similar state-funded programs.

In February 2013, 12 state housing agencies and their

Medicaid agency partners received an inaugural round

of 811 PRA grants totaling $88.3 mil ion to provide rental

subsidies for approximately 3,350 housing units for

nonelderly people with disabilities. HUD’s Office of Policy

Development and Research subsequently commissioned

the first phase of a multiphase evaluation focused on

the initial round of 811 PRA grants. The evaluation’s

overarching research questions are—

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Chapter 1. Background of the Section 811 Project Rental Assistance Program

Background of the

The Frank Melville Supportive Housing Investment Act

of 2010 introduced a number of significant reforms to

Section 811 Project

the Section 811 program, including creating the PRA

program. The new program provides project-based

rental assistance for integrated supportive housing in

Rental Assistance

affordable housing developments with no more than 25

percent of units set aside for people with disabilities.

Program

The Act retained language permitting capital advances

for the development of group homes and other projects

specifically for people with disabilities, but no funds

were appropriated for these projects in fiscal years

2012 through 2014.

This report presents case studies of six states’

The 811 PRA program provides rental assistance

experiences implementing the Section 811 Project Rental

funding to state housing finance agencies that wil

Assistance (811 PRA) program, a new approach to

work in partnership with state human services and

providing affordable rental housing for extremely low-

Medicaid agencies to create community-based

income, nonelderly people with disabilities. This report

supportive housing. This approach responds to several

is one of two produced by the Phase I evaluation, which

policy priorities related to housing and support for

is focused on the first round of 811 PRA grants, awarded

people with disabilities. First, it responds to renewed

to 12 states in February 2013. This chapter provides a

emphasis on achieving the goals of the Supreme Court’s

brief history of the Section 811 and 811 PRA programs,

1999 decision in  Olmstead  v.  L.C.  to al ow people

describes the objectives and data sources for the case

with disabilities to live in the least restrictive settings

studies presented here, and provides a descriptive

possible that meet their needs and preferences. In

overview of the key features of the 811 PRA programs in

their decision, the Supreme Court ruled that, under

the states selected for the case study research. The six

Title II of the Americans with Disabilities Act, people

case studies fol ow in chapters 2 through 7.

with disabilities must be afforded opportunities to live

in a setting appropriate to their abilities, with freedom

The Section 811 and PRA Programs

to choose their daily life activities and to interact with

people without disabilities. As states and communities

Since 1991, HUD has administered the Section 811

have worked to implement the decision (sometimes in

Supportive Housing for Persons with Disabilities

response to litigation), the limited supply of affordable

program. The goal of the Section 811 program is to

and appropriate housing and supports in community-

expand the supply of supportive housing for very

based settings has been a significant challenge.

low-income people with disabilities. The program

traditional y awarded interest-free capital advances and

Second, the Olmstead decision encouraged state efforts

contracts for project-based rental assistance to nonprofit

to “rebalance” their Medicaid systems for providing

organizations to develop supportive housing (such as

long-term services and supports away from institutional

group homes and smal  rental housing developments)

settings such as nursing homes and toward housing

occupied by very low-income households of nonelderly

that is integrated within communities. Medicaid offers

adults with disabilities.1

community-based services to its beneficiaries through its

Home- and Community-Based Services (HCBS) program

The Section 811 supportive housing model provides

and other initiatives. These services help ensure that

residents affordable housing and access to appropriate,

people with disabilities have the services and supports

voluntary supportive services. Organizations that receive

they need to live successful y in the community. In

capital advances must develop a Supportive Services

particular, the Money Fol ows the Person (MFP) program,

Plan that addresses how tenant’s health, mental health,

administered by the Center for Medicare and Medicaid

and other needs will be met. Grantees must either

Services, is a major initiative that provides funding to

provide services directly or partner and coordinate with

many states to support transitions from institutions

service providers in the community to provide services

to community-based settings. The lack of affordable

and must ensure that services are available for the

housing has often constrained the program’s ability to

duration of the 40-year capital advance period.

move people to community settings.

1

Nonelderly adults are defined as adults under age 62. Disabilities may include a physical or developmental disability or chronic mental illness.

1

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Final y, the Affordable Care Act created or strengthened

•  What are the preliminary outcomes of the initial

a number of programs to expand community-based care,

funding round?

but, again, the lack of available affordable housing has

This case study report presents detailed descriptions

been a barrier to these efforts.

of the early implementation experiences of 6 of the

In order to apply for Section 811 PRA funds, state

12 states funded in the inaugural funding round, with

housing agencies must partner with the state agency

a focus on the housing and services context in each

responsible for the administration of the state’s Medicaid

state, the partnerships developed to implement the

program as well as the state health and human services

811 PRA program, and how the new program fits

agency (if different). A memorandum of agreement

within these contexts. In addition, a process evaluation

between the agencies, required as part of the grant

report provides an aggregate summary of 811 PRA

application, outlines the state Medicaid agency’s

implementation in all 12 states.

commitment to identifying and conducting outreach to

The case study research explored the implementation

the target population(s) to be served by the state’s 811

of the Section 811 PRA program in six states that had

PRA program and ensuring that residents are connected

made the most progress toward leasing units by summer

to appropriate supportive services.

2015 when the evaluation’s design phase concluded. The

Congress appropriated funds for the 811 PRA program

research team also considered geographic distribution

in fiscal years 2012, 2013, and 2014, with language that

and program design features such as expected

identifies the 2012 funding round as a demonstration

partnership structures, target populations, and service

round. HUD issued an initial Notice of Funding Availability

funding mechanisms. The case study research focuses on

(NOFA) for a demonstration round of 811 PRA grants

the state context within which the 811 PRA is implemented

in 2012. In February 2013, 13 states were selected to

and addresses the following research questions.

receive 811 PRA grants totaling $98 mil ion to provide

•  What is the programmatic and fiscal context in which

subsidies for an estimated 3,350 units. By early 2015,

the Section 811 PRA program is implemented?

12 grantees had executed cooperative agreements with

HUD to implement the program under its first funding

•  How does the Section 811 PRA program fit in the

round to provide subsidies for an estimated 2,625 units.

states’ existing long-term care systems and initiatives

HUD awarded a second round of funding in March 2015

to support community-based housing?

under a combined NOFA for fiscal years 2013 and 2014.

•  How does the 811 PRA program fit into a state’s

Round 2 PRA funding was awarded to 25 state housing

Olmstead plan or settlement agreement (if applicable)

agencies for approximately $150 mil ion.

or plan to end homelessness?

Evaluation of the Section 811 PRA

•  How does the Section 811 PRA program model

complement other state strategies and models to

Program

house and provide services to very low-income,

nonelderly adults with disabilities, and how do these

This report is one of two major reports produced for an

models vary by different populations? What have

evaluation of the initial round of 811 PRA grants. HUD’s

been the chal enges and successes of leasing up

Office of Policy Development and Research issued a

Section 811 PRA units, moving residents into units,

contract to a research team from BCT Partners and Abt

and providing services and supports?

Associates to carry out the evaluation. The evaluation’s

overarching research questions are—

•  What measures and research approaches could

be used to assess the effectiveness of Section 811

•  How are successful state and local partnerships

PRA program compared with alternative supportive

structured to carry out the 811 PRA program?

housing options for the target populations?

•  How are outreach and marketing efforts designed

In consultation with HUD and its 811 PRA technical

to support fair housing objectives and compliance,

assistance providers, the research team selected the

provide tenant choice, and ensure efficient

fol owing six states for the case study research:

occupancy policies for housing owners and

managers?

•  California

•  How is the 811 PRA program integrated with and

•  Louisiana

adapted to state housing and service delivery

•  Maryland

systems operating in varied political, fiscal, and

housing market contexts?

•  Minnesota

2

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

•  Pennsylvania

several agencies, as shown in table 1.1, because the

•  Washington

housing and services functions necessary to carry out

the 811 PRA program reside in multiple agencies.

The research team reviewed grant applications, the

cooperative agreements executed between HUD and

Table 1.1 highlights the number of units and geographic

the state partners in each state, grantee and partner

scope of the 811 PRA program in each state at the time

websites, and grantees’ quarterly performance

of grant award (February 2013). The case studies discuss

reports as submitted to HUD. The team also obtained

in more detail how program partners worked together to

administrative data from HUD’s data systems—the

define the scope of the 811 PRA program, and their early

Integrated Real Estate Management System (iREMS)

experiences with the effort required to put the program

for data on the characteristics of 811 PRA-assisted

in place.

properties and units; and the Tenant Rental Assistance

Table 1.1 previews the extent to which the 811 PRA

Certification System (TRACS) for the characteristics of

built on or supplemented existing initiatives to provide

811 PRA-assisted households.

housing and services for nonelderly people with

In October and November 2015, two-person research

disabilities. As described in the case studies, in some

teams from BCT Partners and Abt Associates conducted

states the 811 PRA blended well with existing programs

field visits to each of the six states to interview grantee

while in others it differed from those programs and

representatives and their partners. The teams spent an

served to supplement them. The table provides an

average of 4 days in each state. The teams conducted

overview of the states’ approaches to 811 PRA program

in-person interviews (with telephone followup as needed)

targeting and to outreach and referral processes. Each

using standardized semi-structured interview guides,

case study provides additional details on how partners

tailored to the state’s 811 PRA program design and

reached these program design decisions and what their

partners. The interview guides (as reviewed and approved

experience had been with the processes as designed.

by the Office of Management and Budget) are attached in

Final y, table 1.1 notes the number of units under Rental

appendices F, G, and H. Interview respondents included

Assistance Contract (RAC) and the number of 811 PRA

representatives of the state housing and Medicaid

participants housed as of December 2015, based on

agencies, referral agencies, service providers, and

grantees’ quarterly reports. The case studies describe

property managers. In states with occupied PRA units,

the reasons behind the states’ modest production

the teams had informal conversations with PRA-assisted

numbers and review the states’ strategies to address the

residents, when convenient.

challenges they encountered.

A Descriptive Overview of the Six

Housing Context

Case Study States

The Section 811 PRA program seeks to expand access

The following sections provide a brief, descriptive

to affordable housing for people with disabilities by

overview of the 811 PRA program in the six states

providing subsidies for units in affordable housing

included in the case study research. Full case studies for

developments built with other funding sources.

these six states are included in appendices. The text and

Properties can be newly built or existing multifamily

tables here first provide an overview of the states’ 811

developments in which the development costs are

PRA program designs. We then present a brief summary

subsidized by federal sources such as Low-Income

of the findings for the topic areas that were specific to the

Housing Tax Credits (LIHTCs), HOME Investment

case study research, such as the housing and services

Partnerships Program funds, the Community

context within each state; and how the 811 PRA fit within

Development Block Grant (CDBG) program, or other

that state context. The Process Evaluation Report will

federal, state, or private sources. HUD also encouraged

provide a descriptive overview of all 12 states funded in

states to leverage additional affordable units for 811

the fiscal year 2012 grant awards.

PRA participants through dedicated set-asides of public

housing or housing choice vouchers.

811 Program Designs

Grantees determined their request for 811 PRA funds

by calculating an expected average per-unit PRA rental

HUD required at a minimum that applicants for 811

assistance payment based on either the targeted income

PRA funding develop a memorandum of understanding

of the households living in PRA units (for example, 30

between the state housing and Medicaid agency

percent of Area Median Income [AMI]) or local Fair

partners. In some states, the partnerships involved

3

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Table 1.1: Program Design in the C ase S tudy S t ates

Program Design

California

Louisiana

Maryland

Minnesota

Pennsylvania

Washington

California Housing

Maryland Depart-

Finance Agency,

ment of Housing

Pennsylvania Housing  Washington Dept.

California Tax Credit

and Community

Finance Agency,

of Commerce, Dept.

Allocation Commit-

Development, Dept.

Louisiana Housing

Minnesota Housing

Department of

of Social and Health

tee, Department of

of Health and Mental

Corporation and

Finance Agency;

Human Services.

Services. Housing

Partners

Housing and Com-

Hygiene, Dept. of

Dept. of Health and

Department of

Decentralized,

Finance Agency and

munity Development;

Developmental Dis-

Hospitals.

Human Services

county-based system  State Health Care

Dept. of Health Care

abilities. Centers for

served by local lead

Authority (Medicaid)

Services, Dept.

Independent Living

agencies.

play small roles.

of Developmental

may provide case

Services

management.

200 units 34 regions

Number of 811 PRA

200 units in central

150 units in Balti-

95 units statewide

(58 of 67 counties);

units and geographic  335 units statewide

and northern Lou-

more and Washing-

with initial focus on

275 units statewide

started with pilot in

scope

isiana

ton, D.C. metro areas Twin Cities

one county

Built on two previous

Built on Bridges

programs—Bridge

Rental Assistance

Subsidy Program—

Program as well

Modeled PRA on

Department of Social

temporary tenant-

as Olmstead plan,

existing Rental Sub-

and Health Services

Built on PSH program  based rental subsi-

MFP, and Plan to

Agencies had not

sidy Fund program.

had worked with

developed in 2007

dies for people with

End Homelessness.

worked together

Pennsylvania Housing  housing authori-

Previous experience

response to 2005

disabilities until they

Several existing

previously. Each

Finance Agency

ties on vouchers

with housing and

hurricanes. State

can obtain a Housing

programs targeting

had experience with

uses developer

for people with

services for people

hopes to use 811

Choice Voucher; also

homeless with

housing with services

fees to create units

disabilities. Already

with disabilities

PRA to expand

Weinberg Apartments  severe mental illness

but not for institu-

affordable at or

had outreach/referral

beyond coastal

program targeting tax  (operating support

tionalized population.

below 20 percent of

mechanisms for insti-

areas.

credits for apartments  for PSH, income

AMI for people with

tution-to-community

affordable to people

supplements, crisis

disabilities.

transitions.

with disabilities with

financial assistance

incomes at 15 to 30

for people who are

percent of AMI.

homeless or at-risk.)

Waiver clients with

Institutionalized or at  developmental

Institutionalized or at

Long-term homeless

risk; in congregate

disabilities, mental

risk; focus on people

Institutionalized or

Inappropriately insti-

with severe mental

setting and prefer

illness or functional

with developmental

at risk; Medicaid

811 PRA targeting

tutionalized or at risk;

illness; MFP par-

community setting.

disabilities; and MFP

disabilities because

recipients who are

homeless or at risk

ticipants exiting an

Local lead agencies

participants. Online

of developmental

homeless.

institution.

may have additional

assessment tools for

center closures.

targeting.

determining eligibility

and service needs.

Case managers

Regional Tenant

screen applicants,

PATH and MFP

Online assessment

Referral Organiza-

enter info into a cen-

staff do outreach.

tools for eligibility

tions (one for MFP;

Central outreach

tral PRA system that

Housing coordinator

Local lead agencies

and service needs.

one for developmen-

through PSH program  also tracks available

at Department of

serve as single point

Regional housing

811 PRA referral

tally disabled pop-

office. Waitlists by

units. Department of

Human Services

of contact for service  specialist keeps

process

ulation) administer

parish; referrals

Disabilities manages

manages waitlist,

providers, landlords,

regional waiting lists,

waitlists. Owners

to units tracked by

waitlist, which

matches referrals

applicant intake.

makes referrals of

partner with tenant

parish.

includes applicants

to available units,

eligible applicants to

referral organizations

for Weinberg and

and ensures service

available units.

for referrals.

Bridge Subsidy

coordination.

Programs.

811 PRA implemen-

78 units under RAC;

34 units under RAC;

13 units under RAC;

67 units under RAC,

2 units under RAC, 1  32 units under RAC;

tation status as of

28 housed.

7 housed

4 housed

1 housed

housed

11 housed

December 2015

AMI = Area Median Income. MFP =Money Follows the Person. PATH = Projects for Assistance in Transition from Homelessness. PRA = Project Rental Assistance. PSH = Permanent Supportive Housing. RAC = Rental Assistance Contract.

4

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Market Rents (FMRs) for cities where PRA units are

RAC provides funding for 5 years. The use restriction

expected to be located. HUD encouraged applicants for

and renewal funding are contingent on continued

811 PRA funding to propose cost-effective use of grant

Section 811 appropriations. To ensure that community

funds by proposing rents lower than FMRs. Grantees

integration goals are achieved under the 811 PRA

were awarded points for proposing initial rents that are

program, the Section 811 statute specifies that no more

affordable to households with incomes between 20 and

than 25 percent of the units in the affordable housing

50 percent of AMI, with higher points corresponding to

development can be set aside for supportive housing or

lower percentages of AMI.

have an occupancy preference for people with disabilities.

Among the six case study states, four (California,

The 811 PRA program is expected to supplement other

Minnesota, Pennsylvania, and Washington) initial y

housing programs for people with disabilities. The case

targeted units at 50 percent of AMI. The remaining two

studies provide the number of units funded through the

states (Louisiana and Maryland) targeted units at FMR.

common federal y funded affordable housing programs

The estimated monthly rental assistance amount (as

(public housing, housing choice vouchers, and other

established in the cooperative agreement with HUD)

HUD-assisted multifamily programs) in each state. Table

ranged from $589 per unit in Washington to $1,235 per

1.2 notes some of the other funding mechanisms the

unit in Maryland.

six case study states are using to provide supportive

Property owners must commit to a 30-year use restriction

housing for people with disabilities, including leveraged

to provide a specified number of supportive housing

public housing units and housing choice vouchers.

units for nonelderly people with disabilities, and to

Table 1.2 also identifies two key topic areas in which the

a contract with HUD for at least 20 years. The initial

case study states encountered chal enges. First, several

Table 1.2 : Housing C ontex t in the C ase S tudy S t ates

Housing Context

California

Louisiana

Maryland

Minnesota

Pennsylvania

Washington

QAP points to projects

No. Tax credit owners

with 5–10 percent

can apply for 811

No, but eligible

of units set aside for

No, but QAP does

No, but QAP incen-

No, but QAP incen-

PRA. QAP incentives

QAP priorities for

properties with Tax

PSH-eligible people.

favor projects afford-

tives for supportive

tives for supportive

are for special needs

811 PRA

Credits can apply for  Starting in 2017, QAP  able at or below 60

housing in general.

housing in general.

populations in gen-

811 PRA

points for 25 percent

percent of AMI.

eral, up to 75 percent

of units set aside for

set-asides.

PRA program.

811 PRA leveraged

Department of Com-

Bond-funded

151 vouchers or

merce manages five

program with

public housing units

programs that provide

priority points for

from six housing

housing for people

811 PRA and two

811 PRA leveraged

authorities. State

with disabilities

other supportive

60 vouchers through  Rental Subsidy Fund  (capital financing

housing financing

811 PRA leveraged

two housing author-

serves broader target  and rental subsidies.)

programs. One

811 PRA leveraged

97 housing choice

ities. Bridges Rental

population, but similar  State Housing Trust

capital and operating  125 vouchers from

vouchers. Depart-

Assistance Program

approach to 811 PRA.  Fund supports

funding program for

three housing author- ment of Housing and

(see previous

Supportive housing

affordable housing for

Other supportive

homeless/at risk

ities. PSH and 811

Community Devel-

section). Housing

funded through

people with special

housing for people

with severe mental

PRA largely targeted

opment operates a

Trust Fund, Housing

various homeless

needs of all ages.

with disabilities

illness. California

to properties with tax  homeownership pro-

Infrastructure Bonds,  assistance programs.  Housing Finance

Tax California Credit

credits and HOME

gram, bridge subsidy,  and Ending Long-

Nursing Home Tran-

Agency finances mul-

Allocation Committee  Investment Partner-

and rental housing

term Homelessness

sition serves some

tifamily housing with

has priority for

ships Program.

programs for people

initiatives al  focus

nonelderly, but pri-

incentives to develop

projects serving

with disabilities.

on supportive

marily elderly people.  supportive housing

homeless and a

housing for long-term  Medicaid managed

for people with

4-percent set-aside

homeless.

care contractors

disabilities. Supportive

for projects with 50

using reinvestment

housing through vari-

percent set-aside for

dollars to develop

ous federal homeless

special needs.

supportive housing.

assistance programs.

(cont)

5

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Table 1.2 : Housing C ontex t in the C ase S tudy S t ates ( cont )

Housing Context

California

Louisiana

Maryland

Minnesota

Pennsylvania

Washington

Owner interest

PRA rent projections

reported to be key

were based on

challenge in first year

“blended rent maxi-

Owner interest less

Several state

of 811 PRA. Owners

mum” that assumes

than expected.

programs are incom-

unfamiliar with the

an even distribution

Shortage of prop-

patible with PRA

Housing Finance

program; wary of

of units in Baltimore

erties with available

because of PRA’s

Agency doing extra

30-year use restric-

and Washington.

one-bedroom units;

25-percent cap

outreach to owners,

tion with only 5 years

State had to provide

Have been pretty

some properties

on units for people

many of whom

of rental subsidy.

extra education and

accurate so far. To

already have more

with disabilities in

are wary. 30-year

Some properties

Owner interest in

outreach to encour-

reassure owners,

than 25 percent ten-

a single project.

use restriction and

incompatible because

811 PRA

age owners in new

MFP contributed $1m

ants with disabilities.

Owner outreach has

20-year RAC with

of 25-percent cap;

(noncoastal) regions

in rebalancing funds

Owners deterred

been challenging but

only a 5-year PRA

state’s targeted rent

to apply for 811 PRA.  to be held in trust by

because Penn-

viewed as necessary

funding commitment

levels for PRA units

Department of Hous-

sylvania targeted

and successful. State

seems risky to many

are low relative to

ing and Community

affordability at 50

tried to streamline

owners.

high-cost markets.

Development to fund

percent of AMI and

application process

Department of Com-

housing subsidy for

an average monthly

for owners.

merce has stream-

up to 6 months if PRA

rent level of $678.

lined application

funding is no longer

and done additional

funded by HUD.

outreach to owners.

Difficult to develop

and attract properties

at state’s targeted

Very expensive

rent levels for PRA

Washington’s targeted

markets; lack of

units. In population

rent levels for 811

state resources for

Washington and Bal-

hubs with access to

PRA units are per-

Relatively high rental

affordable housing,

timore rental markets  transportation and

ceived to be low given

vacancy rate in state,

Housing market

especially after 2008

too hot to attract

services, excluding

high-cost markets

but rents are still

issues

crash/recession.

owners at Maryland’s  those already at

in Washington. Low

escalating, even out-

Rent levels targeted

targeted rent levels

or above 25-per-

vacancy rates mean

side New Orleans.

for PRA units are low

for PRA units.

cent PRA limit for

few units available for

compared with other

households with

811 PRA occupancy

subsidy programs.

disabilities. These

in the near term.

properties are a

small percent of the

state’s portfolio.

AMI = Area Median Income. MFP =Money Follows the Person. PRA = Project Rental Assistance. PSH = Permanent Supportive Housing. QAP = Qualified Allocation Plan. RAC = Rental Assistance Contract.

states found it challenging to engage property owners’

lack of one-bedroom apartments in some markets

and developers’ interest in the new 811 PRA program.

made it difficult to find appropriate units, given most

The financing mechanism and administrative processes

PRA participants are expected to be small households.

for the new program were unfamiliar to developers. Some

The 25-percent cap on units occupied by persons with

were wary of the 30-year use restriction and 20-year

disabilities was also an issue in some states where

contract term with only 5 years of rental subsidy. Further,

otherwise-eligible properties already had a larger

the requirement that contract rents be capped at the

proportion of units occupied by people with disabilities.

area’s FMR, or at lower rent levels in some grants, was a

Finding units at the states’ target rents for PRA units

particular concern for developers and owners in costlier

(as proposed in their funding applications and finalized

urban areas.

in their cooperative agreements with HUD) proved

Second, a variety of housing supply and market

chal enging in some markets with tight rental markets,

conditions also influenced owner and developer interest

subsidy programs with higher target rents, or both.

in the PRA program. Interview respondents noted a

6

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Services Context

participants. All six states had waivers (usual y more than

one) under Medicaid’s 1915(c) HCBS program. Some

The 811 PRA program targets extremely low-income

states also had resources through 1915(i) or 1115

households with disabilities that are currently

waivers, or through state-funded programs (KFF, 2011).2,3

living in institutions, are homeless, or are at risk of

Table 1.3 also notes whether and how states’ efforts

institutionalization or homelessness. Participants in the

around Olmstead settlements and plans to address

811 PRA program must also be eligible for community–

homelessness informed 811 PRA implementation.

based long-term care services provided under the state’s

Medicaid program. Medicaid cannot pay for housing,

Notably, Maryland and Washington have each used MFP

but it can pay for medical, mental health, and other

rebalancing efforts in ways that support the 811 PRA. To

services and supports that people with disabilities need

reassure owners interested in the 811 PRA, Maryland’s

to maintain their health and, for 811 PRA participants,

MFP program contributed $1 mil ion in rebalancing funds

live stably in a community-based setting. Long-term

to be held in trust by the state housing agency. The funds

care services may be provided under Medicaid waivers,

will be used to fund housing subsidy payments for 811

Medicaid state plan options, or other comparable

PRA participants for up to 6 months if HUD PRA funding

programs that fund long-term services.

is interrupted or discontinued. In Washington, MFP

rebalancing funds were al ocated to create a temporary

Table 1.3 summarizes the funding sources the six case

rental subsidy program for people transitioning from

study states had available for services for 811 PRA

institutions to the community. People reaching the end of

Table 1.3 : Ser vices C ontex t in the C ase S tudy S t ates

Services Context

California

Louisiana

Maryland

Minnesota

Pennsylvania

Washington

1915c for Housing

Stabilization and

Waivers—Community  1915c waivers for

Housing Transition or

1915c waivers for

Two 1915(c) waivers

Nine 1915c waiver

Pathways (develop-

developmental dis-

Medicaid waiver

Crisis Intervention;

intellectual disabilities  for people with

programs; two

mental disabilities);

abilities, brain injury

programs expected

four 1915c waivers

supports and ser-

functional disabilities;

specifically for people

Brain Injury; Medical

1915(i) for mental

to serve 811 PRA

for adults (two for

vices; Adult Autism

five HCBS waivers

with developmental

Day Care; Home and

health population;

participants

people with develop-

Waiver; and HCBS for  for developmental

disabilities.

Community Based

proposed tenancy

mental disabilities,

physical disabilities.

disabilities.

Options.

supports.

two for physical

disabilities).

MFP plus state-

funded supplement to

MFP. Under state

MFP program. Medic-

plan, Community First

aid rebalancing funds

MFP. Three state-

MFP. Health Homes

1915i SPA for

Choice to consolidate

1915i (managed

allocated to create

funded services

Other Medicaid or

starting in 2017. 1115  behavioral health

three previous waiv-

care), MFP, Nursing

temporary rental

programs for mental

state programs for

renewal proposed

includes services or

ers for adults with

Home Transition,

subsidy program for

health (two) and

811 PRA participants

to have tenancy

skill building to get or  disabilities; Balancing

state block grants to

people transitioning

homeless (one)

supports services.

keep housing.

Incentive Program to

counties

from institution to

populations.

supplement MFP and

community. Under

augment HCBS.

state plan—Com-

munity First Choice,

private duty nursing.

(cont)

2

States can offer a variety of services under a State Plan HCBS benefit. Section 1915(i) of the Social Security Act provides federal guidelines under which states can develop HCBS benefits to meet the specific needs of target population(s). Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to waive provisions of major health and welfare programs authorized under the act, including certain Medicaid requirements, and to enable states to use federal Medicaid funds in ways that are not otherwise allowed by federal rules.

3  For descriptions of these programs and other Medicaid waivers, see https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/

Waivers/Waivers.html or http://www.nhpf.org/uploads/Handouts/HCBStable_FS_09-27-13.pdf.

7

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 1. Background of the Section 811 Project Rental Assistance Program

Table 1.3 : Ser vices C ontex t in the C ase S tudy S t ates ( cont )

Services Context

California

Louisiana

Maryland

Minnesota

Pennsylvania

Washington

Rebalancing efforts

predate Olmstead

Olmstead plan (2011)  (early 1990s). Olm-

No Olmstead

Have Olmstead

focused on mental

stead plan (2005).

settlements or plans,  plan and Plan to

health population—

Greater focus on

State has a Ten-Year  but a statewide

No Olmstead consent

End Homelessness.

diversion/transition

homelessness than

Plan to End Home-

commission works

decrees, but lawsuits

Olmstead case set-

from state hospitals.

on people with

State Olmstead or

lessness and a class

on community

against City of Los

tlement plan (2015)

Three settlement

disabilities more

homeless plans

action lawsuit under

integration. Baltimore

Angeles. Olmstead

increases number

agreements (two

broadly. 10-Year Plan

Olmstead (Barthe-

settlement requires

plan (2003).

served in commu-

psychiatric hospital

To End Homeless-

lemy).

city to provide

nity settings by 92

populations; one

ness (2006–2015)

vouchers to people

percent.

developmental dis-

set aggressive tar-

with disabilities.

abilities population)

gets. Some progress,

but not as much as

hoped.

HCBS = home- and community-based services. MFP = Money Follows the Person. PRA = Project Rental Assistance.

the 24-month limit on the temporary subsidy are among

populations. These populations were not targeted in

those who may be served in the 811 PRA program. The

the state’s initial 811 PRA grant, but are the focus of

case studies describe the details of these rebalancing

their second-round grant.

initiatives and other innovative approaches.

•  Louisiana’s 811 PRA program builds on the state’s

How Does the Section 811 PRA Model

existing Permanent Supportive Housing (PSH)

program, an initiative to provide affordable supportive

Fit?

housing to people with special needs in the wake

of the 2005 hurricanes in New Orleans and the

The Section 811 PRA program is a new approach to

surrounding coastal region. Although the state has a

providing affordable supportive housing for nonelderly

number of housing and services resources to support

people with disabilities; the initial funding round was

the 811 PRA program, the state’s goal of expanding

considered a demonstration that would inform efforts to

the geographic reach of the PSH program to other

refine the model in future funding rounds. A key question

parts of the state has been chal enging due to low

for the case study research was how 811 PRA model

program rents and owners who are unfamiliar with the

would “fit” in the context of other federal- and state-

program and the population.

supported affordable housing efforts for this population.

•  Maryland’s 811 PRA builds on wel -established

The six case study states provide a range of

partnerships and programs, and the state’s waiver

experiences with integrating 811 PRA in their housing

programs are wel -aligned with the 811 PRA target

and services contexts.

populations. The state has established a centralized

•  California’s 811 PRA addresses important housing

and integrated online system (using the SocialServ

needs but supplements the other efforts rather than

platform) for applications and referrals and for

integrating with them. The 811 PRA’s 25-percent

monitoring unit availability. The system combines

limit on the proportion of units occupied by people

applicants for the 811 PRA program with those for

with disabilities makes it incompatible with several

two other state programs serving similar populations.

other state programs serving similar populations.4

Although efficient, the combined system may make

Further, in general, California’s current policy

it difficult to distinguish 811 PRA outcomes from the

priorities focus on homeless and mental health

other programs tracked in the same system.

4

The section titled How the 811 PRA Program Fits With Other State Programs of this report details how the 25-percent cap on targeted units within the 811 PRA program makes the program incompatible with other existing housing efforts serving similar populations.

8

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Cha

pter 1. Background of the Section 811 Project Rental Assistance Program

•  Minnesota is building on an extensive history of

collaboration between the state’s housing and

Medicaid agencies. Minnesota’s proposed 811 PRA

rents are lower than rents in other state affordable

housing programs, but the grantee circumvented

that challenge by identifying units within the existing

portfolio with rents limited to 50 percent AMI, which is

below average rents in the metro area. However, the

811 PRA program’s 25-percent limit on the proportion

of units al ocated to people with disabilities is viewed

as a barrier because many properties would exceed

this limit if they participated in the program.

•  Pennsylvania proposed a 200-unit 811 PRA program

that would operate nearly statewide, using a

decentralized, county-based approach. It would build

on an existing state program that provided incentives

to developers to build housing for extremely low-

income people with disabilities. At the time of the

field visit in fall 2015, a pilot effort in one county was

just getting under way. It was too early to tell how

the 811 PRA would fit in the housing and services

context in Pennsylvania.

•  Washington’s 811 PRA program supplements and fil s

gaps in existing state programs. It specifical y targets

nonelderly people with disabilities in institutions

or at risk of institutionalization, a population not

otherwise targeted by state programs. It provides

assistance in integrated settings, unlike other state

housing programs where up to 75 percent of units

may be occupied by people with special needs.

Final y, the 811 PRA provides long-term subsidies,

positioning it as a next step for people with disabilities

who participate in Washington’s two short-term (2

years) rental subsidy programs that serve people

with disabilities. However, owner interest has been

limited so far, primarily due to concerns about low

rents in high-cost areas with strong rental markets.

Although the grantee selected the maximum rent level

it could set for the funding application, it happens to

have the lowest level of rent for all six case studies.

Washington eventual y requested and received from

HUD a waiver al owing units to rent at FMR or 50

percent AMI, whichever is higher.

9

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

10

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

California Section

Established in 1975, CalHFA initial y provided

administration for project-based Section 8 housing in

811 Project Rental

California. The agency’s role later expanded to become

the state’s affordable mortgage lender by making low-

interest loans through the sale of tax-exempt bonds.

Assistance Program

CalHFA also provides downpayment assistance for low-

to moderate-income homebuyers; provides financing

in the form of low-interest loans for the preservation,

acquisition, and rehabilitation of affordable housing;

and administers the 811 PRA program. CalHFA is a

Introduction

self-supporting state agency, supported by revenues

generated through mortgage loans, not taxpayer dollars.

HUD awarded the California Housing Finance Agency

CalHFA’s ongoing program responsibilities are

(CalHFA) with $12,208,558 in Section 811 Project

developing, executing, and administering the RACs with

Rental Assistance program funding in the 2012 funding

owners, including procuring the 811 PRA funds from

round. CalHFA partners with four other state agencies

HUD; ensuring payments are made to owners; and

to administer the program. The 811 PRA funding will

reviewing tenant data submitted to HUD. Agency staff

support rental subsidies for up to 241 units of affordable

review owner applications for rental assistance funding

housing for extremely low-income persons with

under the 811 PRA program. CalHFA asset management

disabilities. Individuals eligible for 811 PRA subsidies

staff are also responsible for monitoring ongoing

are persons who are eligible for Medicaid, between the

compliance of owners through annual occupancy reviews

ages of 18 and 61 at the time of initial occupancy, and

and unit inspections. As the grantee, CalHFA monitors

either reside in long-term institutional care settings and

the performance of its partners and submits quarterly

wish to return to community living or are at risk of being

reports to HUD.

institutionalized. Owners of state-funded affordable

The HCD provides funding for the development and

housing developments partner with local service

rehabilitation of affordable housing through multiple state

providers to apply for 811 PRA funding and ensure

and Federal funding programs. HCD administers the

residents are connected to the health and supportive

state’s CDBG, HOME, and Emergency Solutions Grants

services they need.

programs. HCD staff played a large role in developing the

Evaluators conducted a site visit in November 2015

initial 811 PRA program and the 2012 and 2013 funding

to learn how the five agencies were implementing the

applications. HCD staff also developed the NOFA for

811 PRA program. At the time of the visit, CalHFA had

property owners and the funding application review

awarded rental assistance of $2,707,916 to the property

process. Along with DHCS staff, HCD has performed

owners of four different developments for a total of 78

much of the marketing and outreach to property owners

811 PRA units. Of the 12 811 PRA grantees who received

to solicit 811 PRA program interest.

2012 funding awards, California was the first state to

The TCAC administers federal and state LIHTC

have occupied 811 PRA units; at the time of the site visit,

programs. Although the 811 PRA program is not a priority

19 residents were living in 811 PRA units.

under the state’s Qualified Al ocation Plan (QAP) for tax

Grantee Partnership, Organizational

credits, eligible properties awarded tax credits can apply

for rental assistance under the 811 PRA program. All 811

Structure, and Management

PRA units under contract to date are in LIHTC-funded

CalHFA partnered with the California Department of

properties. TCAC staff contributed to 811 PRA program

Health Care Services (DHCS) (a department within

development and its application and currently helps

the California Health and Human Services [CHHS]

review owner applications. Committee staff also monitor

Agency), the California Department of Housing and

TCAC-funded properties for tax credit compliance.

Community Development (HCD), and the California

The DHCS and the DDS are departments under the

Tax Credit Al ocation Committee (TCAC) to apply for

13-department CHHS Agency. CHHS provides a broad

811 PRA program funding. Together, with the California

range of health, mental health, and social services to

Department of Developmental Services (DDS), which

state residents. DHCS operates Medi-Cal, California’s

became a partner after grant award, these five agencies

Medicaid program, and oversees the California

jointly administer the program and meet biweekly to

Community Transitions (CCT) Project, the state’s MFP

coordinate and resolve program issues.

Rebalancing Demonstration for persons with disabilities

11

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

exiting from institutions. DDS provides administrative

Background Leading to the 2012 811 PRA

oversight to 21 statewide, nonprofit organizations

Application

cal ed regional centers. These regional centers operate

Due to the economic recession in the 2000s, California

California’s Medicaid waivers and state plan services for

experienced a budget crisis between 2008 and

individuals with developmental disabilities. Additionally,

2012, leading to billions in budget cuts in most state

regional centers operate the CCT project for individuals

government sectors. HUD’s NOFA for the 811 PRA

with developmental disabilities.

program offered an opportunity for California to apply

DDS and DHCS staff oversee the organizations that

for rental subsidies for the target population during a

identify 811 PRA participants and coordinate their

period when affordable housing subsidies of any kind

services. Along with HCD staff, housing program staff

were very limited.

from DDS and DHCS market the program to developers

The State Department of Rehabilitation asked HCD to

and owners. DHCS provides tenant data for the HUD

consider applying for 811 PRA funds. In considering

quarterly report. DHCS staff also helped to develop the

the HUD NOFA, HCD approached CalHFA because

811 PRA application. (DDS did not become a partner in

it had experience with rental subsidies gained by

the program until after the 811 PRA funds were awarded.)

administering the Section 8 program. CalHFA partnered

Table 2.1 outlines the organizational roles played by each

with DHCS as the state’s Medicaid agency. HCD,

organization in the 811 PRA program administration.

CalHFA, DHCS, and TCAC staff met frequently to

develop the initial program and funding application. The

application was submitted in August 2012, followed by

the award announcement in February 2013.

Table 2.1: Agency Roles in the 811 P R A Program

CalHFA

HCD

TCAC

DHCS

DDS

•  Perform 811 PRA program

•  Perform 811 PRA program

•  Perform 811 PRA program

•  Perform 811 PRA program

•  Market 811 PRA program

planning.

planning.

planning.

planning.

to owners.

•  Provide owner Notice

•  Provide owner Notice

•

•

Market 811 PRA program

Review owner applications.

of Funding Availability

of Funding Availability

•  Review owner applications.

to owners.

development.

development.

•  Conduct outreach and

training to prospective

•  Administer Rental

•

California Community

Market 811 PRA program

Assistance Contract and

•  Review owner applications.

•  Review owner applications.

Transitions providers

to owners.

subsidy payments.

interested in becoming

a HUD 811 PRA tenant

referral organization.

•  Oversee referrals in

•  Process monthly tenant files

•

•

•

Inspect and monitor TCAC-

Oversee referrals in nursing

institutional settings and

Review owner applications.

and voucher.

funded 811 PRA properties

facilities.

individuals who are “at risk”

of institutionalization.

•  Inspect and monitor 811

•  Monitor HCD-funded 811

•  Oversee coordination of

•  Oversee coordination of

PRA program properties.

PRA properties..

services.

services.

•  Produce quarterly reporting

•  Produce HUD quarterly

•  Track referrals.

for HUD.

reporting.

•  Verify both Regional

Center consumers and

Money Fol ows the Person

participants for age and

Medicaid eligibility.

CalHFA = California Housing Finance Agency. DDS = California Department of Developmental Services. DHCS = California Department of Health Care Services.

HCD = California Department of Housing and Community Development. PRA = Project Rental Assistance. TCAC = California Tax Credit Al ocation Committee.

12

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

HUD signed the Cooperative Agreement with CalHFA

key staff report that they vastly underestimated the staff

on October 30, 2014. DDS did not become a program

time needed to implement and administer the program.

partner until after the 811 PRA funds were awarded.

In addition, DDS planned to hire one new housing

The partners expected that 811 PRA units would be

position in 2016 that will help support the 811 PRA

located statewide in both properties already built

program going forward.

with state affordable housing funds—and therefore

Table 2.2 is a comparison of anticipated staff time for

with existing affordability requirements—and in newly

four key 811 PRA staff against an approximation of

constructed or rehabilitated properties. CalHFA applied

staff time spent on the 811 PRA program during its first

for the maximum 811 PRA funding amount due to the

year of the grant. As shown, the four agencies staff

need for supportive, integrated housing, and the lack of

members spent significantly more time on 811 PRA

affordable housing funding at that time.

program administration than planned, an increase of

more than one FTE.

Program Financial Structure

The 811 PRA program is supported by $931,814 811

State Context: Housing Programs

PRA administrative grant fees and in-kind contributions

of staff time. Because CalHFA is the grantee and wil

Housing

manage the ongoing rental subsidy for a 20-year period,

California has an overwhelming need for affordable

the partners agreed that the agency should receive the

and suitable housing for people with disabilities. The

full administrative fee. Staff from the partner agencies

2013 American Community Survey estimated 3.7

provide their time working on the 811 PRA program as

million people with disabilities live in California and

in-kind contributions.

2.4 percent of state residents receive Social Security

All 811 PRA functions at CalHFA, HCD, TCAC, and DDS

Disability Insurance payments (Census Bureau,

are performed by existing staff. DHCS hired a new ful -

2013). In 2014, the average Social Security Disability

time Housing Specialist through the MFP program who

Insurance payment in California was $877, requiring

took on 811 PRA functions after 2012 811 PRA funding

those whose sole income is Social Security Disability

was announced. The staff burden estimate from the 2012

Insurance to spend more than their entire income

grant application was 3.25 ful -time equivalents (FTEs)

to rent even a studio apartment (Social Security

across four agencies (not including DDS), although al

Administration, 2014a).

Table 2.2 : C alifornia — Planned and Actual Time Spent on 811 P R A Program by Key S t af f

Agency and Key Staff Members

Planned FTEs

Actual FTEs (estimated)

CalHFA—asset management officer and specialist

0.10

0.60–0.80

DHCS—Housing specialist

0.50a

0.85

HCD—specialist, Division of Financial Assistance

0.20

0.50–0.75

Planning and Evaluation Unit

TCAC—specialist, Development Section

0.20

0.20

DDS—section chief Community Development and

0.00b

0.30

Housing, specialist

Combined total

1.00

2.45–2.90

CalHFA = California Housing Finance Agency. DDS = California Department of Developmental Services. DHCS = California Department of Health Care Services. FTE = full-time equivalent. HCD = California Department of Housing and Community Development. PRA = Project Rental Assistance. TCAC =

California Tax Credit Allocation Committee.

a The FTE expectation for the DHCS housing specialist was 1.00 FTE in the 2012 grant application. The expectation for 0.5 FTE on the 811 PRA program was determined after the grant was funded and the position was filled. The housing specialist position was hired to work on all housing-related activities for the MFP program.

b DDS was not a partner to the application.

13

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

California has long committed to create housing

•  The state bond-funded Multifamily Housing Program

opportunities tied to services, but state agencies have

(MHP) General Component provides financing for

not historically created many resources specifically

the construction, rehabilitation, or preservation of

for persons with disabilities coming from institutions.

rental housing for low-income households. In 2015,

Some staff expressed the opinion that this population

HCD made available $47.5 mil ion in MHP funds and

with disabilities is competing with other populations

included priority points for properties that include at

in need to receive state funds. For example,

least five 811 PRA units in their funding application.

homelessness is a significant concern statewide.

As a result, six applications for the MHP General

The 2015 Point-in-Time estimate for homelessness

Component requested funding for 811 PRA units. HCD

in California was about 115,000 with only an

awarded MHP funds to three properties for a total of

approximate one-third of those sheltered (HUD, 2015).

15 811 PRA units.

According to program staff, people with disabilities

•  The MHP Supportive Housing Component provides

that are institutionalized are not as visible compared

financing for supportive housing developments. Units

with people seen living on the street and represent a

funded by MHP Supportive Housing are required

“silent housing crisis.”

to be occupied by people with disabilities in one or

By providing rental subsidies, the 811 PRA program fil s

more of five specific disability categories. As of 2015,

a need for affordable housing specifical y for nonelderly

87 properties were under this program with 2,355

persons with disabilities. HCD and TCAC are purposively

supportive housing units.

policy neutral toward people with disabilities in their

•  The Affordable Housing and Sustainable

funding awards because they strive to serve all low-

Communities Funds is a new state program that

income populations in California.

funds land-use, housing, and transportation projects

Existing Programs

that reduce greenhouse gas emissions. Currently,

Affordable Housing and Sustainable Communities

Although most of California’s housing programs may

is the largest HCD capital development program.

not establish specific priorities, or set-asides for the 811

The first awards were granted in 2015. No priority

PRA target populations, the three state housing agencies

points for special needs projects exist, although it is

all administer various housing programs for low- and

reasonable to assume that some projects will serve

moderate-income Californians, many of which serve and

special needs populations. In 2016, approximately

house persons with disabilities.

$400 million will be available through this program.

CalHFA programs. CalHFA provides financing for

•  The Veterans Housing and Homeless Prevention

affordable multifamily rental housing and makes low-

Program provides both capital and Operating Subsidy

interest loans for very low- and low-income households.

Program funding for affordable housing that serves

Although no specific set-asides are in these programs for

veterans, many of whom have disabilities. The

persons with disabilities, it is likely that many people with

program was funded at $75 mil ion in 2015, with $400

disabilities reside in housing funded in part by CalHFA

mil ion set aside for future years.

and benefit from its programs. (CalHFA does not track

this information.)

HCD also administers Federal funding to cities, counties,

and nonprofit organizations from the CDBG, Emergency

CalHFA does finance one program specifical y for people

Solutions Grants, and HOME programs. Many people

with mental il ness. Administered in conjunction with

with disabilities are ultimately served by these programs.

the California Department of Mental Health, the Mental

In 2016, HCD was expected to receive an al ocation of

Health Services Act Housing Program provides both

funds from the National Housing Trust Fund program,

capital financing and operational subsidies for PSH for

a HUD-administered, formula grant capital funding

individuals with severe mental il ness who are homeless

program that requires 75 percent of the units created to

or at risk of becoming homeless. Enacted in 2004, the

house extremely low-income households at or below 30

Mental Health Services Act is funded through a 1-percent

percent of AMI.

tax on income more than $1 mil ion. In fiscal year

2014–2015, CalHFA lent $33 mil ion under this program

TCAC programs. TCAC awards 9 percent competitive

and created 227 units of supportive housing.

and 4 percent noncompetitive federal LIHTC, as well

as supplemental state tax credits. Applications for

HCD programs.  HCD administers several state-funded

the 9-percent tax credits are highly competitive, and

housing programs that serve people with disabilities.

in recent years TCAC has awarded only LIHTCs to

less than one-half of applications received. In 2014,

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

TCAC awarded $92 million in 9-percent tax credits

Like the Veterans Housing and Homelessness

and $97 million in supplemental state credits for

Prevention Program, the MHP Supportive Housing

the development, rehabilitation, or acquisition of

Component Program provides incentives for setting

affordable housing.

aside more of its units to serve persons with disabilities,

TCAC’s QAP does not provide a preference, set-aside,

including people who are chronical y homeless and

or priority points specifically for 811 PRA projects. The

other homeless populations with disabilities and special

QAP does include a 10-percent set-aside for projects

needs populations. Consequently, the percentage of

serving homeless persons and a 4-percent set-aside

units restricted to persons with disabilities in these

for projects serving at least 50 percent special needs

programs is typical y more than 25 percent, making it

populations, including many people with disabilities.

impossible for developers to be competitive for these

Between 2012 and 2014, approximately 12 to 14

capital sources if they were to choose to use 811 PRA

percent of all tax credit awards were special needs

funding in these properties.

awards, resulting in at least 1,000 units constructed

How the state defines its homeless population creates

or rehabilitated specifically for people with disabilities

additional incompatibilities between the 811 PRA

of all ages. (TCAC does not track whether people with

program and state programs that serve homeless

disabilities are elderly or nonelderly.)

people. TCAC and HCD use HUD’s definition of homeless

individuals, which means that individuals who are

How the 811 PRA Program Fits With Other

institutionalized for more than 90 days are no longer

State Programs

considered homeless. Their use of this definition makes

Several state housing programs are incompatible with

it difficult to serve Money Fol ows the Person participants

the 811 PRA program, the most significant barrier

who must reside in institutional settings for at least 90

the 25-percent cap on targeted units within the 811

days to be eligible for the MFP program.

PRA program. To ensure that 811 PRA tenants are

integrated into communities, statutory language

How Major Housing Assistance Programs

governing the 811 PRA program stipulates that no more

Are Used To Assist the Target Population

than 25 percent of units in any development may be

In addition to the three state housing agencies, other

required to serve or have occupancy preferences for

entities such as local governments, housing authorities,

persons with disabilities. Although federal and state

and private owners also develop and administer

tax credits issued by TCAC are the most prevalent

affordable housing programs in California for people with

financing source used to develop 811 PRA units, only

disabilities. Table 2.3 overviews the number of persons

those projects that do not apply for tax credits under

served by six major Federal y funded housing programs

the special needs or homeless set-asides can qualify

administered in California. As shown, one-fourth of

for the 811 PRA program because the set-asides

people living in public housing in the state are nonelderly

require that a minimum of 50 percent of the units

people with a disability, as are 37 percent of Housing

serve the target population5, which clearly exceeds the

Choice Voucher (HCV) program participants.

25-percent 811 PRA maximum.

In addition to the programs in table 2.3, 30 local public

Mental Health Services Act funds already are dedicated

housing authorities throughout California administer

to serving people with mental il ness and therefore

2,795 federal y funded vouchers specifical y for the Non-

cannot be used on the same unit as 811 PRA funds. For

Elderly Disabled (NED) Vouchers. An additional 232,826

HCD’s Veterans Housing and Homelessness Prevention

units funded with federal LIHTCs are estimated to serve

Program, properties are required to have more than 25

people with disabilities (HUD, n.d.).

percent of their units set aside specifical y for veterans.

CalHFA received guidance from HUD that the 811 PRA

Local Issues—Housing Affordability and the

program cannot require that 811 PRA units in a particular

Rental Market

project serve only veterans. This guidance makes the

California includes some of the most high-cost areas in

use of 811 PRA rental assistance also incompatible with

the country for renting, homeownership, and development,

capital funding for projects serving only veterans.

which is a key deterrent to creating affordable housing

5

It appears that by requiring at least 50 percent of the units be targeted to the special needs or homeless population, California TCAC’s special needs or homeless set-asides are supporting the production of congregate supportive housing (also referred to as single-site supportive housing), a model that has been targeted to persons with substance abuse who may have experienced homelessness or have been diagnosed with a mental illness. Congregate models have been successful at stabilizing housing and improving recovery because the services are available onsite and there is a supportive peer environment that is more intensive than in a scattered-site model, which is the approach of the 811 PRA program.

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Chapter 2. California Section 811 Project Rental Assistance Program

Table 2.3 : C alifornia — Over view of Major Federal Housing Programs

Percent With

Number of Household

Percent Extremely

Disabilities Among

Percent of All Persons

Program

Units Available

Members

Low-Income

Head, Spouse Aged <62

With Disabilities

Public Housing

29,895

78,574

71

23

15

Housing Choice

330,837

710,630

75

37

27

Vouchers

Moderate Rehabilitation

1,955

3,836

92

54

52

Project-Based Section 8

101,741

166,733

83

22

11

202/PRAC

13,359

15,852

83

38

4

811/PRAC

2,511

2,893

86

99

87

PRAC = Project Rental Assistance Contract.

Source: HUD (2016)

opportunities for people with disabilities. Lack of

811 PRA housing staff report that four to six sources

affordable housing is one of the primary reasons

of private and public funding are typical y needed to

that people with disabilities may be at risk for

make an affordable housing project feasible in high-cost

institutionalization in the state.

areas. The approximate construction cost of a new two-

Low-income residents have an especially difficult time

bedroom unit is between $325,000 and $375,000.

finding affordable housing in the state. According

to a recent study of housing needs by the California

Service Provision and Healthcare

Legislative Analyst’s Office, the median monthly rent

Current Status of Service and Healthcare

in California in 2013 was $1,240, more than 50 percent

Programs That Support Community Living

higher than the national average (LAO, 2015). According

to 2007–2011 American Community Survey data, 24

The departments under CHHS administer Medi-Cal waiver

percent of renter households in the state are extremely

programs that provide home- and community-based

low-income (earning 30 percent or less of AMI). More

services. These programs include HCBS waivers that support

than 80 percent of these households paid more than 30

participants in their home or community-based setting as an

percent of their income on rent and experienced housing

alternative to care in a nursing facility or institution.

problems such as overcrowding or substandard housing.

DHCS administers nine HCBS waivers, including the

Owners comprise more than one-half of all occupied

following waivers for people with disabilities.

units, 53.7 percent, compared with 46.3 percent

•  Home- and Community-Based Services Waiver for

of renters. Between 2010 and 2014, the proportion

the Developmental y Disabled. This waiver authorizes

of California owners decreased by 2 percent. The

HCBS for people with developmental y disabilities.

California’s rental market has become tighter as

More consumers of the Developmental y Disabled (DD)

homeownership costs have increased and as the state

Waiver are in California than any other HCBS waiver.

has experienced significant population growth in the

past 15 years. As a result, the state’s rental vacancy

•  The Developmental y Disabled-Continuous Nursing

rate decreased from 6.3 to 3.9 percent between 2010

Care Program provides 24-hour continuous nursing

and 2014. During this same period, the state’s average

care for developmental y disabled and medical y

income remained stagnant, both single family and

fragile persons in residential settings.

multifamily construction starts decreased, and mortgage

•  In-Home Operations has statewide responsibility

requirements tightened, creating additional demand for

for reviewing and authorizing home and community

rental housing in the state.

services through the Medi-Cal Nursing Facility/Acute

The high cost of housing makes affordable housing

Hospital Waiver.

development in the state particularly challenging and

•  In-Home Supportive Services Plus Waiver. The

contributes to the growing need for affordable housing.

Department of Social Services converted In-Home

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

Supportive Services to a 1915(j) state plan option

Developmental Centers and other inpatient settings to

Medicaid program in 2009. Between 2004 and 2014,

homes within the community. DDS has also focused on

the program grew more than 100 percent and currently

creating housing resources for individuals who are at risk

serves more than 440,000 individuals in their homes.

of moving into institutional settings.

•  The Assisted Living Waiver is administered in 13

The 2015 Governor’s Budget proposed closing the

counties. It helps facilitate transition of persons

three remaining Developmental Centers. Policy

with disabilities from a nursing facility to a

initiatives on de-institutionalization of individuals with

community setting or serves individuals at risk of

developmental disabilities have also led to the current

institutionalization.

statutory prohibition on the placement of individuals with

•  Enacted in 2013, the Health Homes Program targets

developmental disabilities into California’s Developmental

Medi-Cal’s highest risk members who present the

Centers, except for acute crisis care. This prohibition,

best opportunity for improved health outcomes

combined with the closure of Developmental Centers,

through Health Homes Program services. Health

has resulted in an increased need for affordable and

Homes Program will go into effect in early 2017.

accessible housing, including in California’s highest

cost areas. DDS’ goal is to provide a variety of housing

•  The 1115 Waiver Renewal (Medi-Cal 2020) authorized in

options from which individuals with developmental

December 2015 will provide Whole Person Care tenancy

disabilities may choose to reside, including housing

support services to members. Whole Person Care is

offered by the 811 PRA program. In 2016, DDS is adding

the coordination of health, behavioral health, and social

one position within the department; the person in this

services to improve the overall quality of patient life.

role will assist with identifying housing resources for

Recent Changes in Programs That Support

individuals who are eligible for affordable housing under

Integrated Community Living

the 811 PRA program.

Changes to Medicaid eligibility criteria. California

Changes in Medicaid resources away from

first expanded Medicaid under its 1115 waiver and again

institutional settings and toward community

expanded eligibility as a result of the Affordable Care Act.

living.  During the past 10 years, departments within

More than 12.8 people are currently enrol ed in Medicaid

CHHS focused on housing as an essential resource

in California.

needed to stabilize healthcare services for individuals.

As discussed in the fol owing section, the state first

Funding. Total Medicaid spending has increased

developed an Olmstead plan in 2003 to help persons

substantial y in California in recent years, as a result of

with disabilities move from institutions to live in the

expanded Medicaid eligibility and as CHHS has pursued

most integrated settings available. In the past decade,

Medicaid resources available to expand HCBS. Between

CHHS has expanded Medicaid HCBS waivers available

2008 and 2014 total Medicaid spending increased from

in California. Medi-Cal 2020, which is California’s 1115

about $36 bil ion to nearly $64 bil ion, a 63.4-percent

Waiver Renewal that will guide DHCS during the next 5

increase (Eiken et al., 2015; KFF, 2017).

years, was approved by the Centers for Medicare and

Funding for long-term services and supports (LTSS)

Medicaid Services in December 2015. The recent 1115

went from approximately $12.7 bil ion in 2008 to nearly

waiver renewal will support increased access to housing

$15 bil ion in 2013 (Eiken et al., 2015). Home- and

with supportive services.

community-based services as a portion of LTSS also

In 2007, DHCS developed the Long-Term Care Division

increased during this period, indicating the continuing

that oversees waivers and long-term service models.

trend of decreased funding for institutionalized care and

In 2007, MFP also awarded DHCS funds to create the

increased funding for community-based services and

CCT Project. To date, approximately 2,700 people

supports. HCBS funding increased from nearly 7 percent

have transitioned out of inpatient care into integrative

of LTSS in 2008 to nearly 63 percent in 2013 (Eiken et

community settings as a result of the CCT Project.

al., 2015). In 2013, California ranked seventh highest for

Housing has become even more of a focus in the

HCBS fund al ocation as a percentage of LTSS funds,

past several years. The hiring of the first staff member

significantly more than the national average of 51.3

dedicated to housing in DHCS did not occur until DHCS

percent (Eiken et al., 2015). Between 2008 and 2013,

hired a housing specialist under the MFP program in 2014.

overall HCBS funding increased by 29.4 percent although

funding for Institutional LTSS increased only 0.7 percent,

In contrast to DHCS, DDS has long focused on locating

again il ustrating the state’s priority in shifting funding

and creating housing resources to help individuals

toward community-based services and away from

with developmental disabilities move out of California’s

institutionalized care (Eiken et al., 2015).

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

How the 811 PRA Program Fits With the

CalHFA and DHCS further categorized the target

Service and Healthcare Programs That

population using these two priorities.

Support Community Living

1. “Individuals residing in an inpatient facility for at least

As discussed in the Housing Context section in chapter 3,

90 consecutive days, for which Medi-Cal has paid for

the 811 PRA program provides rental subsidies specifically

at least one of those days, and who are enrol ed in the

for nonelderly people with disabilities who need affordable

CCT Project.”

housing. Aside from NED Vouchers, no other programs

2. “Individuals receiving Medi-Cal long-term HCBS

in California specifically target assistance to nonelderly

waiver or state plan services who are at risk for

people with disabilities. Other programs that target

placement in an inpatient facility.”

people with disabilities specifically focus on those with

mental il ness or who are homeless, which are not target

Individuals under Priority 1 include residents living in

populations of California’s 2012 811 PRA program.

skilled nursing facilities, developmental centers, and

intermediate care facilities. Most individuals under

California’s Olmstead Plan

Priority 1 are individuals living in skil ed nursing facilities.

CHHS first developed its Olmstead plan in 2003, with

Priority 1 individuals can also include individuals

updates in 2005, 2010, and 2012. The plan covers

with developmental disabilities whose services are

a broad range of strategies to prevent unnecessary

coordinated through the Regional Centers. Al  individuals

institutionalization of people with disabilities. In 2005,

must be enrol ed in the state’s MFP program to qualify

Governor Schwarzenegger convened the Olmstead

under Priority 1 regardless of the waiver under which they

Advisory Committee to help inform policies and 811

receive services. Institutionalized applicants wil  be given

practices that affect Californians’ abilities to receive

priority over noninstitutionalized applicants if both are

services in the least restrictive environment possible. In

ready to move in at the same time.

2012, CHHS expanded the advisory committee’s role to

Individuals under Priority 2 who are at risk of

include a focus on housing and veterans. California has

institutionalization could come from several care settings.

not had any consent decrees compel ing it to create a

Individuals eligible under Priority 2 are primarily DD

statewide plan, although Olmstead lawsuits against the

Waiver consumers who are living in community settings

City of Los Angeles have been filed. As a result, the state

and who are served by a Regional Center. Other waiver

allocated housing vouchers in coordination with healthcare

consumers living in the community are also eligible, but

providers for seniors and those who are homeless.

because the DD Waiver is the state’s largest and serves

The Olmstead plan outlines 12 goals, including one

more than 100,000 consumers, most Priority 2 applicants

specific to housing and helping individuals to transition

are expected to come from this population.

out of institutional care to more integrative settings

Skilled Nursing Facilities

according to their needs and preferences. The most

recent update in 2012 predated the award of 811 PRA

Skil ed nursing facilities house between 90,000 and

funding so the 811 PRA program is not named as a

100,000 In-Home or nursing facility waiver consumers,

resource; however, 811 PRA partners consider the 811

although only 15,000 to 25,000 are between ages 18

PRA program an important resource to meet Olmstead

and 61. DHCS staff estimate that 10 percent of these

housing goals. 811 PRA team members participate in the

individuals would be interested in and able to leave

Olmstead Advisory Committee meetings three times a

the skil ed nursing facility and live independently. As

year, where they discuss the CCT Project and progress

a result, DHCS expects that approximately 1,500 to

toward meeting Olmstead goals.

2,500 nonelderly people with disabilities living in nursing

facilities would be good candidates for 811 PRA units.

Population Served

Individuals transitioning out of nursing facilities can

choose from several different housing models available

Comparison of Target Populations: Planned

through the CCT Project, including living at home alone,

Versus Actual

living with family or roommates, single-room-occupancy

units, or regional care settings.

To be eligible for the 811 PRA program, an applicant

must be between the ages of 18 and 61 at move in,

Regional Centers

extremely low income, and be enrol ed in or eligible for

Regional centers are nonprofit organizations that

services under Medi-Cal waivers administered by DHCS

contract with DDS to provide services to approximately

or DDS.

300,000 individuals with developmental disabilities. In

18

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

California, 21 regional centers exist. Individuals who

811 PRA program among their clients, assess applicants

receive services coordinated through the regional

for eligibility, and maintain a waiting list of applicants

centers may reside in many different settings, including

eligible for the 811 PRA program. When an appropriate

in their own homes, in group homes, in skil ed nursing

unit becomes available, TRO case managers refer

facilities, or in various types of inpatient settings,

applicants to apply at specific properties and help them

including skilled nursing facilities and developmental

complete the application process, provide transition

centers as discussed in the fol owing sections.

services as tenants move in to the 811 PRA units, and

manage the service delivery provision. Owners applying

Developmental Centers

for 811 PRA rental assistance are required to partner with

Approximately 1,000 individuals reside in developmental

one or more TROs before they apply for 811 PRA funds

centers, a reduction from 3,900 in the 1970s. DDS

to manage the influx of qualified applicants for the 811

expects that in the next 5 years, approximately 700

PRA units at their properties.

individuals with developmental disabilities will be

For the 2012 811 PRA application, California uses a

transitioning into integrated community living from

decentralized outreach and referral model. DHCS and

developmental centers as they close. DDS staff estimate

DDS do not maintain a centralized statewide waiting

that approximately 10 percent of these individuals will

list for 811 PRA applicants. TROs are each responsible

be eligible for and interested in moving into integrated

for referring only applicants from their own populations

housing under the 811 PRA program.

to the properties where they have agreements with

Outreach, Referral, and Application

owners. The Notice of Funding Availability requires

that the owner and TRO submit a tenant selection plan

Through the end of 2015, 51 individuals had been

that governs the process of selecting eligible tenants,

referred to complete an application for the 811 PRA

but no standardized requirement exists to maintain

program and 28 residents were living in 811 PRA-funded

a waiting list in a certain way. In their Memorandums

units. CCT organizations referred 39 individuals living

of Understanding that are approved by CalHFA,

in nursing facilities and Regional Centers referred 12

property owners and TROs must agree to give priority

individuals. Most of the referrals were for those meeting

to institutionalized persons for available units. Within

Priority 1 (residing in inpatient facilities for at least 9

the institutionalized and noninstitutionalized target

months); only 7 of the 51 (14 percent) referred to the

populations, property owners decide on the method for

program were at risk for institutionalization.

choosing from 811 PRA waiting list (for example, first

come, first served or a lottery) if fewer units are available

Outreach, Referral, and Application Process

than people ready to occupy them.

Since their 2012 funding application submission,

Target Population Screening and Eligibility

CalHFA and DCHS have made one significant change

in how applicant referrals are coordinated in the

TROs identify eligible 811 PRA applicants within their

811 PRA program. The agencies added DDS as a

respective populations and determine whether they are

partner. Although DCHS had always intended to

eligible for the 811 PRA program. Once the applicant

serve persons with developmental disabilities at risk

is identified, the TRO submits a completed referral to

of institutionalization, the partnership with DDS in

DHCS, which confirms eligibility based on age and

identifying these consumers came after CalHFA was

enrol ment in Medi-Cal. Once a unit becomes available,

notified that the grant was funded. When the 2012

the TRO staff person refers the individual to the property

application was submitted to HUD, it was assumed that

owner to complete an application for the property and

DHCS as the state Medicaid agency would coordinate

provides assistance as needed. Individual property

these noninstitutional placements with DDS. In contrast,

owners establish their own rental criteria, including

placements into the 811 PRA program for DD Waiver

rental history, credit, and criminal background. Owners

consumers from institutions were always expected to be

must outline their selection criteria in their tenant

coordinated through the CCT Project.

selection plans that are submitted to and approved by

CalHFA. The property manager determines whether the

CCT organizations and Regional Centers act as tenant

individuals meet the property’s criteria and works with

referral organizations (TROs) for their respective

the TROs to determine move-in dates or placement on a

customers for the 811 PRA program. Regional Centers

property waiting list.

may also choose to partner with a CCT acting as a TRO

rather than with a developer directly. TROs promote the

19

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

Implications of Target Population and

given equal weight in selecting participants within each of

Outreach and Referral Methods

the two priorities. It is also not clear how the divisions wil

Having two different target populations from two different

track referrals to ensure that unit offers are made according

types of organizations has implications on the 811 PRA

to the appropriate order of priority of the target population.

program’s outreach and referral methods and tenancy

DHCS and DDS staff reported that they both have future

of 811 PRA units. Most 811 PRA tenants and most

plans to establish a position that will assist with tenant

applicants referred have come from nursing facilities. Of

referrals and to help facilitate coordination of 811 PRA

the 28 tenants living in 811 PRA units at the end of the

applications and available units. As of early 2016, CalHFA

2015, only 3 were DD Waiver consumers. The differences

and DHCS staff were considering purchasing software to

in management, procedures, program oversight, funding

track participant applications and priorities.

levels, and access to certain services between the two

organizational types may also lead to some disparities

Housing Strategies

within the 811 PRA program.

Property and Unit Characteristics

The first 811 PRA units were fil ed in a less formal manner

as applicants were individual y matched with 811 PRA

Through the end of December 2015, CalHFA had

units as they became available. As CCT participants were

executed four Rental Assistance Contracts for a total of

initial y identified as the priority target population in the

78 811 PRA units. Table 2.4 shows the number and the

grant application, CCT organizations quickly identified

characteristics of properties with units under executed

potential 811 PRA applicants within their caseloads

RACs. Most units under contract are either studios (47)

when the first 811 PRA units became available. Regional

or one-bedroom units (29), because those two sizes

Center staff did not receive timely information about the

represent the most need. The remaining two units under

811 PRA program and were not ready to make program

RAC are two-bedroom units. Out of the 78 units, 3 are

referrals when the first 811 PRA units became available

currently designated as mobility accessible and none are

in late 2014. As of late 2015, many Regional Center staff

designated as being accessible for persons with vision or

were trained on the program and are prepared to make

hearing impairments. (The accessibility of the remaining

additional referrals going forward.

units will not be known until unit turnover and owners

know which units the 811 PRA subsidy will be applied.)

The decentralized approach to target population

outreach and the lack of a centralized waiting list may

At the end of 2015, 28 of the 78 811 PRA units under

have implications on the number and types of individuals

contract were occupied. The remaining units under

eventual y placed in 811 PRA units. The informal method

RAC are in properties that are ful y occupied with other

of matching consumers to units, which has been used

tenants; this fact has an implication for how quickly

to date, is not easily replicable when the program gets

California meets its occupancy goals. 811 PRA units will

larger. However, it is not clear how DCHS and DDS plan

be fil ed once existing tenants move out.

to coordinate future referrals so that both populations are

Table 2.4 : Characteristics of Proper ties With 811 P R A Unit s

Property Name and

Tenant Referral

811 PRA Units/Total

Owner

City and County

Organization

RAC Amount ($)

Units

Initial Occupancy Date

Home and Health Care

Garden Village, Domus

Sacramento, Sacra-

Management, Alta

450,129

11/195

3/2015

Development

mento

Regional Center

Essex Apts., Insight

Lancaster, Los Angeles

Libertana

1,116,017

37/150

9/2015

Development

Casa Verde, Mercy

San Leandro, Alameda

East Bay Innovations

356,443

10/68

1/2016

Housing

Bermuda Gardens,

San Leandro, Alameda

East Bay Innovations

785,327

20/80

1/2016

Mercy Housing

RAC = Rental Assistance Contract. PRA = Project Rental Assistance.

Source: California Housing Finance Agency (2016)

20

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

CalHFA signed its first RAC in March 2015 for 11 811 PRA

proposed project. HCD staff provide technical assistance

units; the first unit was occupied in March 2015. The owners

on housing components and fair housing marketing

of the property, Garden Village, received Low-Income

strategies, and DHCS staff help with tenant selection

Housing Tax Credits to rehabilitate a severely distressed

plans, services, and outreach to participants. DHCS

property that had fal en into disrepair and foreclosure. By

and DDS staff also facilitate meetings and partnerships

the time the new owners, Domus Development, obtained

between owners and TROs.

the property from the bank, drugs and criminal activity

All five agencies review and approve 811 PRA funding

had plagued the property, and about one-half of its units

applications according to their respective expertise. The

sat vacant. Domus completely rehabilitated the property,

agencies maintain a checklist kept on a shared website

reducing its unit count from 201 to 195 and added indoor

that shows whether each component has been reviewed

and outdoor community spaces, two pools, a computer lab,

and found acceptable. Applications are discussed at the

onsite management, and security.

biweekly program meetings and the group col ectively

Property Selection Methods and Financing

decides whether to move forward with awarding a RAC.

Outreach to owners.  To gain interest in the 811 PRA

Financing. Projects eligible for 811 PRA funding in

program, key staff from HCD and DHCS extensively

California must be funded by HCD, CalHFA, or TCAC.

marketed the 811 PRA program to owners of state-

All 811 PRA projects awarded have been financed with

funded multifamily properties. HCD and DHCS staff

LIHTCs, and some properties have as many as six

held webinars, conducted in-person local meetings

sources of funding sources, including financing through

throughout the state, and responded to questions from

HCD, CalHFA, and TCAC programs previously described.

developers. Contact information for HCD and DHCS staff

Eligible properties include both already-built properties

is also provided in all marketing and application materials

funded through one of the three state housing agencies

and on the 811 PRA program website.

and new construction and rehabilitation properties,

provided that they meet the 811 PRA occupancy

Program staff have conducted limited targeted outreach

schedule.

to owners of existing projects in their housing agency

portfolios because agency data systems do not enable

Implementation Schedule

staff to easily determine which properties may be eligible

CalHFA proposed an 18-month leasing schedule in its

for 811 PRA subsidies. Program staff report that their

2012 funding application and expected to occupy up to

outreach methods have been time-consuming, but

19 811 PRA units per month, or 228 units in the first year

necessary and ultimately successful. The effort needed to

of the grant. CalHFA’s expectation for occupancy in its

obtain adequate applications was not unexpected given

first grant year represented about two-thirds of the 811

California’s complex and expensive housing development

PRA units it expected to fund under the 2012 811 PRA

market, the statutory 25-percent limit discussed

program. Per its grant Cooperative Agreement, 811 PRA

previously, and the cap on the 811 PRA contract rent to

units must be under contract by 2022 and all PRA funds

be affordable to households earning up to 50 percent of

should be spent by 2025.

Area Median Income.

In addition to the 78 units under RAC through

Owner application process. The 811 PRA application

November 2015, an additional 28 units are pending

period began August 1, 2014, and is open until all 811

RAC execution. The pending units consist of 13 811

PRA funds are awarded. HCD staff streamlined the

PRA units in a 54-unit Solano County development and

application process to make it as easy as possible for

15 811 PRA units in three projects funded through the

owners interested in the program to apply for funding.

MHP. As of February 2016, the total number of 811 PRA

HCD staff created an application form, sample tools,

units under RAC and pending RAC execution was 106,

including memorandums of agreement between owners

representing more than one-half of the 2012 projected

and TROs, tenant selection plans, board resolutions, and

number of units under the grant. HCD and DHCS

affirmative marketing plans. Owners are encouraged to

staff planned to conduct another round of outreach

use the standard documents but may propose changes if

marketing to owners in 2016 and expect to continue

in compliance with program requirements.

to make progress toward recruiting enough properties

HCD and DHCS staff also provide technical assistance

needed to meet their program goals.

to owners throughout the application process. When

owners first express interest, an HCD staff member holds

an initial call to discuss program requirements and the

21

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

Rent and Subsidy Levels

Regional Center consumers receive lifetime services

In response to the significant need for rental subsidies

under the DD Waiver after they leave the institution as

for the target population, the agencies applied for the

long as they are eligible and have an individual services

maximum funding amount available to their state and

plan (cal ed an Individual Program Plan or IPP) in place.

determined the number of 811 PRA units that it could

A service coordinator conducts routine visits with the

support. Staff estimated the number of 811 PRA units

consumer every 90 days and ensures that the IPP is being

using HUD’s calculated initial tenant rent payment and

appropriately implemented. As may be agreed to in the

a Fair Market Rent at the higher end in the state (Santa

IPP, a Supportive Living or Independent Living service

Cruz County). CalHFA based rents on 40 percent of

provider funded by the Regional Center may have more

AMI, although HUD scored its application using 50

frequent consumer contact to assist with daily needs,

percent of AMI. CalHFA initial y included costs for onsite

including cooking, shopping, transportation to healthcare

service coordinators within its application budget (similar

appointments and daily activities, and equipment needs.

to requirements for other state supportive housing

Coordination of Services and Housing

programs), but HUD did not approve these costs. The

average committed 811 PRA rental subsidy amount

CCT coordinators and Regional Center service providers

under the first 78 units under RAC is $578 per unit

help participants move into 811 PRA units and ensure

per month thus far, compared with the average $705

ongoing connection to services. Although services

budgeted rental subsidy in the Cooperative Agreement

are provided according to individual consumer plans,

(based on a contract rent of $993 per month and a tenant

services are coordinated differently for CCT participants

contribution of $288 per month).

living in inpatient facilities than participants who are at

risk for placement into institutional care.

Unit and Tenant Turnover

CCT organizations have funding available for transition

As of November 2015, of the 19 units occupied, 2 have

services through the MFP program, and all CCT

turned over. As of December 2015, of the 28 units

participants receive 12 months of transitional services

occupied, 3 participants have exited the program. One

after they leave inpatient care. MFP funding covers

resident returned to an inpatient facility due to health

the costs of furniture and household goods, security

concerns, 1 left the program, and 1 resident died. In

deposits, and first and last months’ rent. Participants

addition, 1 811 PRA participant requested a move due

also have access to a 24-hour call system. Individuals

to needing a larger bedroom size for a family member or

with developmental disabilities who are transitioning

live-in aide.

from an institutional setting receive transition services

funded through the Regional Center’s CCT Project. Once

Service Provision and Coordination

CCT participants reside in the community, their ongoing

supportive services may be funded through the HCBS

The exact services each person receives varies depending

waiver under which they receive services.

on his or her individual needs and the Medi-Cal services

he or she is eligible to receive. HCBS waiver services

Individuals who are “at risk” and do not meet the

include case management, community transition services,

90-day institutional stay criteria do not qualify for

private duty nursing, family home health aides, utility

services funded through MFP. Transitional services can

reimbursement, habilitation services, and respite care,

be provided under the DD Waiver or other long-term

among many others. In addition to HCBS waivers, persons

care services as long as those transitional services are

with disabilities in California can also be served through

included in an individual’s IPP.

a state plan service, through a Medi-Cal Managed Care

Gaps in Services

Plan, or through county-funded services. Counties in

California provide some level of services to people with

Gaps in services may occur because different services

disabilities, including comprehensive specialty mental

are available in different locations throughout the state

health services, substance use disorder services, and

and through different Medi-Cal waivers. Service provider

long-term care services.

staff also note the need for some providers, such as

home health aides, in some locations due to pay that

Ongoing Services

is not competitive. The range of services available

CCT participants are eligible for ongoing services

also depends on the knowledge and training of staff at

through enrol ment into a Medi-Cal waiver. Some large

individual CCTs and Regional Centers. CCT capacity and

service provider organizations are also CCTs and can

services offered vary widely, and some organizations

provide a continuity of services.

may transition very few individuals out of inpatient care.

22

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

2013 811 PRA Application

assisted units, 811 PRA program staff experienced

some challenges navigating HUD’s reporting systems.

CalHFA applied for and received $11,985,436 in

CalHFA’s Asset Management staff encountered difficulties

2013–2014 811 PRA funding, slightly less than its

submitting tenant records into HUD’s Tenant Rental

2012 award of $12,208,558. The 2013–2014 funds are

Assistance Certification System, and releasing subsidy

slated to subsidize more units than the 2012 funds

payments to owners. Because owners may not move

or 283 units compared with 241 in 2012. Significant

tenants into 811 PRA units until TRACS and Integrated

differences exist between the 2013–2014 funding

Real Estate Management System data are submitted, any

application and the 2012 program. CalHFA targeted

delays in entering data can delay the occupancy of 811

assistance to one geographic area, Los Angeles City

PRA units. CalHFA also experienced a delay of several

and County, and specifically to homeless persons with

months in getting the first subsidy payment released by

disabilities. The agencies targeted this area because

HUD. As of November 2015, all data issues with TRACS

of two factors: (1) the availability of a pool of flexible

and iREMS have been resolved with HUD and all rental

county subsidy funds that are compatible with 811 PRA

subsidies have been retroactively paid to the owners.

program requirements (that can be used to bring the

total contract rent on the unit to FMR), and (2) the large

CalHFA monitors DHCS and DDS activities through regular

number of homeless persons within the area needing

meetings and quarterly reports. DHCS and DDS maintain

housing and services. The 811 PRA program will also

separate systems for tracking referrals, applicants, and

help meet the requirements of lawsuits mandating

tenants from their respective populations. At the time of

services for persons who are homeless. The Housing

the site visit, DHCS and DDS were developing databases

Authorities of the City of Los Angeles and the County of

to better track participant information.

Los Angeles agreed to set aside a combined 150 HCVs

Currently, California has a decentralized, unautomated

for homeless, nonelderly people with disabilities as

system for tracking and prioritizing 811 PRA-eligible

leverage for the 811 PRA funding.

applicants and referrals to units. DHCS and CalHFA are

exploring purchasing software to assist with referral

Leveraging

tracking and prioritization.

CalHFA did not leverage any HCV units or other subsidized

Successes and Challenges

units as part of its 2012 grant application. The agency

and its partners felt it was too onerous to try to obtain

The first 811 PRA tenants moved from institutions to

leveraged vouchers from specific PHAs, as their program

new integrated housing units in March 2015. Program

was statewide. However, as noted previously, the grantee

staff from all five agencies discussed initial successes

and the partner agencies provide in-kind contributions of

and challenges they have experienced in 811 PRA

staff time to support the 811 PRA program.

program implementation.

Program Administration,

Factors Contributing to Program Success

Assessment, Information Systems,

Early program planning.  California was the first state

and Data Infrastructure

to have tenants in units funded by the 2012 811 PRA

program. CalHFA staff attribute their ability to fill the first

CalHFA monitors the 811 PRA grant through regular

811 PRA units to their early program start and continual

meetings with al  four partnering agencies and through

planning process. Agency staff met biweekly to flesh out

a shared website to track team members’ activities.

program details after the grant application was submitted.

CalHFA also maintains a public website with detailed

From previous experience with HUD programs, staff

up-to-date information on the 811 PRA program and

knew that execution of the grant agreement could take

funding opportunities. CalHFA uses Housing and

some time and they wanted to be ready to hit the ground

Development Software system to send, receive, and

running once they had received contractual approvals. In

process tenant and voucher records for the residents in

anticipation of potential delays, CalHFA released the NOFA

the 811 PRA program. CalHFA was the first grantee to

for 811 PRA funding in August 2014, 2 months before

use this system and helped Housing and Development

HUD signed the Cooperative Agreement on October 2014,

Software modify the system for 811 PRA.

so they would be ready to issue awards once they were

under HUD agreement. The NOFA strategy was a prudent

Because California was the first state to execute a RAC

and successful method of attracting developers and

with an owner and to house individuals in 811 PRA-

owners. CalHFA did not want to al ocate counties a certain

23

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

amount of assistance based on needs and risk not finding

Improved quality of life for 811 PRA residents.  Three

properties that met the 25-percent statutory limitation on

811 PRA tenants residing at one property, and their

units restricted to persons with disabilities.

service providers, were interviewed during the site visit.

Effective partnerships.  Program staff credit much

All expressed their gratitude for the 811 PRA program as it

of their 811 PRA program progress to the effective

has provided the comprehensive quality care and housing

partnerships of the five agencies. Although the five

they need. All three residents stated that they were very

agencies did not have a long history of partnering together

satisfied with their units and caregivers, and felt that they

prior to the 811 PRA program, they quickly established a

had access to a social community on site. The caregivers

close working relationship. The partnership is effective due

(representatives from both a Regional Center and CCT)

to the ongoing communication between the parties and

stated that the residents were thriving under this program.

clear delineation of program tasks. Since the start of the

811 PRA Program Challenges

planning process, staff from the four agencies (later five

as DDS became a partner) have met biweekly to resolve

811 PRA program staff reported some challenges

issues and make program decisions. Although CalHFA

in the initial program administration, both due to the

stated in the grant application it would cross-train staff

complexity and high development costs in California

from each other’s agencies, clear delineation of program

and to the constraints of the 811 PRA program. The

tasks seem to exist by agency depending on the expertise

evaluation team further identified some areas of the

of each agency and particular staff. This approach

program that have an effect on the efficiency and

has helped the agencies be more efficient in program

effectiveness of the 811 PRA program.

administration and resulted in less duplication of effort.

The availability of capital sources, such as LIHTCs or MHP

Committed staff. The 811 PRA program has made

funds, real y drives when owners apply for the 811 PRA

progress through the personal efforts and perseverance

program. California has spent considerable time figuring

of individual staff members. HCD staff established points

out how to use capital sources with the program because

for the 811 PRA program in the most recent MHP General

many sources are incompatible. All 811 PRA projects have

Component program NOFA. DHCS and DDS staff worked

been financed with LIHTCs to date. A lot of soft money is

diligently to quickly fill the initial 811 PRA units to meet tax

needed to make the projects financial y feasible, especial y

credit occupancy deadlines. CalHFA staff worked with

in urban settings and high cost areas in California. Some

HUD and the software vendor to resolve TRACS related

projects have as many as six funding sources.

modification to accept 811 tenant files and vouchers.

Low contract rents at 50 percent of FMR are also a

Several staff spent considerable time on marketing to gain

challenge in attracting developers and owners. Developers

owner interest in the program.

prefer to participate in programs that provide higher rental

Streamlined owner application and review process.

subsidy and secure a higher percentage of units.

California’s project owner application process is one

Capital financing is needed to provide financial

that other grantees can replicate. 811 PRA housing staff

incentive and ease financial feasibility. To ensure

simplified and streamlined the process to make it as easy

financial feasibility due to high development costs in

as possible for owners to apply for funding. Interested

California, CalHFA and its partners have tried to team

owners may apply any time, as the application process

up with compatible funding sources to expand the 811

is continuously open. HCD staff first have a call with any

program. However, this task has not been easy due

interested owner to discuss program requirements and the

to programmatic restrictions in many of the funding

proposed project. California has a sample memorandum

sources. California requested HUD to al ow for targeting

of understanding with a TRO and a tenant selection plan

its program partly to veterans to piggyback onto veterans

online as well as the application that owners may review

funding. California Housing Finance Agency was told

and complete. Although owners may alter certain tenant

that this targeting to veterans would be a fair housing

selection plan sections, it must be in compliance with

problem and was therefore not permitted.

program requirements. Therefore owners are encouraged

Different target populations. The two distinct target

to utilize the standard tenant selection plan. HCD and

populations, CCT participants and Regional Center

others on the team provide technical assistance to the

participants at risk for institutionalization, are overseen

owner in completing the application if needed.

by different agencies and have different funding sources

The use of a shared private website to track each agency’s

attached. The differences in the management and

progress in the owner application review process is an

funding sources could lead to some 811 PRA participants

efficient method to qualify owners and properties.

getting some services that are not available to other

24

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 2. California Section 811 Project Rental Assistance Program

811 PRA participants. The CCT or Money Fol ows the

these populations. Thus, HCD and DCHS have needed

Person is for individuals who are in institutional settings

to spend considerable staff time conducting outreach to

with Medicaid covering the cost of their stay. CCT can

potential project sponsors to gain additional interest.

pay for transition coordination, first month’s rent and

Lower targeted contract rents in 811 PRA program.

deposit, home furnishings setup, assistive technology,

Another deterrent to owner interest in the 811 PRA

and home modification. All the CCT participants are

program is that the rents that CalHFA targets under

enrol ed in the Nursing Facility/Acute Hospital Waiver,

811 PRA are significantly less than the rents al owed

which pays for case management, nursing, and personal

for under other housing programs funded in the state.

care. On the other hand, individuals from the Regional

The PRA program enables grantees to determine the

Center institutional settings or at risk of being homeless

rent level al owable for PRA units, as long as it does not

are usual y on the Developmental y Disability Waiver. This

exceed the area’s FMR as determined by HUD. Grantees

waiver covers assistive technology, home modifications,

were awarded points in their grant applications for

and ongoing health services, but does not pay for rent,

proposing lower rent levels. In its 2012 grant application,

deposits, or furnishings which participants usually get

CalHFA established target PRA rents to be affordable

help with from family members. Most Regional Centers

to persons earning 50 percent of AMI. Other housing

also have limited funds to help with home setup. The

programs funded through the state enable developers

exact services each person receives varies depending

to set rents at FMR, which are substantial y higher.

on their individual needs and the Medi-Cal and Regional

For instance, the rent proposed by CalHFA based on

Center services he or she is eligible to receive.

blended rents in Santa Cruz County was $755. The rent

CCT coordinators and Regional Center service providers

determined in the cooperative agreement with HUD

help participants move into 811 PRA units and ensure

was $955, and the FMR at the time of the proposal was

ongoing connection to services. Although services are

$1,329. If multiple sources are available for affordable

provided per individual consumer plans, services are

housing in the state, developers will natural y seek the

coordinated differently for CCT participants living in

sources that will be the most financial y feasible.

inpatient facilities than participants who are at risk for

The rent level proposed by California was a result of

placement into institutional care.

HUD and the state’s desire to try to fund as many units

Getting a complex program launched and running

as possible with the most cost-effective approach. The

smoothly.  811 PRA program staff reported that a

challenges experienced during program implementation,

significant challenge was the amount of planning and

specifical y the lower than expected owner interest,

staff time needed to develop program policies and

shows that the grantee might have been overly optimistic.

procedures and getting the program implemented at the

Challenges in service provision.  The 811 PRA program

five state agencies. Nearly all staff interviewed reported

reflects a policy shift away from institutional settings and

that they spent considerably more time on the program

toward community-based services and supports. This

than initial y planned. Key CalHFA, DCHS, California

change has led to some chal enges in service delivery for

Department of Developmental Services, and California

the target population.

Department of Housing and Community Development

staff all routinely spent more than one-half of their time

The limitation on the number of 811 PRA units within one

implementing the program in the first year, in contrast to

development can be a chal enge for service provision.

initial staff estimates of 0.10 to 0.20 each. Administrative

DCHS staff report that many services, such as nursing

fees are not sufficient to reimburse the value of actual

services, can be provided more efficiently at properties

staff time spent on the project.

where several individuals need services, and economies

of scale can be achieved. Reimbursement of Medicaid

Percent cap on targeted housing units. The

waivers are also calculated differently if services are

requirement that limits properties participating in the 811

shared among multiple individuals at one property.

PRA program to have no more than the 25-percent cap

California Community Transitions and Regional Center

of units set aside for the target population has been an

staff noted difficulty attracting service providers due to

impediment to recruiting owners in California. Several

low Medicaid reimbursement. CCT organizations have

state housing financing programs are incompatible with

had a particularly difficult time hiring Home Health Aides.

the 811 PRA, including those that award points for units

The lack of services in an area can dictate if 811 PRA

specifical y set aside for special needs housing in the

units will be approved because availability of services

state’s QAP. Many owners whose mission is to serve

is required for a property to be approved for 811 PRA

low-income people or persons with disabilities were not

funding. The CCT Project does not operate in all 58

eligible to apply because their properties already support

counties in California.

25

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

Louisiana Section

Supportive Housing program. The program provides a

stable housing environment in an integrated, community-

811 Project Rental

based setting for individuals and families with disabilities

who have supportive service needs. Since 2007, the

PSH program has assisted individuals with severe and

Assistance Program

complex disabilities, providing affordable rental housing

(through rental subsidies) with voluntary, flexible, and

individualized services.

Original y, the PSH program targeted Louisiana’s

neediest area, the Gulf region (cal ed the Gulf

Introduction

Opportunity, or GO Zone). The GO Zone PSH program

is part of Louisiana’s larger Road Home Program, a

In 2012, the Louisiana Housing Corporation (LHC) and

far-reaching initiative that rebuilds housing in Louisiana,

the Louisiana Department of Health (LDH) partnered to

making it safer and more resistant to flooding and

apply for Section 811 Project Rental Assistance program

hurricane damage.

funds. HUD awarded Louisiana $8,489,928 to provide

Although not directly hit by the hurricanes, the storms

rental subsidies for 199 units of supportive housing

affected other state areas. Such extreme weather

for nonelderly adults with disabilities with extremely

has exacerbated the preexisting housing affordability

low incomes. Beyond the 811 PRA program’s statutory

crisis across the state, disproportionately affecting

eligibility requirements, Louisiana’s target populations

persons with disabilities. In the other state areas, the

were prioritized in this order:

indigent population with high service support needs has

1.  Persons who are inappropriately institutionalized.

increased. Due to these factors, Louisiana wanted to

2.  Homeless persons.

expand its PSH program outside the GO Zone. When the

opportunity arose to apply for 811 PRA program funds,

3.  Persons who are at risk of homelessness (including

LHC and LDH saw an opportunity to expand and target

those living in transitional housing for persons who are

the PSH program into these areas. Thus, Louisiana’s 811

homeless) and persons at risk of institutionalization.

PRA program targets eligible households in the northern

To learn about 811 PRA program implementation, two

and central areas of the state. The 811 PRA program has

evaluators conducted a site visit in October 2015.

become an important resource for expanding the PSH

At the time of the visit, six residents resided in three

program statewide.

developments in northern Louisiana. At the close of 2015,

The 811 PRA program is a component of the PSH

Louisiana had 34 units under a RAC; 9 units were vacant,

program due to the similarity of mission, the populations

18 were unavailable (waiting on turnover), and 7 were

served, and the type of services provided. Although

occupied with 811 PRA residents.

the 811 PRA program is a PSH program component,

Grantee Partnership, Organizational

this report, to enhance clarity will refer to the 811 PRA

program specifical y unless information applies to the

Structure, and Management

overall PSH program.

Background

Partnerships and Organizational Structure

Since 2005, Louisiana has been deeply affected by

LHC is the 811 PRA program grantee. The Louisiana

several severe storms. Hurricanes Katrina and Rita

Housing Authority (LHA), a department under LHC,

devastated the Gulf Coast region, displacing more than a

administers the 811 PRA program. Since 2007, LHA

mil ion people. Hurricane Katrina damaged approximately

and LDH have worked closely together to develop

one mil ion housing units, including 500,000 units in

and manage the PSH program. Their long history of

Louisiana (Sorrel s, 2015). A month after Hurricanes

collaboration in developing and implementing supportive

Katrina and Rita, more than 600,000 people in the Gulf

rental housing for persons with disabilities provided the

Coast region were without stable housing (Plyer, 2015).

experience and background needed to apply for and

The aftermath of these storms left many people homeless

administer the 811 PRA program. Administered by LHA

or at risk of homelessness.

and LDH, the PSH program is composed of several state

and HUD-funded programs. Two examples are the 2,000-

To meet the displaced and homeless population’s

unit Project-Based Voucher program and the 1,000-

housing needs, Louisiana developed the Permanent

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

unit shelter-plus-care component of the PSH program.

Executive Management Council. The LDH deputy

Given the partners experience administering these rental

secretary chairs the Executive Management Council.

assistance and service programs, LHA and LDH wanted

Council members include the assistant secretaries for

to expand the PSH program structure and processes to

several LDH program offices. These program offices

the 811 PRA program.

include the Office for Citizens with Developmental

LHA and LDH are responsible for the daily management

Disabilities, Office of Behavioral Health, Office of Aging

of the 811 PRA program; the Executive Management

and Adult Services, Office of Public Health, Bureau of

Council oversees the program. Joint responsibilities

Health Services Financing (Medicaid), Bureau’s MFP

include dispute resolution, data col ection, program

director, and LHA executive director. LDH provides

evaluation, Executive Management Council participation,

staff to the Executive Management Council who assist

and ongoing communication. Individual agency

with performing organizational duties. The Executive

responsibilities are described in the fol owing sections.

Management Council governs the 811 PRA program,

The delineation of responsibilities between LHA and LDH

including making decisions about the target population,

has not changed since the 811 PRA funds were awarded.

program eligibility, program expansion, contracts, and

budgets. It also reviews progress reports and program

Louisiana Housing Corporation and Louisiana

performance. Committee members meet monthly and

Housing Authority. Created in 2011, the LHC

more frequently as needed.

consolidates the state’s funding sources and affordable

housing programs. It also provides a coordinated

Program Financial Structure

approach to the state’s housing policy to ensure an

Of the $8,489,928 in 811 PRA funds awarded to

adequate supply of affordable and accessible housing

Louisiana, $7,861,045 is designated for rental assistance.

for all state residents. LHC al ocates federal LIHTC and

The remaining $628,883, or 8 percent of the rental

oversees the HOME Investment Partnerships Program,

assistance amount, is intended to cover administrative

Louisiana Housing Trust Fund, and other housing

costs. All 811 PRA administrative funds have been

development programs. LHC is also a Project-Based

al ocated to LHA, because it must administer the RACs

Contract Administrator, overseeing 172 contracts with

during the life of the grant requirements.

14,447 units.

In Louisiana’s 811 PRA program application, LHA

LHA administers the PSH program, which includes

expected to have one ful -time staff person, the LHA

managing the 811 PRA program. Managing the 811

executive director, managing the program through the

PRA program includes identifying eligible properties,

startup phase. In addition to the executive director, a

reviewing property owners’ applications for 811 PRA

housing finance specialist or program specialist has

funding, underwriting and awarding 811 PRA funds,

assisted with program administration. The LHA chief

developing and executing RACs between LHA and

financial officer and other LHC staff are responsible for

property owners, and ensuring 811 PRA program

administering TRACS and the Line of Credit Control

compliance. LHA has oversight over all properties

System (LOCCS). In addition, LHC contracts with a

selected for the 811 PRA program.

housing specialist who identifies units for the 811 PRA and

Department of Health and Hospitals. LDH is

PSH programs. The actual amount of LHC staff time to

responsible for assessing or establishing the population

implement the program far exceeds what was expected.

targeting policy; providing local infrastructure for

The fact that the 811 PRA program involves expanding

outreach, referral, and supportive service delivery; and

the PSH GO Zone program into a broader service areas

sustainability planning for services linked to 811 PRA-

drives up staff time. LHC staff time is paid through 811

PSH units. LDH is also responsible for:

PRA administrative fees.

•  Outreach to potential 811 PRA program participants.

LDH original y expected the LDH PSH program director

•  Referral of individuals to the 811 PRA program.

and the MFP project director to dedicate 15 percent of

their time to the 811 PRA program, and the assistant

•  Connection of program participants to services.

secretary for the Office of Behavioral Health to dedicate

•  Participation in property selection.

5 percent. In addition to the three LDH staff assigned

to assist with 811 PRA program management and

•  Oversight and monitoring of LDH agencies and

implementation, LDH has a project coordinator who

service provider agencies.

manages daily administrative and programmatic tasks.

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

State Context: Housing Programs

the least restrictive settings possible that meet their needs

and preference was the legal basis for the  Barthelemy v.

Housing Policy

Louisiana Department of Health Hospitals class action

lawsuit (referred to as “Barthelemy”) filed in 2000 by

Many factors influence the State of Louisiana’s housing

Louisiana’s Protection and Advocacy System. The suit

policies, including the effects of several damaging

against LDH was filed on behalf of individuals living in

storms, including Hurricanes Katrina and Rita. These

nursing homes or at imminent risk of being placed in one.

storms reduced available housing and resulted in

The lawsuit aims to increase the options for community-

increases in displaced persons and homelessness.

based services and ensure that all individuals are informed

Thus, Louisiana strived to meet the needs of its affected

of their housing and service options.

residents by providing community-based housing with

long-term supports, especial y to the most vulnerable

Existing Programs

population, extremely low-income homeless individuals

After Hurricanes Katrina and Rita, HUD provided

with disabilities. As part of these efforts, Louisiana’s

Louisiana approximately $25.9 mil ion in disaster

PSH program provides an affordable rental housing

recovery funds for operating assistance, bridge rental

resource that assists homeless persons with disabilities

assistance, and technical assistance, along with $72

and those at-risk of homelessness. In 2014, Louisiana

mil ion in supportive services grants. HUD Disaster Funds

created its comprehensive plan to end homelessness.

are expected to end in early 2018, and most funding for

The plan, Ma Maison, which means “my home,” outlines

services is now reimbursed by Medicaid. Since 2007, the

statewide policy priorities for ending homelessness. The

PSH program has housed more than 2,300 of the most

priorities are—

vulnerable individuals with disabilities (TAC, 2012).

1.  To end chronic homelessness by 2016.

LHC’s Qualified Al ocation Plan provides points to LIHTC

2.  To prevent and end homelessness among veterans

applications when those responsible for operating the

by 2015.

tax-accredited projects agree to participate in the PSH

program by al ocating 5 to 10 percent of the project’s

3.  To prevent and end homelessness for families, youth,

units to PSH-eligible applicants. In the 2017 QAP, LHC

and children by 2020.

plans to indicate that extra points will be awarded to

4.  To set a path to ending all types of homelessness

those projects al ocating up to 25 percent of the total

(Sweazy, 2014).

units to the 811 PRA program. In addition to LIHTC, LHC-

In addition, New Orleans participates in the Dedicating

LHA administers several other local, state, and federal

Opportunities to End Homelessness Initiative, along with

housing programs with the following outcomes:

10 other U.S. communities with critical homeless rates.

•  Between 2007 and 2012, it al ocated $75 mil ion in

The Louisiana Housing Corporation 811 PRA program

HOME funds to develop 125 affordable housing units.

operates in concert with the Dedicating Opportunities to

•  The one-time, $34 mil ion allocation in Neighborhood

End Homelessness Initiative, a part of the state’s long-

Stabilization funds developed 328 units of affordable

term approach to eradicate and prevent homelessness.

housing.

The state’s approach to eradicating and preventing

•  The Louisiana Housing Trust Fund 2007 allocation of

homelessness includes providing a continuum of housing

$25 mil ion developed 148 homeownerships and 174

programs and services. The Louisiana Balance of State

rental units.

Continuum of Care (BoS CoC) program is the state’s

housing and services organization covering rural areas

Table 3.1 provides an overview of the other federal

of the state not covered by a parish or city. BoS CoC

housing programs administered in Louisiana. An

provides funding for efforts to quickly rehouse homeless

examination of the information in table 3.1 indicates that

individuals and families and for efforts by nonprofit

these programs serve a significant number of nonelderly

providers to decrease homelessness. BoS CoC services

disabled households.

include outreach, intake, assessment, emergency shelter

Between 1997 and 2009, Louisiana Housing Authorities

services, and PSH for people with disabilities.

received 650 Non-Elderly Disabled Category 1 HCVs

In addition to its goal of eradicating homelessness,

(HUD, n.d.). NED Vouchers are available to those in

Louisiana provides alternative, community-based housing

eligible nonelderly households with disabilities that want

options for inappropriately institutionalized persons

to live in a community setting, regardless of whether they

with disabilities. The Supreme Court’s 1999 decision in

move from institutional settings. Supportive services are

Olmstead v. L.C.  to enable people with disabilities to live in

also provided to NED tenants.

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

Table 3.1: Louisiana Federal Housing Programs

Percent With

Number of Household

Percent Extremely

Disabilities Among

Percent All Persons

Federal Program

Units Available

Members

Low Income

Head, Spouse Aged <62

With Disabilities

Public Housing

19,872

41,921

66

27

19

Housing Choice Vouchers

55,664

12,1562

68

30

20

Moderate Rehabilitation

112

464

86

23

15

Project-Based Section 8

15,507

26,343

75

28

15

811/PRAC

959

973

80

97

94

PRAC = Project Rental Assistance Contract.

Source: HUD (2016)

Rental Housing Market

Service Provision and Healthcare

Renter households comprise 36 percent of al  Louisiana

households, and 23.5 percent of al  renter households

Policy

are extremely low income (National Low Income Housing

Historical y, Louisiana’s long-term care has been largely

Coalition, 2016a). The rental markets in New Orleans and

institutional. In the early 1990s, Louisiana had one of the

along the Gulf are under intense pressure due to a loss of

highest numbers of nursing homes and nursing home

rental housing from the severe storms and high demand,

residents per capita in the United States (Louisiana

which in turn puts pressure on other rental markets in the

Department of Health and Hospitals, 2013). In 2000, the

state. New Orleans is the sixth worst city in the United States

state began the process of “rebalancing” by increasing

for renters; with a 9-percent hike in rents and a 1.5-percent

spending on home- and community-based supports

decline in income since 2009 (Woodward, 2015). The rental

and services (Louisiana Department of Health and

housing market in northern Louisiana, part of the 811 PRA

Hospitals, 2013). Louisiana’s service and healthcare

target area, is soft but has tightened since the beginning of

policy is outlined in the state’s 2007 Plan for Choice in

2012. Its estimated overall vacancy rate is 7.7 percent, which

Long-Term Care (Plan for Choice) (Louisiana Department

is lower than the overall state vacancy rate.

of Health and Hospitals, 2007). This plan details how the

Rental housing affordability is a serious concern in

state intends to reform how long-term care services are

Louisiana. A household paying more than 30 percent

delivered.

of its household income for rent is considered cost

Recent Changes Supporting Community Living

burdened. In Louisiana, 53 percent of renter households

are cost burdened (Sorrel s, 2015). The affordability

Recent changes in programs have supported Louisiana’s

crisis is more severe for extremely low-income

policy shift toward integrated community living through

households, such as those served by the 811 PRA

the provision of Medicaid-funded home- and community-

program. In January 2016, the National Low-Income

based services. Medicaid data examination il ustrates

Housing Coalition reported that nearly three out of

these spending and funding changes. Between 2008

four extremely low-income households were “severely

and 2014, total Medicaid spending increased from

cost burdened,” paying more than 50 percent of their

about $6.1 bil ion to nearly $7.4 bil ion statewide, a

income on rent (NLIHC, 2016b). The Coalition further

20.5-percent increase (Eiken et al., 2015; KFF, 2017).

reported a shortage of 107,438 units for extremely low-

Funding for overall LTSS increased from approximately

income households in Louisiana and that, for every 100

$2 bil ion in 2008 to $2.4 bil ion in 2013 (Eiken et al.,

extremely low-income renter households, only 35 units

2015). Home- and community-based services, as a

are both affordable and available (NLIHC, 2016a). These

portion of LTSS, increased from 34 percent of LTSS in

data make clear the need for 811 PRA rental subsidies

2008 to 39.5 percent in 2013. The percentage al ocated

for extremely low-income households that have persons

to HCBS, however, is significantly below the 51.3-percent

with disabilities.

national average (Eiken et al., 2015). Institutional funding

decreased as a proportion of LTSS from nearly 66 percent

in 2008 to 60.5 percent in 2013.

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

Expansion of Medicaid 1915(c) HCBS Waivers

companion care, community integration and

This policy shift away from institutionalization and

development, housing stabilization transition, and

toward integrated community living is evidenced by

individual and family support.

LDH’s expanded services. With approval from the

Olmstead Plans, Settlements, Consent

Centers for Medicare and Medicaid Services (CMS),

Decrees

LDH’s expanded its services in its Medicaid 1915(i)

Plan for mental health, and its offerings through the

As discussed previously in the Housing section, the

1915(b) Waiver. Most importantly for 811 PRA, LDH was

landmark Olmstead decision was the legal basis for the

granted approval for the expansion of five 1915(c) Home-

Barthelemy lawsuit.  Barthelemy was settled in 2009,

and Community-Based Waiver amendments. These

several years before the 811 PRA program. By the terms

approvals resulted in increased services available to 811

of the agreement, Louisiana increased its expenditures

PRA program participants.

on HCBS by $118M from 2009 through 2013.

The following list provides short descriptions of the

Although not part of the settlement agreement, the

1915(c) waivers that LDH uses to provide support

811 PRA program does play a role in helping Louisiana

services to 811 PRA program participants. For a more

accomplish its rebalancing efforts by providing rental

detailed description of these services, please see the

subsidies to 811 PRA program-eligible individuals to

section titled Service Provision (Types, Transition Versus

support their community living. Moreover, 811 PRA is

Ongoing, by Target Population, Gaps.

completely in line with the state’s vision for long-term

care reform as outlined in the state’s Plan for Choice. As

•  Residential Options Waiver. This waiver provides

noted in the proceeding section, the Louisiana 811 PRA

a comprehensive set of ongoing and transitional

program has three priority populations, two of which

services for individuals with intel ectual disabilities,

relate to institution related populations—those who are

autism, and developmental disabilities. The Residential

inappropriately institutionalized and those who are at-risk

Options Waiver covers services that include day

of institutionalization.

habilitation, respite care, assistive technology or

specialized medical equipment and supplies, dental

Population Served

care, supports for community living, environmental

accessibility adaptations as wel  as transportation and

To be eligible for the 811 PRA program, individuals are

transition supports.

required to meet the fol owing 811 PRA program and

local state requirements: (1) have a household member

•  Community Choices Waiver. Community Choices

with a disability and be receiving Medicaid services or

provides a comprehensive set of services for

other funded services; (2) need housing supports offered

individuals with physical disabilities ages 21–64.

by the 811 PRA program; (3) be extremely low income

This waiver provides services that include caregiver

(which means total annual household income cannot

temporary support, assistive technology or

exceed 30 percent of the AMI); and (4) be between the

specialized medical equipment and supplies, home

ages of 18 and 61 at time of admission.

delivered meals, housing stabilization, monitored

inhome caregiving, environmental accessibility

Louisiana has further prioritized the populations it wil

adaptations as well as nonmedical transportation and

serve through the 811 PRA program. Persons who are (1)

housing transition supports.

inappropriately institutionalized; (2) homeless persons;

or (3) at risk of institutionalization or homelessness

•  Supports Waiver.  This waiver provides day

(including those persons living in transitional housing or

habilitation, prevocational services, respite,

those who are homeless).

support coordination, supported employment,

housing stabilization service, and housing

The 811 PRA quarterly report of 2015, the first year

stabilization transition for individuals with

of program implementation, indicates that of the 207

intellectual disabilities, autism, and developmental

households referred to the 811 PRA program, 50 percent

disabilities ages 18 and older.

met the criteria of being at risk of homelessness and

16.4 percent met the definition of being homeless.

•  New Opportunities Waiver.  New Opportunities

Only 5.8 percent of 811 PRA program applicants

provides services to individuals with autism,

were institutionalized and 9.7 percent were at risk of

intel ectual disabilities ages 3 and older. Services

institutionalization. Because the 811 PRA program

include center-based respite, employment related

application is available to the public via LDH’s website

training, supported living, skil ed nursing, adult

and many applications are submitted prior to screening

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

for eligibility, 37 percent of the households had no

list for a residential unit. The waiting list is organized by

designated target population. Final y, the data showed

parish and referrals to units are tracked by parish.

that 28 percent of applicants were categorized with

a physical disability, 47 percent with a mental health

Target Population Eligibility

disability, and 25 percent with an intel ectual or

As noted previously, by the end of 2015, the 811 PRA

developmental disability.

quarterly report showed that 207 households had been

referred to the 811 PRA program. Of these households,

Outreach, Referral, and Application

more than 50 percent (104 households) met the state’s

priority for being at risk of homelessness and 107

Outreach, Referral, and Application Methods

households had a member with a mental health disability.

The outreach, referral, and application process is

However, of the 207 referrals, 121 were found ineligible

centralized and managed by LDH’s PSH program unit.

for the 811 PRA program with the large majority ineligible

Serving the 811 PRA program, this PSH unit has an

because they were not eligible for services.

Outreach Implementation Team. Composed of staff

Implications of Outreach, Referral, and

from the Office of Behavioral Health, Office of Aging and

Application Methods on Individuals Referred

Adult Services, Office for Citizens with Developmental

and Placed

Disabilities, Office of Public Health, Medicaid, and

the Money Fol ows the Person program coordinator,

Because the outreach, program application and eligibility

Outreach Implementation Team oversees both state and

determination, unit referrals, and waiting list management

local outreach efforts. This team ensures that program

are centralized, 811 PRA program staff can coordinate

directors are aware of the program eligibility criteria and

811 PRA program efforts efficiently. In contrast, LHA and

available housing units.

LDH administered the PSH program using a decentralized

Regional efforts include—

system previously that had many inherent flaws.

Varying agency staffing levels, capacities, and program

•  Identifying appropriate regional agency

commitments made the former PSH program intake and

representatives of the various target populations.

eligibility process difficult both to manage and to achieve

•  Establishing regional stakeholder teams

overall consistency. Having a centralized process for the

representative of the various populations.

811 PRA program, from outreach through unit referral,

has resulted in an overall systemic improvement, per LHA

•  Providing initial and ongoing briefing for regional

staff. Therefore, once the 811 PRA program is up and

stakeholder teams.

ful y operational, the unit occupancy process should be

State and regional teams also utilize CoC participants,

smoother and more efficient than in the past.

advocates, and other stakeholder groups who work

with individuals who have difficulty acquiring services.

Housing Strategies

The PSH Unit monitors outreach efforts and eligible

applicants on the waiting list.

Property and Unit Characteristics

However, because the 811 PRA program application is

As of October 2015, Louisiana had two RACs and eight

publicly available on the LDH website, some applications

811 PRA program units; six units were unavailable. As

come into the 811 PRA program prior to screening for

of the end of 2015, 34 units were under RAC, 2 of which

eligibility. As soon as an application is received, Medicaid

were accessible to persons with mobility impairments,

eligibility is determined. Once eligibility for one or

and 32 units were not accessible. Of the 34 units, 18

more of the services has been determined, LDH refers

were one-bedroom units, the unit size that most 811 PRA

individuals who meet the PSH requirements for the 811

program applicants need. In addition, 14 two-bedroom

PRA program based on the referral protocol established

and 2 three-bedroom units existed under RAC.

by LHA.

Property Selection Methods and Financing

Within the eligible target populations, referrals are

prioritized per the target population priorities previously

PSH and 811 PRA units are identified and funded as part of

listed in the section titled Comparison of Target

the state’s LIHTC selection process. LHC utilizes the state’s

Populations: Planned Versus Actual. LDH maintains the

QAP to award additional points to developers that integrate

database in the Yardi Voyager, or Yardi, system to track

PSH units into their developments. As of the end of 2015,

each applicant throughout the housing eligibility and

of the 34 units under RAC in the 811 PRA program, all the

selection process. Once determined eligible for the 811

units were financed with LIHTCs, HOME funds, or both.

PRA program, the participant is placed on the waiting

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Chapter 3. Louisiana Section 811 Project Rental Assistance Program

At the time of applying to the 811 PRA program, LHA

Once a project is selected, a RAC is negotiated and

expected that 811 PRA units would come from those

executed between the LHA and the property owner

“existing (already built)” and “new (under construction

of the units. When the property is ready for program

or to be built)” units awarded LIHTCs during the 2011

participation, a RAC will be executed. The RAC initial term

and 2013 funding rounds. Further, it was thought that

is 20 years plus renewals. The RAC contains a 30-year use

developers who had a positive experience developing

agreement that requires units continue to serve extremely

properties under the PSH program in the GO Zone would

low-income individuals with disabilities. 811 PRA

want to participate in the new areas. LHA expected

properties receive local FMR for the 811 PRA units and are

developers who had not exhausted their 25 percent set-

ensured housing vacancy payments for up to 60 days at

aside to participate in the 811 PRA program.

80 percent of the total monthly rent. Property owners or

LHA anticipated that it could meet its 811 PRA unit goals

managers are informed that 811 PRA program participants

quickly by placing identified properties under RAC from

are eligible to receive (1) financial assistance to pay the

its 2011–2013 LIHTC and HOME inventories. However, the

utility and security deposits and (2) supportive services

long delay in HUD’s program implementation significantly

and guidance from case managers. One of the housing or

affected Louisiana’s 811 PRA production because several

service providers certified under the PSH program assigns

of the projects were already ful y rented by the time the

these case managers.

grantee received its Cooperative Agreement. Furthermore,

Implementation Schedule

LHA realized that it had underestimated the time it would

take to educate and form relationships with the developer

In October 2015, the properties in table 3.2 were either

community in new regions. Obtaining developments

under a RAC or had an application in process.

for the 811 PRA program proved to be far more time-

Per its Cooperative Agreement, Louisiana had initial y

consuming than LHA had anticipated. Also, at first, LHA

expected that it would have 24 units under RACs in 2014

found that fewer properties than anticipated were available

with an additional 75 in 2015. With 34 units under RACs at

that met program requirements.

the end of 2015, Louisiana had not achieved its goals but

LHA now thinks that it has a good pipeline of units and

has many properties in the pipeline. As of the beginning

can meet its program commitment by 2017. It is making

of 2016, Louisiana expected to have more than 130 units

some changes to its QAP too, which will increase 811

under RACs by the end of the year.

PRA units. By increasing the points awarded for 811 PRA

Rent and Subsidy Levels

participation from 5 to 10 percent, and eventual y from 10

to 25 percent (the al owable maximum) in its 2017 or 2018

Louisiana projected that the first 100 units available

QAP, LHA expects to increase the pool of potential 811

would be covered by five different FMRs. The state also

PRA and PSH units more quickly.

expected to set initial rents to owners based on the 2012

FMRs, increased annual y by 2.4 percent in accordance

Property Selection Process

with Louisiana’s Operating Cost Adjustment Factor. In the

The QAP requires developers pursuing PSH points to

application for the 811 PRA program, Louisiana projected

request a letter of support for their project from the

that the average contract rent for year one would be $795,

Executive Management Council. When a request is

with an average monthly rental assistance payment of

received, the council and its staff meet to assess the

$673. The final budget signed for the 2012 Louisiana 811

bedroom size(s, amenities, accessibility, and geographic

PRA program differs slightly from the application amounts.

location of the proposed units. LDH then designates

The budget establishes an average contract rent of $813

staff to conduct a site visit to the proposed property

per unit per month, with $597 coming from 811 PRA

to assess the surrounding environment and proximity

program rental assistance and $216 from the tenant.

to public transportation. The Executive Management

Unit Offers and Tenant Turnover

Council utilizes the information to determine whether to

support the project for the 811 PRA program. LHC does

Once deemed eligible for Medicaid and the 811 PRA

not support the selection of projects that LDH determines

program, an individual is placed on a waiting list. At the

cannot be reasonably occupied by the 811 PRA program

end of 2015, Louisiana had 72 households on the 811

target population. The Executive Management Council

PRA waiting list. When a unit becomes available, three

makes the final decision about which properties are

individuals on the waiting list are offered the opportunity to

selected for the 811 PRA program after LHC decides

view the unit. During 2015, 39 811 PRA-eligible participants

which projects wil  receive LIHTCs.

were referred to units and seven units were occupied.

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 3. Louisiana Section 811 Project Rental Assistance Program

Table 3.2 : Proper ties Under R AC or A pplication in Process

Property

Parish and City

Number of 811 PRA Units

Initial and Expected Occupancy Date

Austin Village

Morehouse

2

2016, 2017

Cypress Landing

Caddo, Shreveport

31

2015

Embassy House Apartments

Caddo, Shreveport

3

2016, 2017

Fairmont Towers

Caddo, Shreveports

60

2016, 2017

Renaissance at Al endale

Caddo, Shreveport

2

2015

Sycamore

Oachita, Monroe

3

2016, 2017

Villages at Eagle Point

Bossier, Bossier City

1

2016, 2017

PRA = Project Rental Assistance. RAC = Rental Assistance Contract.

Source: Louisiana Housing Authority, Internal Report.

Application for a unit occurs at the property. Eligibility

2.  Services for individuals with a developmental

for a unit is determined by housing development’s owner

disability who meet requirements for services

or property manager. Property managers establish their

provided by the Office for Citizens with

own tenant selection plan, which includes admission

Developmental Disabilities.

criteria. These criteria, however, must conform to 811

3.  Services provided by the Office of Behavioral Health

PRA program eligibility criteria and with Louisiana’s

for individuals with a serious mental il ness including

Housing First housing policy. The Housing First

those with co-occurring disorders.

approach provides, without prerequisites, immediate

access to PSH to individuals and families experiencing

4.  Services for individuals with a chronic health

homelessness. Formerly institutionalized or homeless

condition, physical, sensory, or cognitive disability

persons move directly into permanent housing units with

whose conditions meet the requirements of “in need

no requirement that they first agree to support services

of PSH” but do not meet the threshold requirements

or achieve a certain level of self-sufficiency. Intensive

for long-term care services provided by the Office

voluntary support services are offered to the program

of Aging and Adult Services and whose disabling

participant, aimed at helping the person maintain health

condition emerged after the age of 22.

and tenancy. A property owner or manager cannot reject

These populations are the highest priority for LDH and

a potential resident based on the resident not having

its agencies. Although eligibility for one or more of the

supportive services.

services is required, program participants have the right

As of October 2015, no 811 PRA units had turned over.

to refuse services; service participation of individuals

residing in 811 PRA program units is voluntary.

Service Provision and Coordination

Coordination of Services and Housing

Service Models

LDH coordinates services and housing. The 811 PRA

LDH ensures services are available to assist the target

project coordinator acts as the 811 PRA-PSH tenant

populations with community living and for helping

service manager and is the primary point of contact

program participants comply with the rental lease for

between LDH and property owners and managers. The

the 811 PRA program unit. To be eligible for an 811 PRA

coordinator communicates with property managers and

program unit, applicants must have access, at the time of

tracks program participants from referral to a housing unit

admission, to one or more of the fol owing.

through move-in and residency. Further, the coordinator

works to foster good relationships between property

1.  Services for individuals with a disabling chronic health

managers, program participants, and service providers. In

condition, physical, cognitive, or sensory disability

the event of a dispute between a program participant and

who meet requirements for services provided or

a property manager, the coordinator manages the initial

funded by the Office of Aging and Adult Services.

steps in the resolution process. Lastly, the coordinator

conducts site visits, provides feedback, and makes

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 3. Louisiana Section 811 Project Rental Assistance Program

recommendations to the 811 PRA management team on

Support services are provided by agencies certified by

ways to improve program administration and coordination.

LDH and fall into four categories: (1) HCBS targeted for

To ensure that 811 PRA program applicants can

individuals with chronic or physical health disabilities

successfully move into 811 PRA program units, LHA

who meet the threshold for long-term care; (2) HCBS

has committed $1.25 million in HOME Tenant-Based

targeted primarily for individuals with developmental

Rental Assistance during the initial 5-year 811 PRA

disabilities; (3) community-based behavioral health

grant period. The funds will provide security and

services; and (4) services coordination for individuals

utility deposit assistance to program participants who

with long-term chronic health conditions or physical

require additional assistance to secure an 811 PRA

disabilities who need continuous and long-term support

program unit.

but do not yet meet the threshold for long-term care

services.

Service Provision (Types, Transition Versus

In addition to HCBS, LDH also provides the Louisiana

Ongoing, by Target Population, Gaps)

Medicaid State Plan services, such as Community

LDH administers Medicaid for the State of Louisiana.

Psychiatric Support and Treatment (CPST) and

Louisiana 811 PRA program participants have access to

psychosocial rehabilitation. CPST are goal-oriented

both the traditional Medicaid HCBS [1915(c) waivers] and

supports and solution-focused interventions. These

Louisiana’s Medicaid State Plan services. LDH operates

services are intended to achieve goals or objectives

the HCBS waivers listed in table 3.3, which has a detailed

identified in the person’s individualized treatment plan.

listing of the services available under each waiver. CMS

CPST provides community and home-based case

approved LDH’s five 1915(c) Home- and Community-

management services and access to behavioral health and

Based Waiver amendments. These approvals resulted in

medical supports, and il ness management skil s training.

increased services to program participants.

Table 3.3 : Louisiana 1915 ( c ) HC B S Waiver s

1915(c) Waivers

Summary

Provides day habilitation, prevocational, home respite care, shared living services, support coordination, supported employment, assistive technology or specialized medical equipment and supplies, Residential Options Waiver

dental, community living supports, companion care, environmental accessibility adaptations, host home, nursing, one-time transitional services, PERS, professional services, transportation and community access for individuals with developmental disabilities.

Provides adult day health care, caregiver temporary support, support coordination, assistive

devices and medical supplies (assistive technology), environmental accessibility adaptation, home delivered meals, housing stabilization, housing transition or crisis intervention, monitored inhome Community Choices Waiver

caregiving, nonmedical transportation, nursing, personal assistance services, skil ed maintenance therapy, transition intensive support coordination, and transition services individuals with physical disabilities ages 21–64.

Provides day habilitation, habilitation, prevocational services, respite, support coordination, Supports Waiver

supported employment, housing stabilization service, housing stabilization transition, PERS for individuals with developmental disabilities ages 18 and older.

Provides center-based respite, day habilitation, employment related training, supported employment, supported living, skilled nursing, specialized medical equipment and supplies, adult companion care, community integration and development, environmental accessibility adaptations, housing New Opportunities Waiver

stabilization, housing stabilization transition, individual and family support, one-time transitional, PERS, professional services, remote assistance, substitute family care for individuals with developmental disabilities ages 3 and older.

Provides crisis stabilization, independent living and skills building, parent support and training, Coordinated System of Care

short-term respite, youth support and training for individuals with serious emotional disturbances ages 0–17 and individuals with mental illness ages 18–21.

HCBS = home- and community-based services. PERS = Personal Emergency Response Systems.

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 3. Louisiana Section 811 Project Rental Assistance Program

Psychosocial rehabilitation services assist individuals

By exchanging emails daily with LDH PSH staff and

with mental il ness by providing them with support

participating in monthly meetings with the Executive

services that mitigate functional deficits and

Management Council, LHA assesses program progress

interpersonal or environmental barriers associated with

that is reported to HUD. Using TRACS and the LOCCS,

mental il ness. Activities are designed to meet the goals

LHA accepts, processes, and makes payment to

outlined in each person’s individualized treatment plan.

property owners or managers in the 811 PRA program.

The psychosocial rehabilitation intent is to restore the

As mentioned in the Outreach, Referral, and Application

ful est possible integration of individuals as active and

Methods section, 811 PRA program staff use Yardi to

productive members of his or her family, community, or

track each 811 PRA program applicant through the

culture with the least amount of ongoing professional

housing referral, selection, and placement process.

intervention.

Some LDH staff members stated that Yardi is difficult

Pretenancy services (known as transitional services

to navigate and some methods are cumbersome. Staff

in other states) are available to all 811 PRA and PSH

reported maintaining their own spreadsheets to track

program participants, regardless of the type of waiver

program participants. Yardi is also the financial system

under which they receive services. Participation in

used to generate payments to owners in the PSH

services voluntary and services are available from prior

program. Owners are required to utilize Electronic Funds

to move-in through occupancy, if needed and desired.

Transfer to receive payment.

The types of service provisions vary based on each

individual’s need and Medicaid eligibility. LDH certified

Successes and Challenges

agencies receive financial support from other sources

Building from the design, organizational structure,

and offer additional transitional services on top of the

and management of the GO Zone PSH program,

pretenancy services provided by Medicaid waivers.

LHA and LDH have extensive experience starting up

However, the availability and depth of coverage of these

and implementing a supportive housing program.

additional resources vary greatly from one provider to

Nonetheless, 811 PRA program staff and their partners

another.

expect the startup phase of the program to require a

2013 811 PRA Application

significant time and effort to put all program components

in place. The fol owing sections provide the successes of

Louisiana decided not to pursue additional 811 PRA

and chal enges to program implementation as reported

program assistance in the 2013–2014 funding round. The

by 811 PRA program staff and their partners.

state wanted to ful y implement its 2012 program first.

LHA confirmed that it approved that decision, because

Successes

program implementation has been challenging.

Program experience and commitment. Despite

chal enges in 811 PRA program implementation,

Leveraging

Louisiana’s experience in PSH program administration

To provide rental assistance to extremely low-income

gave the state a head start because some program

individuals with disabilities, LHA secured 125 housing

components were already developed under the PSH

choice vouchers from three local housing authorities—

program. By the end of 2015, 811 PRA program staff

Calcasieu, East Baton Rouge, and Shreveport. No

thought that they had “final y turned a corner” in program

vouchers have been leveraged yet. LHC is working

implementation and could make much more progress in

on Memorandums of Understanding (s) with the three

2016. In addition, the 811 PRA program staff are highly

housing authorities.

committed to achieving program success. From the

most senior staff person to the service providers, all

Program Administration,

stakeholders connected with the 811 PRA program have

voiced their commitment to “doing whatever it takes.”

Assessment, Information Systems,

811 PRA program staff’s relationship with property

and Data Infrastructure

owners and managers.  Both LHA and LDH staff feel

LHA conducts daily program administration. Biweekly,

that their relationship with property owners or managers

LHA and LDH meet to discuss 811 PRA program

participating in the program is strong. Because staff have

implementation. In addition, LHA and LDH hold biweekly

established and maintained a strong relationship with

cal s with interested stakeholders.

property owners or managers in the program, 811 PRA

program staff and property managers worked patiently

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 3. Louisiana Section 811 Project Rental Assistance Program

through all program implementation aspects, including

System by property owners. Thus, the actual amount

the long delay in the start of the program and in payment

of staff time required to implement the program has

of security deposits and rent.

greatly exceeded what LHA and LDH anticipated in their

Units under RAC and occupied units. Despite some

application to the 811 PRA program.

initial difficulty obtaining participating properties in the

Attracting property owners and developers.

target areas of the state, Louisiana has executed three

LHA experienced some difficulty attracting property

Rental Assistance Contracts with a total of 34 units.

developers and owners to the 811 PRA program. LHA

In addition, 7 of those units were occupied at the end

reported that it takes multiple interactions to convince

of 2015. With all 2015 grantee production considered,

property owners or managers to become interested

Louisiana was one of only four grantees able to

in applying to the program. LHA staff members have

house more than one occupant during the first year of

strong connections to the development community in

program implementation.

the northern and central parts of the state because of

Providing gap funding to expedite unit occupancy.

their involvement with other housing programs. Despite

To ensure that 811 PRA program applicants can

these wel -developed relationships, LHA staff reported

successful y move into 811 PRA program units, LHC

that the learning curve for the 811 PRA program has been

committed $1.25 mil ion in HOME Tenant-Based Rental

surprisingly steep for developers or owners. The time it

Assistance during the initial 5-year 811 PRA grant

has been taking for (1) program staff to educate property

period. This funding will help remove an impediment to

owners or managers about the program and (2) property

community-based housing by covering the cost of 811

owners or managers to apply and be accepted into the

PRA tenant security and utility deposits not covered by

program has affected the number of units available for

811 PRA or other funds.

the program.

The development community in the northern and central

Challenges

parts of the state reported wanting to wait to see how

Delay in program startup.  811 PRA implementation

the program is being implemented before participating.

by the grantee was impeded by the delay in HUD’s

In addition, because of the demand for rental housing,

implementation of the 2012 program, including the delay

property owners and managers can receive higher

in the execution of the Cooperative Agreement. Louisiana

market rate rent for their units than they would receive

had identified units for availability in 2013 through

under the 811 PRA program. Despite some initial

2014 that it planned to include in its 811 PRA program.

hesitancy, developer participation has increased in

However, by the time the Cooperative Agreement was

subsequent QAP funding rounds.

final y issued, these projects were no longer available.

Unit size restrictions and not having enough of the

Further, these delays affected the grantee’s ability to

housing units that best meet the needs of program

develop a waiting list. The grantee was concerned that

participants. Most 811 PRA program participants on

given the target populations’ vulnerability, applicants

the waiting list for housing need a one-bedroom unit.

would have to wait too long for housing assistance.

811 PRA program staff reported that finding property

The amount of time program implementation is

owners or managers with existing one-bedroom units

requiring. Although the 811 PRA program is a part of the

has been difficult. Program management would find it

existing PSH structure, the 811 PRA management team

very helpful if the program received a waiver to enable

had to reengineer processes and structures to meet 811

single-person households to lease two-bedroom units at

PRA requirements and to expand its work into areas

the one-bedroom payment standard. 811 PRA program

outside of the GO Zone. 811 PRA program staff greatly

staff also stated that property owners or managers with

underestimated the time it would take to implement a

one-bedroom units have been interested in program

program with the complexity of the 811 PRA program.

participation. However, they were ineligible, because no

support services were nearby, as would be the case in

All stakeholders, from service agency staff to

rural parts of the state. However, it is important to note

developers, have required 811 PRA program training

that LHC is changing its QAP to give preference to one-

because it is a new program, with new guidelines,

bedroom units for the 811 PRA program. This change will

processes, and requirements. Per LHC staff, the

result in an increase in the unit size needed for the 811

most chal enging procedures and requirements for

PRA program as units become available in the future.

stakeholders to acclimate were related to Medicaid

waiver bil ing for service agencies, and payment

Coordinating LIHTC timing to achieve 811 PRA

requests in Tenant Rental Assistance Certification

occupancy. A concern expressed by LHA was that

37

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 3. Louisiana Section 811 Project Rental Assistance Program

significant time is needed to prepare and house

applicants from the target populations, such as moving

institutionalized persons to a community rental unit. The

time required to move an applicant to a community-

based unit does not always coincide with the deadlines

imposed by Low-Income Housing Tax Credit regulations,

such as occupancy deadlines. Even the provision of

vacancy payments does not necessarily solve this

problem, because investors will accept only actual

occupancy of the units as meeting the regulatory

occupancy requirement. A payment in lieu of occupancy

does not meet initial LIHTC occupancy requirements.

Such situations can result in a unit being fil ed by a non-

811 PRA program tenant, which means that the unit is

unavailable for an 811 PRA program tenant until vacated

at turnover.

811 PRA program sustainability. LDH voiced concern

about the long-term sustainability of the 811 PRA

program. Before execution of the LDH-OCD Cooperative

Endeavor Agreement, LDH brought up the sustainability

issue. The administrative costs of the 811 PRA program

far exceed the amount provided under the administrative

portion of the 811 PRA grant. The Louisiana 811 PRA

program depends heavily on MFP funds for operational

support. On June 26, 2015, CMS issued guidance on

coverage of housing-related activities and services

for individuals with disabilities. It is crucial that LDH

understands how it can use the provisions of the CMS

guidance to fill funding gaps on the service side between

now and until MFP ends and funds are exhausted.

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

Maryland Section

finance agency. DHCD administers affordable housing

programs throughout Maryland. These programs include

811 Project Rental

federal LIHTC, Federal Housing Administration Risk

Sharing Program, HOME, Community Development

Block Grant, and HCVs, as well as state-funded housing

Assistance Program

development and rental assistance programs such as

the Rental Housing Program, and Partnership Rental

Housing Program (Partnership). DHCD also serves as a

Performance Based Contract Administration (PBCA) for

HUD, and is a public housing agency (PHA) operating

Introduction

the HCV, formerly Section 8) program primarily in

Maryland’s rural jurisdictions.

In 2012, HUD awarded the Maryland Department of

DHCD operates a wide range of programs to assist

Housing and Community Development (DHCD), in

persons with disabilities. Four of them are (1)

partnership with the Maryland Department of Health and

Homeownership for Individuals with Disabilities Program;

Mental Hygiene (DHMH) and Maryland Department of

(2) Individuals with Disabilities and Special Needs (IDSN)

Disabilities (MDOD), $11,229,308 in Section 811 Project

program; (3) Bridge Subsidy Program; and (4) Harry and

Rental Assistance program funds to support 150 units

Jeanette Weinberg Foundation’s Maryland Affordable

with rental assistance. DHCD proposed to make available

Rental Housing Opportunities for Persons with

150 units of PSH from existing housing stock, as well as

Disabilities Initiative (Weinberg Apartments Initiative).

units from newly constructed or renovated properties.

Together, these varied programs increase PSH

These units will be in the Baltimore and Washington

opportunities in the community. DHCD incentivizes

metropolitan areas.

development of affordable rental housing for persons

Evaluators conducted a site visit in November 2015

with disabilities through the state’s QAP. DHCD also

to learn about Maryland’s 811 PRA implementation

finances group homes and the Special Housing

experiences. At the end of 2015, 13 units were available

Opportunities Program, which enables persons with

under RAC and 4 units were occupied.

disabilities who elect to live in a group living situation.

Taken together, these DHCD programs have produced

Grantee Partnership, Organizational

thousands of units of affordable housing for persons

Structure, and Management

with disabilities.

Overview

Maryland Department of Health and Mental

Hygiene

DHCD is the primary applicant and grantee for 811

PRA and has partnered with DHMH and MDOD for full

DHMH is the state Medicaid agency. DHMH operates

program implementation and delivery. The division of

the Medicaid program and oversees the Developmental

responsibilities is based on areas of functional and

Disabilities Administration, Behavioral Health

specialized capabilities. This section begins more

Administration,6 and the MFP Demonstration program.

broadly with an overview of each agency, its role within

DHMH operates nine home- and community-based

the state, and the relevant programs they administer.

Medicaid waivers, including six that serve adults with

The section then reviews the specifics of the partnership

disabilities as an alternative to institutionalization.

and each agency’s roles and responsibilities for the 811

•  Community Pathways Waiver.

PRA program.

•  Home- and Community-Based Options Waiver.

Maryland Department of Housing and

•  Brain Injury Waiver.

Community Development

•  Medical Day Care Waiver.

DHCD is the state agency charged with promoting

•  Community First Choice.

homeownership, increasing and preserving affordable

rental housing, as well as preventing and eliminating

•  Community Personal Assistance Services.

homelessness in Maryland. DHCD is the state’s housing

These waivers are described in more detail in the section

6

In July 2014, Mental Hygiene Administration merged with the Maryland Alcohol and Drug Abuse Administration to form the Behavioral Health Administration.

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

titled Service Provision and Healthcare. Community

continued on as they participated in the Governor’s

Pathways Waiver, Home- and Community-Based Options

Commission on Housing Policy. MDOD’s Secretary served

Waiver, and Brain Injury Waiver are Medicaid-funded

as Chair of the Commission’s Affordable and Accessible

services. Community First Choice and Community

Housing for Individuals with Disabilities Subcommittee.

Personal Assistance Services are services provided by

DHCD, DHMH, and MDOD worked on a few initiatives

the Maryland State Medicaid Plan. DHMH also provides

together, including the Real Choice Systems Change

community-based supports to individuals with behavioral

Grant effort described previously, the Bridge Subsidy

health disabilities. In 2011, DHMH provided psychiatric

Program and the Weinberg Apartments Initiative.

rehabilitation services to 2,851 individuals and other

supportive services to 8,686 people.

Design and Structure of Maryland’s 811 PRA

Maryland’s MFP program has transitioned 1,260 people

Program

out of institutions to home- and community-based

Eligible 811 PRA applicants will lease units within

settings. MFP has experienced a very low reinstitutional

properties supported with federal resources, including

rate of less than 6 percent since it began.

LIHTC, private activity bonds used for multifamily

development (MF-Bond), Federal Housing Administration

Maryland Department of Disabilities

Risk Sharing Program, and HOME, as well as state

MDOD’s mandate coordinates the delivery of state

resources such as Maryland’s own Rental Housing

services to people with disabilities to improve outcomes.

Program (RHP), Partnership Rental Housing Program

Established in 2004, MDOD is the first state cabinet

(Partnership), and other resources.

level department of its kind in the United States. This

Rental assistance is provided to individuals with

department works to remove barriers for people with

disabilities who are making or are ready to make the

disabilities and create new opportunities in education,

transition to integrated housing arrangements. 811

employment, transportation, community living and

PRA provides this population access to housing units

housing. MDOD and DHMH have a long history of

that may have been previously out of reach. Individuals

partnership. In addition to the peer outreach and support

in the 811 PRA program are automatical y placed on

services component of the MFP program, MDOD

the HCV waiting lists of DHCD and other PHAs who

operates several federal grants for DHMH, such as the

have partnered with DHCD, DHMH, and MDOD for the

Medicaid Infrastructure Grant.

program. If an 811 PRA participant is offered an HCV, he

MDOD initiated the Statewide Taskforce for Affordable

or she may not have to move from the unit.

Housing to take advantage of additional private, public-

Extremely low-income nonelderly adults with disabilities

sector, and federal funding opportunities in 2010. In 2011,

between 18 and 61 years old who are enrol ed in

this effort resulted in DHMH’s successful application for

Medicaid are general y eligible for 811 PRA. However,

the Building Sustainable Partnerships for Housing Real

the Maryland 811 PRA program established priority

Choice Systems Change Grant funded by CMS. MDOD

target populations. This prioritization is discussed in

co-chaired the Advisory Group for Real Choice Systems

greater detail in the section titled Population Served of

Change Grant with DHMH. The project was instrumental

this report.

in providing program infrastructure to implement a

permanent supported housing program such as 811 PRA.

The organizational structure is modeled after the

MDOD also directly manages the Maryland Attendant

Bridge Subsidy Program. This structure is a centralized

Care Program, the Maryland Technology Assistance

model wherein responsibilities for enrol ment, waitlist

Program, and the Constituent Service Program, which

management, and referrals to units for the 811 PRA

helps people with disabilities navigate the state service

program are performed by one entity. In Maryland, these

system and increase their ability to self-advocate.

responsibilities are held by MDOD. DHCD sources the

units, and DHMH and others provide support services.

Partnership

Supportive services for persons in the 811 PRA program

The DHCD, MDOD and DHMH col aboration started in

are mainly provided by DHMH. DHMH provides several

2001 as staff from all three agencies worked together

voluntary support services available to 811 PRA

on the Community Access Steering Committee7 and

participants through 1915(c) Medicaid waivers. These

7

A 2001 Executive order established the Community Access Steering Committee to explore Olmstead-related policy actions. This committee is discussed in more detail in the section titled Service Provision and Healthcare.

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

services are described in detail in the section titled

program requirements. DHCD is also responsible for

Service Provision and Healthcare. However, MDOD also

overall program administration including reporting to HUD.

made the Attendant Care Program available to 811 PRA

Maryland Department of Health and Mental Hygiene

participants.

responsibilities.  Through its contracted support service

811 PRA Roles and Responsibilities

providers, DHMH will enroll eligible applicants on the

811 PRA waiting list into voluntary supportive services.

Each agency’s responsibilities for the program effectively

DHMH also provides long-term supports and services

fold into its existing operations. Table 4.1 provides a

to program participants, including case management

summary of each organization’s responsibilities.

services that are designed to assist recipients in

Maryland Department of Housing and Community

maintaining good tenancy in the units. DHMH provides

Development responsibilities.  DHCD’s responsibilities

several a number voluntary support waiver and state plan

are centered around housing. DHCD is charged with

services available to tenants in 811 PRA Demo units who

sourcing and managing housing units for the 811 PRA

are eligible for Medicaid-funded services. These services

program. However, it is important to note that although it

are described in detail in the Service Provision and

is ultimately DHCD’s responsibility to select units for 811

Healthcare section.

PRA funding, it works diligently with DHMH and MDOD

DHMH, in col aboration with MDOD, established

in sourcing and selecting units for the program. The

memorandums of understanding with the six centers

three agencies engage in weekly dialogue to ensure units

for independent living in Maryland. This partnership

sourced are meeting the service needs and geographic

is designed to ensure that individuals in the target

preference of the 811 PRA program applicants. DHCD

populations who do not have case management as part

modified its QAP application process to incentivize the

of their service package, or who lose Medicaid eligibility

participation of developers seeking financing for projects

during tenancy, have access to community services and

in the 811 PRA program. These efforts are discussed in

supports to ensure successful tenancy. These supports

more detail in the section titled Financing.

and services include independent living training and

DHCD also creates, executes, and monitors all RACs,

counseling; information and referral (designed to identify

including use agreements and other contractual

resources, services, and service providers in public,

documents. DHCD is charged with making rental

private and community organizations that can assist

assistance payments to property owners and conducting

living independently); individual and systems advocacy;

site visits to 811 PRA units to ensure compliance with

and peer counseling.

Table 4.1: Mar yland 811 P R A Program Division of Responsibilities

DHCD

DHMH

MDOD

•  Identify and finance eligible units for 811 PRA

•  Make available Medicaid services.

•  Manage waiting list

program.

•  Execute Rental Agreement Contracts with property  •  Monitor performance of support service providers. •  Conduct outreach to 811 PRA eligible individuals.

owners.

•  Outreach to developers, landlords, and property

•  Outreach, training, and technical assistance to

•  Manage referrals to 811 PRA units.

owners.

support service providers.

•  Monitor 811 PRA unit occupancy and compliance

•  Assist in training housing and support services

•  Assist DHCD in outreach to developers or landlords

with eligibility requirements.

providers.

or property owners.

•

•

•

Collect and report data on service delivery, costs,

Provide education, training, and technical support

Make rental payments to property owners.

and outcomes.

to housing and support service providers.

•  Collect and report required occupancy and

•  Assist in program evaluation and data collection.

•  Assist in program evaluation and data collection.

financial information.

•  Ongoing support and communication with DHMH,

•  Assist in providing education, training and

•  Ongoing support and communication with DHMH,

MDOD, housing providers, and support services

technical support to housing and support service

MDOD, housing providers, and support services

providers.

providers.

providers.

DHCD = Maryland Department of Housing and Community Development. DHMH = Maryland Department of Health and Mental Hygiene. MDOD = Maryland Department of Disabilities. PRA = Project Rental Assistance.

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

DHMH and MDOD will provide housing training and

•  Quality and compliance specialist 1 (0.1 FTE on 811

technical assistance to The Center for Independent

PRA).

Living staff and Medicaid-funded case managers across

•  Quality and compliance specialist 2 (0.1 FTE on 811

all support services agencies to support the tenancy 811

PRA).

PRA program participants.

The MFP program director helps MDOD problem solve

Department of Disabilities responsibilities.  MDOD’s

and troubleshoot issues with the pipeline of moving

role is integral to the 811 PRA program. MDOD staff

individuals out of institutions and into integrated housing.

manage the daily operations of the 811 PRA program.

The housing director provides technical assistance and

For example, MDOD staff handle application requests,

training to housing providers as well as support to service

manage the waiting list and oversee the referral

providers. The housing specialist provides technical

process to 811 PRA units. Also, MDOD staff ensure that

assistance to supports planners regarding enrol ment and

available units are tracked in the system and that eligible

service provision standards.

applicants are notified about available units. MDOD also

provides training to support services providers.

DHMH has two quality and compliance specialists for

MFP who contribute part of their time to 811 PRA. The

Program Staffing

quality compliance specialists monitor al  the transitions

In al , the program operates with a total of 6.75 ful -time

from nursing facilities, including 811 PRA participants.

equivalents across al  positions. DHCD contributes 2.15

The housing specialist, together with the quality and

FTE, and DHMH contributes 1.45 FTE (this staff excludes

compliance specialists, work col aboratively to ensure

Projects for Assistance in Transition from Homelessness,

that individuals successfully move into 811 PRA units.

or PATH, and MFP staff). MDOD contributes the most staff

MDOD has the most staff committed full time to 811 PRA.

time to the 811 PRA program with 3.2 FTE staff assigned.

Of the four staff assigned to 811 PRA, two spend most of

DHCD’s responsibilities for the 811 PRA program are very

their time on the program. Two of the positions are funded

well interwoven into its staff’s current responsibilities.

by MFP funds through DHMH via a memorandum of

As such, at DHCD only the project manager spends

understanding. MDOD staff working on 811 PRA are—

the most time on the 811 PRA program. All other team

•  Chief of staff (0.1 FTE on 811 PRA).

members spend a small amount of time on the 811 PRA.

•  Program director (0.4 FTE on 811 PRA).

The core team at DHCD working on 811 PRA include—

•  Housing program liaison (0.85 FTE on 811 PRA).

•  Program director (0.1 FTE on 811 PRA).

•  Waiting list manager (0.9 FTE on 811 PRA).

•  Project manager (0.75 FTE on 811 PRA).

DHCD, DHMH, and MDOD will use their existing

•  Grants manager (0.2 FTE on 811 PRA).

infrastructure and processes to manage the 811 PRA

•  Contract administrator (0.2 FTE on 811 PRA).

program. Maryland estimates the 811 PRA program wil

•  PHA administrator (0.1 FTE on 811 PRA).

cost the agencies an estimated $2 mil ion to operate.

Meanwhile, only $831,800 of the 811 PRA program funds

The program director oversees DHCD staff work

can be used for administrative costs. Agencies must

dedicated to 811 PRA and the Project Manager is the most

leverage funds from other sources to cover the gap. As

heavily involved. The Project Manager is the primary point

noted previously, DHMH and MDOD staff working on

of contact at DHCD for 811 PRA and works with property

the 811 PRA program are funded primarily through MFP

owners to ensure RAC execution. The Grants Manager

funds with some support coming from Medicaid funds.

assists with grant reporting and communications. The

DHCD is mainly using internal resources to support its

Contract Administrator ensures that rent payments are

commitment to the 811 PRA program.

delivered on time and paid accurately.

DHMH staff working on 811 PRA are ful y dedicated to MFP.

State Context: Housing Programs

Therefore, even though they contribute only a portion of their

time to the 811 PRA, their daily work is completely aligned

Financing

with 811 PRA. DHMH staff working on 811 PRA include—

Under Maryland’s QAP, property developers who

•  MFP program director (0.5 FTE on 811 PRA).

receive funding for family projects from DCHD are

required to target and market 5 percent of their units for

•  MFP housing director (0.5 FTE on 811 PRA).

persons with disabilities with incomes at 60 percent or

•  MFP housing specialist (0.25 FTE on 811 PRA).

below of Area Median Income. These requirements are

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

in place for at least 60 days after the property is ready

○ Providing tenant service packages.

for occupancy.

○ Leveraging nonstate funds.

DHCD modified its QAP to encourage property developers

○ Being near good job, transportation, educational,

to participate in the 811 PRA program. Property developers

and recreational opportunities.

have an opportunity to earn bonus points in their

application if they agreed to restrict up to 25 percent of

○ Sponsorship with demonstrated development and

the units in the property for persons with disabilities who

management ability.

have incomes at or below 50 percent of AMI. Furthermore,

•  The Partnership Rental Housing Program finances

property developers must hold this restriction for at least

affordable housing projects, by local governments

90 days after the property reaches 80 percent occupancy.

or PHAs, for households below 50 percent of the

To create a pipeline of eligible properties for the 811 PRA

statewide median income. The Partnership Rental

program, DHCD used its LIHTC al ocation, as well as

Housing Program may also be used by nonpublic

other federal and state financing programs, to catalyze the

entities to create permanent supportive housing for

creation of 811 PRA units in the state. The fol owing is a list

persons with disabilities or special needs (IDSN units)

of DHCD’s affordable rental housing financing programs.

at 30 percent of AMI. Typical y, IDSN units do not

exceed 10 percent of the units in a project.

•  DHCD receives about $13 mil ion in 9-percent LIHTC

annual y. LIHTCs are awarded on a competitive

•  The Rental Housing Works initiative and the Maryland

basis, typical y with State Rental Housing funds. In

Housing Rehabilitation Program provides financing

addition, projects financed with tax-exempt bonds

to create or preserve rental housing with federal,

may also be eligible for LIHTCs (4 percent) outside of

state, or local affordability requirements. The

the competitive process. LIHTC projects are rent and

Rental Housing Works initiative and the Maryland

income restricted for 30–40 years. DCHD monitors

Housing Rehabilitation Program are primarily used in

these properties regularly.

conjunction with the Multifamily Bond Program.

•  The Multifamily Bond Program provides below-market

Supportive Housing Programs

construction and permanent financing for affordable

DHCD, DHMH, and MDOD have worked on several PSH

rental housing. It finances new construction,

programs under the umbrella of Maryland Partnership for

acquisition, and rehabilitation of existing housing.

Affordable Housing. The group has operated the Bridge

•  The HOME Investment Partnerships Program is a

Subsidy Program and the Weinberg Apartments Initiative

federal program that provides funds to state and local

for several years. Both programs serve target populations

governments to promote affordable housing activities.

like that of 811 PRA. Moreover, both programs are

DHCD sets aside a portion of its annual al ocation

designed and implemented very similarly to 811 PRA.

to be awarded competitively with LIHTC and Rental

Bridge Subsidy Program was one of the Governor’s

Housing Funds.

Commission on Housing Policy’s recommendations.

•  State Rental Housing Funds is a financing program

The Bridge Subsidy Program is a tenant-based rental

designed to spur the creation of new affordable

assistance program designed to provide housing for

rental housing units. These funds can also be used

extremely low-income persons with mental or physical

to substantial y rehabilitate existing affordable rental

disabilities. To be eligible, individuals must be at least 18

housing stock. The program is compatible with tax-

years old, have an annual income of $15,000 (or less),

exempt bond financing, LIHTCs, and other private

and receive Supplemental Security Income or Social

or public funds. Rental housing funds are awarded

Security Disability Insurance.

competitively, typical y in conjunction with LIHTCs. All

Individuals in the Bridge Subsidy Program are given

projects must be in Priority Funding Areas. For-profit,

preference in a participating PHA’s HCV waiting list.

nonprofit, and public entities submit applications,

Bridge Subsidy Program participants receive rental

which are evaluated against criteria set forth in

assistance payments until they receive HCVs. Maryland

Maryland’s Qualified Allocation Plan including—

has successful y implemented two versions of a Bridge

○ Restricting units to tenants with incomes below 60

Subsidy Program, 2006 and 2010, respectively. Through

percent of AMI.

2013, Bridge Subsidy Program had 130 recipients.

○ Restricting units to low-income tenants for more

Maryland secured an additional $2.6 mil ion in funding

than 40 years.

through MFP Rebalancing Initiatives to implement a third

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

version of this program in 2014. The 2014 Bridge Subsidy

served by six major federal y funded housing programs.

Program provides 3 years of rental assistance payments

HCVs is Maryland’s largest federal housing program. It

to individuals transitioning from institutions to the

accounts for 51,796 units, which is 45 percent of the total

community. Maryland anticipates serving an additional

units (114,730) made available by federal programs in

94 households in the third cohort.

the state. A significant number of households receiving

The agencies also collaboratively administer the Weinberg

HCVs are headed by a nonelderly person with a disability.

Apartments Initiative, which began in 2011 and is funded

Moreover, table 4.2 shows that 33 percent of Section 8

by a Harry and Jeannette Weinberg Foundation grant.

recipients and roughly 4 out of 10 households (39 percent)

The Weinberg Apartments Initiative creates project-

in public housing are also headed by a nonelderly person

based housing for individuals with disabilities and their

with a disability. In addition, Maryland has 1,422 NED

households. Weinberg Apartments Initiative units have

Vouchers, 112 of which are Category 2.

40-year use agreements. Through 2013, 20 units have been

Service Provision and Healthcare

created through this initiative with $2 mil ion in funding.

DHMH administers Medicaid for Maryland. Maryland

DHCD also administers Non-Elderly Disabled Category 1

811 PRA program participants have access to both

and 2 vouchers. NED Category 1 vouchers are designed

the traditional Medicaid home- and community-based

to provide nonelderly individuals with disabilities with

services [1915(c) waivers] as well as Maryland’s expanded

an opportunity to obtain affordable community-based

Medicaid State Plan. DHMH operates the HCBS waivers

rental housing; NED 2 vouchers are targeted to persons

listed in table 4.3, with a detailed listing of services

with disabilities currently residing in nursing homes or

available under each waiver.

other healthcare institutions who want to transition to

community living. Through 2009, Maryland received 1,310

Community Pathways Waiver: serves 20,000 persons with

NED 1 vouchers and 112 NED Category 2 vouchers.

intel ectual and developmental disabilities. Home- and

Community-Based Options Waiver: serves 3,943 adults

Both DHMH and MDOD work closely with supports

18 and older who meet nursing facility level of care.8 Brain

planners or case managers to identify eligible participants

Injury Waiver: assists 49 adults with traumatic brain injury

for the Bridge Subsidy Program and Weinberg Apartments

acquired after age 22. Medical Day Care Waiver: serves

Initiative. They also provide voluntary services and supports.

4,532 individuals aged 16 and above

DHMH makes the referrals for NED Category 2 HCVs.

In addition to HCBS, DHMH also provides the Maryland

Additional Federal Housing Programs

Medicaid State Plan services, such as Community

In addition to state agencies, local governments, housing

Personal Assistance Services, which serves 5,400 adults

authorities, and private owners develop and administer

and Community First Choice (CFC). The agency expanded

affordable housing in Maryland for people with disabilities.

services and coverage for its Medicaid State Plan because

Table 4.2 provides an overview of the number of persons

of the Affordable Care Act. Through the Affordable

Table 4.2 : O ther Federal Housing Programs in Mar yland

Percent With Disabilities

Number of Household

Among Head, Spouse Aged

Percent of All Persons With

Program

Number of Units Available

Members

<62

Disabilities

Public Housing

14,600

27,381

39

26

Housing Choice Vouchers

53,519

115,355

37

24

Moderate Rehabilitation

419

1,005

31

22

Project-Based Section 8

24,021

38,316

33

18

811/PRAC

1,185

1,156

99

13

PRAC = Project Rental Assistance Contract.

Source: HUD (2016)

8

In January 2014, the Older Adults Waiver and Living at Home Waiver merged to become the Home- and Community-Based Options Waiver.

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

Table 4.3 : 1915 ( c ) Waiver s ( Home- and C ommunit y- Based Ser vices )

Service Type

Service

HCBO

CP

TBI

Home- and community-based services

Assisted living

X

Assistive devices, equipment, technology

X

Attendant care, personal care, personal supports, CSLA

X

Behavior consultation and supports

X

X

Case management, service coordination, resource coordination

X

X

Clubhouse model of day supports

New

Day habilitation

X

X

Dietitian, nutritionist services

X

X

Environmental accessibility modifications

X

Environmental assessments

X

Family and individual support services

X

X

Family and consumer training

X

X

Fiscal intermediary

X

Home-delivered meals

Medical day care

X

X

Nurse monitoring for personal care services

X

Personal emergency response system

X

Residential habilitation

X

X

Respite care

X

Senior center plus

X

Supported employment

X

X

Supports brokerage

X

Transition services

X

Transportation

X

CP = Community Pathways waiver. CSLA = community-supported living arrangements. HCBO = Home- and Community-Based Options Waiver. TBI =

Traumatic Brain Injury.

Care Act, DHMH implemented the CFC program. CFC

○ Personal Emergency Response Systems

consolidated previously overlapping services within the

○ Consumer training

Medical Assistance Personal Care, Living at Home, and

Older Adults Waiver programs into a unified and expanded

○ Nurse monitoring

program. This expansion increased access to vital services

○ Transition service

that prevent institutionalization and hospitalization. Home-

○ Items that substitute for human assistance

and Community-Based Options Waiver participants are

also eligible to receive CFC services. The CFC program

▪  Home delivered meals

provides the following services.

▪  Assistive technology

•  Community First Choice

▪  Environmental assessments

○ Supports planning

▪  Environmental modification

○ Personal assistance services

▪  Other

45

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

•  Community Personal Assistance Services program

healthcare service infrastructure. BIP supplements the

○ Personal assistance services

resources provided by MFP and helped Maryland invest

$106 mil ion in HCBS.

○ Support planning

○ Nurse monitoring

Olmstead Settlement

•  Disposable medical supplies and durable medical

Maryland does not have an Olmstead Settlement

equipment

Agreement and does not have an Olmstead plan.

However, the Community Access Steering Committee

•  Home health

was created in 2001 by Executive Order and placed

•  Psychiatric Rehabilitation Program

under DHMH. The committee consisted of the secretary

of DHMH, the director of the Governor’s Office for

DHMH also provides community-based supports to

Individuals with Disabilities, the secretary of Budget and

individuals with behavioral health disabilities, which is

Management, a representative from the governor’s office,

limited to Medicaid eligible adults. DHMH has provided

and six other members appointed by the governor. The

psychiatric rehabilitation services to 2,819 individuals and

Steering Committee made several recommendations to

other supportive services to 8,704 individuals in 2013.

develop additional supportive housing opportunities in

Additional y, DHMH’s Waitlist Equity Fund is utilized to

the state, as well as develop systems that help people

fund services for—

transition from institutions into the community.

•  Individuals transitioning from Intermediate Care

Because of the Steering Committee’s work, Maryland

Facilities for Individuals with Intel ectual Disabilities.

passed legislation that increased the number of people

These facilities are also cal ed state residential centers.

to be served through Community Pathways Waiver and

•  People not yet receiving services.

required the Department of Health and Mental Hygiene

Lastly, DHMH implemented Money Fol ows the Person

to submit an amendment to expand the Home- and

in 2007. MFP has successful y transitioned 1,933 people

Community-Based Options Waiver.

with disabilities from institutions into the community.

It is also worth noting that the City of Baltimore is under

Through MFP, Maryland has encouraged the use of

a consent decree because of a settlement agreement in

HCBS supports by streamlining the transition process.

the 2004 housing discrimination lawsuit (Ricky D. Bailey,

et al., v. Housing Authority of Baltimore City, or Bailey.

Funding

Bailey required the City of Baltimore to provide HCVs and

Changes in Medicaid resources away from

other accommodations to persons with disabilities.

institutional settings and toward community living.

Between 2008 and 2014, total Medicaid spending in

Population Served

Maryland increased from about $5.7 bil ion to nearly

To be eligible for the 811 PRA program, applicants must

$9.4 bil ion, a 63.4-percent increase. Funding for long-

meet mandatory program requirements. Also, Maryland

term services and supports went from $2 bil ion in

has established placement priorities to ensure that

2008 to nearly $2.8 bil ion in 2013 (Eiken et al., 2015;

the state’s priority policy issues, such as aligning with

KFF, 2017). Home- and community-based services, as

Olmstead requirements and ending homelessness, are

a portion of LTSS, also increased during this period,

addressed. These priority target populations are in this

indicating the continuing trend of decreased funding

priority order.

for institutionalized care and increased funding for

community-based services and supports. HCBS funding

1.  Institutionalized Medicaid recipients.

increased from 35.4 percent of LTSS in 2008 to 53.6

2.  Households at risk of institutionalization due to current

percent in 2013, which is more than the national average

housing situation.

of 51.3 percent (Eiken et al., 2015). Maryland ranks 21st

in the nation for its percentage of Medicaid funds spent

3.  Community Pathways Waiver participants moving

on HCBS (Eiken et al., 2015).

from group homes or ALUs to independent renting and

Residential Rehabilitation Program participants moving

Other sources of support.  In 2012, Maryland received

to independent renting.

funding through the Balancing Incentive Program. The

Balancing Incentive Program, which is administered

4.  Homeless persons who are Medicaid recipients,

by Centers for Medicare and Medicaid Services,

prioritized in the HEARTH Act definition order

incentivized the state to expand HCBS and improve the

(HEARTH Act of 2009).

46

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

Within these target priorities, the 811 PRA program

Supports planner and case managers and The Center for

serves persons with mental, physical, or developmental

Independent Living staff received continuous training in

disabilities. The target populations for the 811 PRA

811 PRA program requirements, affirmatively furthering

program units will access a range of inhome and

fair housing marketing requirements, enrol ment

community services through Maryland’s HCBS waiver

procedures, unit application processes, transition

programs, such as Home- and Community-Based

planning, and person-centered planning for community-

Options Waiver, Brain Injury Waiver, and Community

based housing by DHMH and MDOD.

Pathways Waiver, as well as Maryland’s Medicaid State

Plan programs including CFC and Community Personal

Referral and Application

Assistance Services.

Successful applications are entered into the waiting list,

which is maintained by MDOD. Selection of participants

Outreach, Referral, and Application

for referral to available units will be based on date

of application, priority population status, selected

Outreach

geographic area, and readiness to transition to an 811

811 PRA program outreach to potentially eligible

PRA unit.

persons will be conducted through regular supports

Property managers notify MDOD staff of unit availability

planner or case manager client contact, MFP outreach

via telephone or email. Within one week of notice that an

efforts in institutions, as well as program informational

existing unit is available or 6 months in advance of new

materials distributed to CILs, advocacy organizations,

or substantial rehabilitation unit availability, MDOD staff

consumer groups, service providers, and other

sends notification letters to the applicants, their assigned

healthcare organizations. Program information and

case manager, and other identified contacts. MDOD staff

outreach activities include information about eligibility

also fol ows up by telephone, email, or both. Applicants

criteria and instructions for enrollment procedures.

have a specified time from the date of mailed notification

Outreach activities include efforts to contact difficult-

letter to respond if they are interested in the unit.

to-reach populations, including non-English speaking

Supports planners or case managers assist applicants

populations, and persons with visual impairments and

with obtaining required documents and completing other

disabilities that affect their ability to communicate.

necessary forms. These documents are provided to

Program information and outreach activities are

property managers or owners. Property managers review

tracked and analyzed to determine the effectiveness

the applications and select a tenant based on their

of the outreach efforts in reaching certain populations,

selection criteria and the applicants order in the priority.

geographic regions, and service systems.

An offer of tenancy is provided to the applicant who

Program applications are submitted by an applicant’s

is ranked highest based on priority category, property

supports planner or case manager. The Center for

screening, application date, and readiness for transition.

Independent Living staff will provide case management-

Tenant training is provided and required for all 811 PRA

like services to people who do not have access to case

residents. The training curriculum includes a briefing on

management services. The Center for Independent Living

the 811 PRA program and covers topics regarding lease

staff submit applications on their behalf.

terms, financial responsibility, tenant responsibilities,

On identifying an interested person, supports planners

and fair housing or reasonable accommodations. This

or case managers will screen for eligibility based on

training should be completed within 2 months of move-in.

program criteria. Supports planners or case managers

Should the selected applicant refuse or fail to complete

log into the Maryland Housing Search, or SocialServe

the transition process, the unit will be offered to the

system to enter demographic and program information

next eligible applicant. Applications not selected will be

about the applicants, including their priority category,

returned to the waiting list and resume their place in line.

current living situation, unit size and desired county

Property managers receive the contact information of case

of residence. MDOD staff will review each application

managers to help with participant tenancy. MDOD staff

and approve, deny, or request additional information

and the MFP Housing Director also provide their contact

from case managers, depending on the circumstances.

information to all property owners and managers, and wil

Successful applications are logged and date stamped by

continue to serve as points of contact related to participant

the system. MDOD staff also maintain the waiting list and

tenancy. A Tenant Issue Process exists to ensure timely

update applicant status as appropriate.

and responsive handling of issues affecting tenancy.

47

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

The daily management and coordination of services

It would be easy for savvy 811 PRA applicants or

to tenants are provided by supports planners or case

their supports planner or case manager to indicate a

managers and other selected service providers, based

preference for areas of the state in which they do not

on the individual needs of participants identified in their

intend to live to increase their chances of being selected

person-centered plan.

for a unit. Maryland 811 PRA staff should monitor this

Per the fourth-quarter 811 PRA report, 834 people were

situation closely.

referred to the Maryland 811 PRA program throughout

2015. Of those referrals, 59 were institutionalized, 14

Housing Strategies

were at risk of institutionalization, 227 were homeless,

Property and Unit Characteristics

40 were at risk of homelessness, 118 were leaving group

homes, adult care homes or other residential settings,

Existing versus new construction. DHCD intended

376 were classified as “other.” Out of 834 referrals, 15

to utilize existing properties and new construction or

were found ineligible for 811 PRA. As of December 31,

substantial rehabilitation properties to source units for

2015, the 811 PRA waiting list has 819 applicants.

the 811 PRA program. Initial y, DHCD estimated that

about one-half of the 811 PRA units would be sourced

Compared with other 811 PRA grantees, Maryland has

from existing properties financed by the agency and

a very large 811 PRA waiting list. At the end of the first

through new construction and substantial rehabilitation

quarter of 2015, Maryland already had 693 persons

projects in the pipeline during the next 4 years.

on the 811 PRA waiting list, of which 548 came from

previous waiting lists and 145 came from new 811 PRA

Property selection methods and financing.  DHCD will

applicants. Because eligibility criteria are comparable,

select projects for the 811 PRA program using DHCD’s

Maryland was able to place eligible Weinberg applicants

existing portfolio of properties, as well as projects in the

on the 811 PRA waiting list. As noted previously, the

pipeline which are awarded DHCD financing. Only those

Weinberg Initiative predates the 811 PRA program by

projects with DHCD oversight or funding are selected for

a few years and the waiting list for this program was

811 PRA.

already robust, which accounts for the size of the 811

For existing developments, DHCD created a Notice of

PRA waiting list. In addition, Maryland chose to have one

Funding Availability for its existing portfolio of properties

portal for all three programs to make it easier for case

that would be eligible for 811 PRA. In sourcing 811

managers to access the programs for their clients.

PRA properties, DHCD works closely with DHMH and

As of December 31, 2015, 28 811 PRA applicants were

MDOD to ensure that units selected for the program

referred to 811 PRA units. Of the 28 applicants referred to

are in areas where the target population wants to live.

811 PRA units, 4 moved into 811 PRA to units.

DHCD also ensures that 811 PRA units are near public

transportation, and public and private amenities, such as

Implications

shopping, medical, and recreation.

Centralized design lends itself to program size.  The

For newly constructed projects, DHCD updated its QAP

centralized nature of the program seems to complement

to give developers of affordable housing bonus points

the design of the program. Overly centralized programs

for accepting 811 PRA units (see the Financing section

often run into issues in larger scale operations.

for a description of how Maryland modified its QAP to

Centralized programs when faced with a lot of activity

incentivize property developer participation in the 811 PRA

either experience bottlenecks or suffer lower quality

program). The incentive initial y applied only to projects

when staff get overwhelmed. However, Maryland seems

in the Baltimore and Washington, D.C. metropolitan

to have automated many of the tasks that could have

statistical areas (MSAs). The incentive area was expanded

resulted in bottlenecks. This automation has enabled the

after Maryland received its FY2013 811 PRA grant.

state to operate the program at scale.

Current status.  As of December 31, 2015, DHCD

Implications of unit location and amenities

executed 1 RAC, which accounts for 13 two-bedroom

preference. As noted previously in this section, a key

units. Maryland’s 811 PRA program goal for 2015 was 45

feature of the referral process is the match between

units under RAC, out of its total goal of 150 units during

the location or amenities of a unit and the preference

the 5-year grant period. Maryland is 32 units below its

of the 811 PRA participant. One aspect of this process

goal for 2015 and 137 units short of its 150 target. To

that requires special attention is the way in which

date, Maryland has successful y moved four households

the supports planners or case managers enter this

into 811 PRA units.

information on the program application.

48

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

Initial y, DHCD anticipated sourcing one-half, or 75 out of

apartment in the City of Baltimore was $893 per month.

150 units, of its 811 PRA units through existing properties.

In 2015, however, the average rent for a one-bedroom

However, DHCD was not able to source 811 PRA units

apartment in Baltimore was $1,077. In 3 years, the

from existing properties. The one NOFA issued received

average rent for a one-bedroom unit in Baltimore

very little response. DHCD attributes this difficulty to

increased by 21 percent. The same could be said of two-

two factors. First, at the time of the application for the

bedroom apartments. In 2012, the average rent for a two-

811 PRA grant, DCHD was not aware that Environmental

bedroom apartment in Baltimore was $1,076. By 2015,

Regulations and Responsibilities (ERRs) would be applied

the monthly rent of two-bedroom apartments increased

to existing properties selected for 811 PRA. Second,

by 22 percent to $1,316 (see table 4.4).

DHCD’s existing portfolio has a high occupancy rate (90

Although rental prices in Washington D.C. are much higher

to 95 percent). Very few properties have vacancies, and

than in Baltimore, the increases in rental costs are less

many properties have waiting lists.

pronounced, albeit stil  significant. In 2015, the average

DHCD has found success in securing commitments

one-bedroom unit in Washington D.C. was $1,763, 7

through new construction. DHCD’s goal is to source 105

percent higher than it was in 2012 ($1,651) (see table 4.5).

one-bedroom and 45 two-bedroom units. Aside from the 13

Two-bedroom units were similarly more expensive in 2015

two-bedroom units under RAC, DHCD has commitments

($2,250) than it was in 2012 ($2,091). Although the Maryland

for 43 one-bedroom units and 20 two-bedroom units in the

811 PRA program will not source units in Washington,

construction pipeline. If these commitments materialize,

D.C., the rental prices can be used as a barometer for the

it will push DHCD past the halfway point at 51 percent of

Maryland communities surrounding the city.

its total goal (when units already under RAC are included).

Moreover, these commitments, plus those already under

Rent and Subsidy Levels

RAC, represent 41 percent of DHCD’s one-bedroom goal

DHCD’s goal is to evenly distribute units between the

and 73 percent of its two-bedroom goal.

Washington, D.C. and Baltimore MSAs. The Washington,

Rental housing market. A quick review of the Baltimore

D.C. MSA refers to units in the Maryland counties of

and Washington D.C. rental housing market seems

Calvert, Charles, Frederick, Montgomery, and Prince

to corroborate DHCD’s suggestion. For the calendar

George’s. The Baltimore MSA refers to units in the

year ending 2012, the average rent for a one-bedroom

Maryland counties Baltimore City, Baltimore County, Anne

Arundel, Carroll, Harford, Howard, and Queen Anne’s.

Table 4.4 : Average Rent s in Baltimore ( 2012 Ver sus 2015 )

Year

One Bedroom

Two Bedrooms

All Beds

2012

$893

$1,076

$1,163

2015

$1,077

$1,316

$1,264

Difference

$184

$240

$101

Percent increase or (decrease)

21

22

9

Source: Rainmaker Insights (n.d.)

Table 4.5 : Average Rent s in Washington, D.C. ( 2012 Ver sus 2015 )

Year

One Bedroom

Two Bedrooms

All Beds

2012

$1,651

$2,091

$1,833

2015

$1,763

$2,250

$1,947

Difference

$112

$159

$114

Percent increase or (decrease)

7

8

6

Source: Rainmaker Insights (n.d.)

49

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

DHCD assumed that 70 percent of the units will be

all the eligibility criteria for participation in the home-

one-bedroom units and 30 percent will be two-bedroom

and community-based services waiver, and 4. The

units. The 811 PRA rent structure developed is based

home- and community-based services provided to the

on this unit mix and on a blended rate of rents, cal ed

individual would qualify for federal matching funds.9

the “blended rent maximum,” in Washington, D.C.,

Maryland’s MFP policy ensures that the highest priority

and Baltimore. The “blended rent maximum” was

population can enroll in waivers regardless of the

calculated by considering an even distribution of units

programs’ budget caps. This approach ensures that 811

in the Washington, D.C. and Baltimore MSAs. For the

PRA participants will have access to support services.

Washington, D.C. MSA, one-bedroom rents are $1,328

and two-bedroom units are $1,506. The Baltimore MSA

Coordination

one-bedroom rents are $1,025 and two-bedroom unit

DHCD, DHMH, and MDOD developed procedures to

rents are $1,231. The “blended rent maximum” calculates

ensure that the program operates within the principles

to an average 811 PRA monthly rent of $1,235 per unit

of the PSH model. Under this model, services are strictly

based on DHCD’s assumptions. The anticipated monthly

voluntary but are available when needed. Once a tenant

average 811 PRA subsidy is $1,055 per unit and the

moves into a unit, the primary relationship will be between

average tenant payment is $180 per unit.

the tenant and the property manager. To support tenancy,

DHCD’s initial estimate seems to be fairly accurate thus

however, contact information will be shared between

far. For example, for the two-bedroom units in the 811

tenants, case managers, property managers, and 811

PRA program at a property in Baltimore MSA, the rent is

PRA program management staff. Moreover, to support

$1048 per month. The tenants also receive $137 in utility

this relationship, the program will provide every tenant

allowance, which varies between participating properties.

with education regarding the rights and responsibilities of

tenancy, reasonable accommodations, use and care of the

Unit and Tenant Turnover

unit, and financial responsibilities.

Maryland has not experienced any unit turnover yet. Four

Under the Tenant Issue Process, property managers

individuals were housed in 811 PRA units in the fourth

are trained to contact the tenant directly to resolve any

quarter of 2015.

issue. If resolution cannot be reached with the tenant,

Service Provision and Coordination

the property manager is instructed to contact the

tenant’s case manager to discuss the issue and possible

strategies for resolution. The property manager can

Service Provision

contact the MFP Housing Director as a last resort.

Maryland 811 PRA program participants access

Like the process established between tenants and

ongoing healthcare services and transition services

property managers, participants and service providers

through both traditional Medicaid HCBS as well as

have a direct and primary relationship. Supports

Maryland’s expanded Medicaid State Plan. These

planners or case managers help in developing the plan

services are discussed in detail in the Service Provision

and selecting service providers. Once a participant

and Healthcare section. Supports planners or case

is engaged with a provider for a service, the service

managers assist participants with development of

provider is instructed to work with the client directly. If

their individualized and person-center service plans.

an issue comes to the attention of property managers

Afterward, the supports planners or case managers help

concerning service providers that may affect continued

811 PRA participants receive these services.

tenancy, property managers are instructed to contact the

Integral to Maryland’s transition efforts is its MFP policy

tenant, and involve the case manager or housing director

codified in State law:

as an escalation procedure.

The Department may not deny an individual access to

a home- and community-based services waiver due to

2013 811 PRA Application

a lack of funding for waiver services if: 1. The individual

Maryland received two rounds of 811 PRA

is living in a nursing facility at the time of the application

funding—$11,229,308 in 2012 (first round) and $9,808,054

for waiver services, 2. At least 30 consecutive days

in 2013–2014 (second round). For its 2012 program, DHCD

of the individual’s nursing facility stay are eligible to

proposed to source 150 811 PRA units through the annual

be paid for by the program, 3. The individual meets

LIHTC funding round for new construction or rehabilitation

9

Maryland Code, Health—General §15-137.

50

C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 4. Maryland Section 811 Project Rental Assistance Program

projects as well properties in its existing affordable

Program Administration,

housing portfolio. DHCD proposed to source an additional

150 units for its 2013 program using the same methods.

Assessment, Information Systems,

The design for both rounds of funding are the same. Both

and Data Infrastructure

will focus on the same target populations and leverage

the same support services and staffing arrangements.

Program Administration

However, the 2012 program is only sourcing 811 PRA units

DHCD, in consultation with DHMH and MDOD, selects

in the Baltimore and Washington, D.C. metropolitan areas

projects for 811 PRA. DHCD performs all reviews and

although the 2013 program is sourcing units statewide.

underwriting tasks. DHCD also creates, executes,

Leveraging

and monitors all Rental Assistance Contracts and use

agreements managing the rental assistance payments.

DHCD ensures compliance with 811 PRA requirements

Housing Choice Vouchers

and mandatory reporting to HUD. DHCD conducts

DHCD leveraged set-asides of 97 housing choice

regular physical inspections of the 811 PRA units using

vouchers from Maryland’s PHAs. The commitments do

UPCS and by fol owing a frequency and sample size used

not include HCVs already reserved for nonelderly people

for the LIHTC program.

with disabilities as part of a PHA’s NED baseline. Through

DHMH provides voluntary long-term support services

2015, no HCVs have been leased yet under the 811 PRA

through the four HCBS waivers and Maryland Medicaid

HCV commitment. Table 4.6 outlines the PHAs and their

State Plan services to 811 PRA participants.

commitments.

DHMH ensures that case managers and other providers

Other Sources Leveraged

maintain contact with tenants in 811 PRA units per the

DHMH contributed $1 mil ion in MFP rebalancing funds

individual’s plan of service. DHMH and MDOD train and

to support the 811 PRA program. DHCD holds the MFP

support case managers across all support services

funds in a trust. This fund will cover the housing subsidy

agencies to better ensure housing stabilization for 811

for 811 PRA participants for up to 6 months if 811 PRA

PRA tenants.

is not renewed and HUD funding is no longer available.

MDOD staff will manage the daily operations of the 811

The 6-month period will provide time for residents to

PRA eligibility and unit identification lists. MDOD will be

move to new homes or secure vouchers. If 811 PRA

responsible for ensuring that available units are tracked in

receives ongoing funding past the first 5-year period,

the system and that eligible applicants are notified about

the MFP funds will be directed toward an expansion of

available units.

the Weinberg Apartments Initiative, which also increases

affordable and accessible integrated housing for the

same population.

Table 4.6 : Leveraged Housing Choice Voucher s

Public Housing Agency

Vouchers

Maryland Department of Housing and Community Development

15

Housing Authority of Prince George’s County

10

Rockville Housing Enterprises

10

Housing Authority of College Park

2

Housing Authority of the City of Hagerstown

15

Baltimore County Department of Social Services

25

Saint Mary’s County Public Housing Authority

5

Housing Commission of Anne Arundel County

10

Housing Authority of the City of Frederick

5

Total

97

Source: 2012 Maryland 811 Project Rental Assistance application

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

Financial Management

•  LOCCS. HUD’s primary grant disbursement system,

DHCD has extensive experience with financial management

handling disbursements for most of its programs.

of HUD programs, including PBCA, HCVs, HOME,

Once voucher data are submitted to TRACS and

CDBG, Emergency Solutions Grants program, CSBG,

approved for payment, a LOCCS payment is triggered.

Weatherization, and others. For 811 PRA, DHCD expects to

On receipt of a LOCCS notification email, a pending

follow rules and regulations of these programs, including—

state warrant is prepared from the payment detail that

is uploaded from the LOCCS email notification and

•  Maintaining separate accounting records for the activities

sent to Maryland’s Disbursement System. Once the

of the 811 PRA. Payments to owners will also be

funds noted in the LOCCS email have been received

maintained separately from the administrative expenses.

in DHCD’s bank account, the state’s disbursement

•  The 811 PRA account will be reconciled monthly by DHCD

system sends an electronic funds transfer to the

DFA staff and reviewed by the Grant Accounting Manager.

owner’s account on the same day. The tracking

system keeps a complete record of the LOCCS

•  Complete and accurate records will be maintained

deposits and voucher payments made on behalf of

for 811 PRA units in a Grant Accounting sub-ledger

each contract.

database, which would be reconciled monthly by the

DHCD DFA Grant Accountant and reviewed by the

•  Enterprise Income Verification (EIV).  EIV is a web-

Grant Accounting Manager.

based database containing employment and income

information on participants in HUD’s rental assistance

DHCD leverages its PBCA payment infrastructure to

programs. This information is made available to ensure

process 811 PRA vouchers. The process for payment

“the right benefits go to the right persons.” The income

begins when the property owner or the property owner’s

information displayed in this system is supported

agent submits the voucher and tenant data to DHCD

through a matching agreement between HUD, National

through the Tenant Rental Assistance Certification System.

Directory of New Hires or Department of Health &

DHCD reviews this information, bundles all the property

Human Services, and the Social Security Administration.

owner’s submission under its parent account10 and

DHCD will use EIV to monitor the number and type

sends the data to HUD via TRACS. If HUD accepts the

of discrepancies associated with an 811 PRA Demo

submission, the total amount for payment is reserved in the

project and will assist projects in investigating and

Line of Credit Control System. LOCCS then transfers the

resolving any errors with either tenant identifiers or

payment to DHCD, which then processes the funds and

income data entered into the TRACS system.

distributes payment to each property electronically.

•  Maryland Housing Search (SocialServe).

Information Systems

SocialServe is a web-based application specifical y

DHCD, DHMH, and MDOD measures and tracks the

designed for a PSH system enables case managers

performance of the 811 PRA by using a variety of HUD,

to assist in enrol ing and determining the eligibility of

DHCD, DHMH, and MDOD systems. The fol owing is

applicants for the Weinberg Apartments Initiative and

a description of the systems used to col ect data and

the 811 PRA programs. The same application is used

measure 811 PRA outcomes.

by MDOD to central y manage the waiting list and

select applicants for referral to owners.

•  TRACS. A web-based database collects data files

that support the certification, recertification, and

Successes and Challenges

subsidy bil ing for HUD multifamily projects. TRACS

provides authorized users with summary and status

Challenges

data on submitted vouchers. DHCD will use the

TRACS system to accept process, approve, and

811 PRA implementation delay. 811 PRA program

submit voucher payment requests for all 811 PRA

staff reported some chal enges in the initial program

Demo projects. TRACS will also be monitored to

administration due to HUD implementation delays. It took

ensure data compliance thresholds are met and al

more than 18 months from the initial award for HUD to

errors requiring correction are addressed by owners

issue program materials and the Cooperative Agreement.

or agents. Existing DHCD automated and accounting

The Maryland 811 PRA program could not begin formal

systems interface with the TRACS system and LOCCS

program implementation without having a signed

to provide timely payments to owners.

Cooperative Agreement.

10

Each participating property submits its vouchers and tenant data via a child account to the state agency administrating the 811 PRA program.

The state agency bundles all the submissions under its parent account and submits the data to HUD in TRACS.

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

Burdensome environmental review requirements.  811

turnover, it has not significantly affected the program’s

PRA program staff reported some chal enges in the initial

operations. Staff working on 811 PRA from one agency

program administration due to the constraints of the

took a position at another agency that also works on 811

811 PRA program requirements or structures. 811 PRA

PRA; the shifts have not affected program continuity. The

program staff were not initial y aware that environmental

team has maintained institutional knowledge.

review requirements would be applicable to existing

Maryland Department of Disabilities. MDOD is a

properties. These requirements eliminated several

cabinet department focused exclusively on serving

potential properties from which 811 PRA units could have

persons with disabilities. It acts as an advocate for the

been sourced. Maryland had planned for one-half of its

population within the service delivery system. MDOD can

150 811 PRA units to come from existing properties.

coordinate available resources within larger agencies,

Struggle to source existing units.  The 811 PRA program

such as DHCD and Maryland Department of Health and

staff reported chal enges in finding and bringing existing

Mental Hygiene and help focus their service delivery.

units into the program. The sole NOFA issued for the

Partnership strength.  DHCD, MDOD, and DHMH staff

existing housing portfolio received minimal responses as

began working together in 2001 on the Community

very few properties have vacancies and many properties

Access Steering Committee and later participated in

also have long waiting lists. Property owners are not

the Governor’s Commission on Housing Policy. MDOD’s

inclined to participate in a relatively new program like 811

Secretary chaired the Commission’s Affordable and

PRA as they would much rather lease the vacant units to

Accessible Housing for Individuals with Disabilities

applicants on their existing waiting lists.

Subcommittee. MDOD initiated the Statewide Taskforce

The chal enge of not being able to source one-half of the

for Affordable Housing to take advantage of additional

150 811 PRA units from existing properties as planned

private, public sector, and federal funding opportunities

slowed the program staff’s ability to house applicants on

in 2010. In 2011, this effort resulted in DHMH’s

the waiting list. Program staff expressed desire to find

successful application for the Building Sustainable

more proactive ways to source existing units.

Partnerships for Housing Real Choice Systems Change

Grant funded by CMS. MDOD co-chaired the Advisory

Successes

Group for Real Choice Systems Change Grant with

Maryland’s web-based referral system.  The web-

DHMH. The three agencies also worked on other

based system designed for a PSH system has enabled

initiatives, including the Bridge Subsidy Program and the

the 811 PRA program to absorb the number of referrals

Weinberg Apartments Initiative.

to the system by enabling case managers to assist in

DHCD’s Director of Multifamily Housing attributed the

enrolling and determining the eligibility of applicants

success of 811 PRA program and the partnership to the

for the Weinberg Apartments Initiative and the 811 PRA

following.

programs. The system is also used by MDOD to manage

the waiting list and select applicants for referral to owners.

1.  All three agencies have shown continuous commitment

to the partnership since col aboration began in 2001.

Money Follows the Person-funded Bridge Subsidy

Program. DHMH contributed $1 mil ion in MFP

2.  Staff from all three agencies were immersed in

rebalancing funds to support the 811 PRA program.

cross training and mutual learning to understand

The MFP funds will finance rental assistance for 811

each other’s language and expertise, leading to the

PRA participants for up to 6 months if the 811 PRA is

building of mutual respect for each agency’s roles and

not renewed and HUD funding is no longer available.

responsibilities in various initiatives.

This MFP funding availability has al ayed some property

3.  The principle of trust and transparency is emphasized

owner concerns about fund availability for future years.

and valued by the three agencies, which guides their

Additional y, Maryland’s MFP policy ensures that the

collaboration continuously.

highest priority population wil  be able to enroll in

4.  The 811 PRA program staff from all three agencies

waivers regardless of the programs’ budget caps, thus

communicate with each other as often as every

guaranteeing that 811 PRA participants will have access to

other day to exchange ideas, share experiences and

support services.

knowledge, and address challenges collectively. This

Staffing continuity. Although key positions within the

level of frequent engagement directly contributes to the

Maryland 811 PRA program have experienced some staff

program success and the partnership accomplishment.

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Chapter 4. Maryland Section 811 Project Rental Assistance Program

Besides interacting with each other, the three agencies

col ectively are in constant communication with the

developer community in Maryland. Building relationships

and trust with various developers and property owners not

only facilitates goal alignment, but also ensures cooperation

from property owners and management companies at the

program operation and management level.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

Minnesota Section

included investments of nearly $1.4 bil ion to support

a continuum of affordable housing activities, including

811 Project Rental

internal y generated resources, to serve high-priority

populations, including persons with disabilities.

Minnesota Housing administers and allocates Low-

Assistance Program

Income Housing Tax Credits. It annual y revises the

QAP and develops selection criteria and eligibility

requirements for tax-credit al ocations that reflect the

state’s priorities. Minnesota Housing partners with

local foundations and other state agencies, including

Introduction

DHS, to award capital funding to projects through

the annual consolidated request for proposals. This

In 2012, HUD awarded the Minnesota Housing Finance

agency administers state-appropriated funding and

Agency (Minnesota Housing), in partnership with the

federal resources, including the HOME and the Housing

Minnesota Department of Human Services (DHS),

Opportunities for Persons With AIDS Program; it is

$3,085,500 in Section 811 Project Rental Assistance

preparing to administer the National Housing Trust Fund.

program funds to support 85 units with rental assistance.

Minnesota Housing has a long history of administering

Minnesota Housing proposed to make available 85 units

HUD programs that operate very similarly to the 811

of permanent, supportive housing from existing housing

PRA program. Minnesota Housing has experience

stock for extremely low-income, nonelderly adults with

managing rental assistance programs, such as the

disabilities. Although Minnesota’s 811 PRA program

project-based Section 8 developments that include

is statewide, the initial program interest came from

Performance Based Contract Administration and

development owners in the Twin Cities region, which is

Traditional Contract Administration (TCA) programs,

composed of two counties—Hennepin and Ramsey. The

as well as Section 236 contracts. Minnesota Housing’s

city of Minneapolis is in Hennepin County, and the city of

Multifamily Division—which includes approximately 120

St. Paul is in Ramsey County.

permanent staff organized into four functional areas:

Evaluators conducted a site visit in October 2015. At the

(1) Supportive Housing; (2) Production or Underwriting;

close of 2015, Minnesota Housing had placed 67 units

(3) Asset Management, Compliance, and Contract

under RACs, exceeding its 2015 annual goal of 35. One

Administration; and (4) Operations and Reporting—

unit was occupied.

administer these programs.

Grantee Partnership, Organizational

The state has increased Minnesota Housing’s funding

level significantly during the past several years through

Structure, and Management

Housing Infrastructure Bonds. Minnesota Housing’s

Housing Infrastructure Bonds funding increased from

Overview

$30 mil ion in 2012 to $80 mil ion in 2014. According to

Minnesota Housing is the primary applicant and grantee

Minnesota Housing, it dedicates most of these funds

for the 811 PRA program and has partnered with DHS for

(approximately 66 percent) to supportive housing for the

full program implementation and delivery. This section

long-term homeless population. This funding is separate

begins with an overview of each agency, its role within

from the funds Minnesota Housing allocates from other

the state more broadly, and the relevant programs

state-appropriated programs such as the Minnesota

each agency administers. The section continues with a

Housing Trust Fund (HTF). Minnesota Housing also

discussion about the partnerships and a description of

al ocates most of its $19 mil ion HTF to serve the long-

each agency’s roles and responsibilities for the 811 PRA

term homeless population.

program. This division of responsibilities is based on

Minnesota Department of Human Services

areas of functional and specialized capabilities.

DHS is the state’s lead Medicaid agency and administers

Minnesota Housing Finance Agency

a variety of healthcare and supportive services. These

Minnesota Housing promotes homeownership and

services general y fall into one of four categories.

increases and preserves affordable rental housing,

•  Medicaid Home- and Community-Based Services,

as well as prevents and eliminates homelessness.

including 1915(c) waivers for persons with disabilities

Minnesota Housing’s 2010-11 Affordable Housing Plan

and home care services.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

•  Adult Mental Health Services, including Adult

administering this survey since 1989). According to

Rehabilitative Mental Health Services, Assertive

Minnesota Housing staff, “the long history of partnership

Community Treatment, and Adult Mental Health

has made this work easier for us. A core group of our staff

Targeted Case Management.

and a core group of their staff work together weekly, if not

•  MFP Rebalancing Demonstration program.

daily.” The ongoing partnership resulted in benefits for

the 811 PRA program. The agencies were able to build off

•  State-funded programs, such as Minnesota’s state-

existing objectives and deliverables from other interagency

funded Long-Term Homelessness Supportive Services,

agreements when developing the 811 PRA agreement.

Group Residential Housing, Housing With Supports for

Adults With Serious Mental Il ness (HSASMI).

In their 2013 col aboration with many of the state’s

leading advocacy groups and service providers through

DHS administers its programs through local lead agencies

the Interagency Council, Minnesota Housing and DHS

that implement many aspects of Medicaid, including

adopted a new state plan to end homelessness in

eligibility determination, assessment of individual need

Minnesota, entitled  Heading Home: Minnesota’s Plan to

for services, coordination of services, oversight of service

Prevent and End Homelessness. Along with the Olmstead

providers, and direct service provision. DHS oversees

plan and programs such as Moving Home Minnesota,

and monitors the performance of local lead agencies and

which is Minnesota’s MFP program, this new plan serves

overall compliance with federal regulations, state statutes,

as the platform to build Minnesota’s 811 PRA program.

rules, and policies. DHS provides informational updates

and policy guidance, as well as training opportunities,

Design and Structure of Minnesota’s 811

for local lead agencies and other service providers. DHS

PRA Program

also uses Substance Abuse and Mental Health Services

For its 2012 811 PRA application, Minnesota Housing

Administration (SAMHSA) evidence-based practices

determined that the most advantageous opportunity to

fidelity standards to evaluate PSH.

implement the 811 PRA program in the 24 month limited

Minnesota Housing and Department of

time frame was to use only existing developments as the

Human Services Partnership

source of 811 PRA units. Developments with rent-restricted

units (such as those in the LIHTC portfolio), as well as

Minnesota Housing and DHS have worked together

developments with existing unsubsidized units in Minnesota

since the Bridges Rental Assistance Program began in

Housing’s Section 8 portfolio, provided great initial sources

the late 1990s. Bridges Rental Assistance Program is a

of 811 PRA units. Already monitored, these properties

state-funded program that provides interim supportive

have staff with federal program administration experience

housing subsidies for people with severe mental il ness

and may have staff with previous experience coordinating

who are waiting for appropriate longer-term subsidies.

supportive housing. By using existing rental properties,

The agencies reinforced their col aborative efforts in

Minnesota Housing anticipates that extremely low-income

2004 when Minnesota Housing made ending long-term

renters will be able to access current, nonsubsidized rental

homelessness a strategic priority. The partnership has

units, which have been typical y unaffordable.

continued to strengthen over time.

Minnesota Housing determined the number of 811 PRA

Historical y, the agencies have col aborated by way of

units to apply for by checking the existing portfolio for

interagency agreements, interagency councils, and

the number and location of studio and one-bedroom

serving as advisors on each other’s programs. Prior

units with rent limits at 50 percent AMI or less.

to the 811 PRA program, the two agencies executed

Minnesota Housing also reviewed its staff capacity and

interagency agreements for the Bridges Rental

how many RACs it could reasonably bring online with its

Assistance Program, Operating Subsidy Program, and

current staffing levels.

HSASMI in conjunction with Homeless Management

Information System and the Wilder Research Survey.

Minnesota Housing decreased the units it could support

with its first round of 811 PRA funding from 95 to 85

The agencies have collaborated on the Minnesota

after receiving HUD guidance on how the budget

Interagency Council on Homelessness (Interagency

should be calculated. The agency initial y planned for

Council) since 1993 (Minnesota Housing and DHS

a project timeline that ramped up over time, which

co-chair the interagency council). Minnesota Housing

would eventual y lead to 95 units leased by the end of

and DHS have also raised money together to support

the 5-year program. HUD clarified that all units must

the Wilder Research survey that focuses on people

be funded for a full 60 months of rental assistance.

who are experiencing homelessness (Wilder has been

Consequently, although the program is labeled as a

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

5-year grant program, in reality it will take about 8 years

for property selection are covered in more detail in the

before each 811 PRA unit receives rental assistance

Housing Strategies section.

funding for 60 months. Consequently, Minnesota

Minnesota Housing treats the 811 PRA program as

Housing had to adjust its unit calculation to 85 slots.

another “arrow in its quiver” of housing programs. The 811

811 PRA Roles and Responsibilities

PRA program benefits from this arrangement leveraging

Minnesota Housing’s existing programmatic infrastructure.

Minnesota’s 811 PRA program folds into each of the two

agencies’ existing operations (in contrast to being run as

Operational y, within Minnesota Housing, the 811 PRA

a “standalone” program). Table 5.1 provides a summary

program is implemented in the following manner.

of each organization’s responsibilities.

•  A Supportive Housing program manager oversees the

Minnesota Housing Finance Agency responsibilities.

811 PRA program.

Minnesota Housing is charged with sourcing and

•  The 811 PRA program review team reviews and

managing housing units for the 811 PRA program.

selects applications and oversees projects under

Agency staff conduct outreach to property owners

development.

educating them about the 811 PRA program. Minnesota

•  811 PRA housing management officers review the

Housing has identified specific properties within its

tenant selection plans, although housing assistance

portfolio that may contain housing units eligible 811

payment officers execute RACs.

PRA program participation. Minnesota Housing also

modified its request for proposals application process

•  HMOs within the asset management and compliance

to incentivize participation of developers seeking

team perform inspections and site visits and ensure

financing for new construction projects in the 811

compliance with RACs and federal and state program

PRA program. Specifical y, for the 2016 request for

requirements.

proposals, Minnesota Housing increased the points

•  TRACS data analysts ensure compliance with federal

available (from 5 to 10) to owner or developers building

and state program requirements, as well as make

supportive housing for special populations. Minnesota

accurate and timely payments to property owners.

Housing staff work with selected property owners in

Minnesota Department of Human Services

executing RACs. Once properties are accepted into

responsibilities.  DHS uses the same operating

the 811 PRA portfolio, Minnesota Housing staff are

principles as Minnesota Housing. The 811 PRA program

charged with compliance monitoring and ensuring timely

responsibilities of DHS are woven into its existing program

rental assistance payments. The specific strategies

Table 5.1: Minnesot a — 811 P R A Program Division of Responsibilities

Minnesota Housing

Department of Human Services

Recruit and collaborate with local lead agencies responsible for implementing

Identify or finance eligible units for 811 PRA program.

the Projects for Assistance in Transition from Homelessness, or PATH, program.

Recruit and collaborate with Money Follows the Person providers.

Manage waiting list. Oversee referral process in collaboration with local lead

Execute RACs with property owners.

agencies and MFP providers.

Provide outreach, training, and technical assistance to local lead agencies and

Provide outreach to developers, landlords, and property owners.

MFP providers.

Monitor local lead agencies and MFP provider processes for referring individuals

Monitor 811 PRA unit occupancy and compliance with eligibility requirements.

for housing placement.

Monitor local lead agencies and MFP providers to ensure tenants have necessary

Make rental payments to property owners.

access to housing and support services.

Collect and report required occupancy and financial information.

Collect and report data on service delivery, costs, and outcomes.

Provide ongoing communication with Department of Human Services, local lead

Provide ongoing communication with Minnesota Housing, local lead agencies,

agencies, and housing providers.

MFP providers, and housing providers.

MFP = Money Follows the Person. PRA = Project Rental Assistance. RAC = Rental Assistance Contract.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

infrastructure. Minnesota Housing’s focus is on housing;

•  Coordinating DHS data collection and analysis.

the responsibilities of DHS center on providing services

•  Participating in knowledge sharing, outreach, training,

and supports. As the Medicaid lead agency, DHS offers a

and technical assistance for the 811 PRA program.

wide variety of healthcare programs.

Working on the 811 PRA program, key DHS staff fill the

811 PRA program participants access these services

following positions.

and supports either through Projects for Assistance in

Transition from Homelessness, or PATH, or MFP.

•  Housing coordinator.

•  PATH is a federal and state-funded program dedicated to

•  MFP director.

providing outreach to people with a serious mental il ness

•  An Adult Mental Health Division administrator oversees

experiencing homelessness and connecting them with

housing policies for people with serious mental il ness

housing and services. Program funds are awarded to

and provides the state contact for PATH.

county governments that then either provide the services

directly or subcontract the work to vendors (typical y

Program Funding

private social services agencies). Currently, 11 PATH

In al , the program operate with a total of 3.15 ful -time

projects in the state serve an estimated 1,400 people.

equivalents across al  positions. Minnesota Housing

•  MFP is dedicated to increasing use of HCBS and

contributes 2.15 FTE, and DHS contributes 1.0 FTE.

reducing use of institutional y based services. MFP

These numbers exclude PATH and MFP staff.

referrals are administered through county governments,

The core Minnesota Housing team working on the 811

managed care organizations, tribes, and service

PRA program includes—

contractors. MFP operates in a small unit within the

continuing care administration. Currently, 167 people are

•  Program manager (0.4 FTE on the 811 PRA program).

enrol ed in MFP, of which 103 moved into community-

•  Operations project manager (who supports the

based settings, with another 25 in the pipeline.

program manager) (0.4 FTE on the 811 PRA program).

DHS assumes important responsibilities for the 811

•  Asset management and compliance supervisor,

PRA program. DHS staff provide the quality assurance

PBCA (0.25 FTE on the 811 PRA program).

function and are charged with making sure that 811 PRA

•  TRACS and housing assistance payment (0.1 FTE on

participants receive the services they need. DHS staff

the 811 PRA program).

also manage services that 811 PRA participants access

through the Medicaid state plan, which includes home-

In addition, asset management staff who report to the

and community-based waivers.

asset management and compliance supervisor, include—

DHS provides information to lead agencies and other

•  0.25 FTE from the housing management officers

stakeholders about opportunities through the 811 PRA

who do annual inspections and program monitoring.

program. The agency also provides training and 811

HMOs travel to property sites, conduct physical

PRA program technical assistance to PATH agencies,

inspections and audit tenant files. These staff

especial y referrals, access to services, and utilization of

members are the same staff who monitor their

811 PRA program rental assistance.

project-based Section 8 properties; they modified the

monitoring process to meet 811 PRA requirements.

Furthermore, DHS staffs the Housing Coordinator, a

critical role in the Minnesota 811 PRA program. The

•  0.15 FTE for staff to process monthly vouchers

Housing Coordinator must be a DHS staff member so

coming in from Project-Based Rental Assistance

that he or she has access to participants’ confidential,

sites, rol ing up the payments from the properties and

health-related service information. The Housing

submitting the data to HUD.

Coordinator’s responsibilities include—

•  0.15 FTE for the Contracts Team executing RACs and

•  Coordinating with the Minnesota Housing program

amending rents.

manager to track 811 PRA unit availability and

Initial y, Minnesota Housing’s 811 PRA staffing plan was

occupancy status.

expected to need about 0.75 FTE for the initial program

•  Matching referrals to units from 811 PRA-eligible MFP

setup, which would then gradual y decrease to a 0.5 FTE

and PATH participants.

level as it exits the startup phase. Minnesota Housing

has, however, spent considerably more staff time on

•  Managing the 811 PRA waiting list.

program administration than it had envisioned in the

•  Ensuring service coordination.

application. Currently, Minnesota Housing dedicates

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

about 2.15 FTE across all roles. Minnesota Housing

leverages funds available through this program to

leadership understood that some initial investment of

promote the development of supportive housing using

staff time was required, but never expected it would be

point incentives in the Qualified Al ocation Plan.

at a FTE level for this long of a period.

•  Minnesota HTF and Ending Long-term

The 811 PRA program has also used a small amount of time

Homelessness Initiative Fund (ELHIF).  In the

from the legal and accounting departments. In addition,

initial startup of Minnesota’s Business Plan to End

Minnesota Housing anticipates al ocating more staff time

Long-Term Homelessness, HTF and ELHIF were

for col ecting and reporting data and performance metrics

two primary capital-funding vehicles for supportive

once the program begins to lease its units.

housing, particularly for developments that

In its application, Minnesota Housing estimated that

composed of 100 percent supportive housing units.

it would cost about $350,000 to fund the positions it

During the 5-year period ending in 2011, these funds

committed to during the 5-year period. However, that dol ar

provided more than $29 mil ion in capital loans and

figure was based on a much lower level of effort. Minnesota

another $4.2 mil ion in operating subsidies, resulting

Housing estimated the program would require the most

in funding for 44 projects and 20 new contracts,

effort during the first 4 months and al ocated 1.5 FTE

which led to the creation of more than 1,000

during this period. Minnesota Housing believed the level of

supportive housing units.

effort would taper to 0.75 FTE for months 5 through 9 and

•  Low and Moderate Income Rental (LMIR)

eventual y level off to 0.5 FTE from month 10 through the

Program. The LMIR program provides mortgages

end of the 5-year period. Although the 811 PRA program

for the construction, acquisition, rehabilitation, or

will provide a $235,500, or 8 percent of the 811 PRA rental

refinancing of affordable housing units. It is Minnesota

subsidy amount, toward administrative expenses during

Housing’s third-largest program with $176 mil ion in

the 5-year term, Minnesota Housing staff now believe that

outlays during the 5-year period. These loans funded

program costs will be much higher than initial y estimated.

84 projects with 5,448 units, 4,937 of which were

Minnesota Housing is using its own resources to fund its

assisted and 229 of which are supportive housing.

staff commitments to the 811 PRA program that have not

Minnesota Housing believes that the 811 PRA program

been adequately covered by the 811 PRA grant.

will assist in increasing supportive housing production,

DHS supports the program by providing resources for

especial y at LIHTC properties. Applications received

the Housing Coordinator position. This position, covered

extra points for agreeing to incorporate permanent

DHS funds received from MFP, is a 1.0 FTE set-aside for

supportive housing in their proposed developments in

the 811 PRA program. DHS estimates it will spend more

Minnesota Housing’s consolidated request for proposals

than $385,000 for the first 5 years of the program for this

process. (These extra points were significant because

position alone.

applying for state financing is very competitive.)

State Context: Housing Programs

Aside from providing the needed financial incentive

(through rental assistance), Minnesota Housing believes

that property owners may be more likely to participate

Housing Programs

knowing that the 811 PRA program has the necessary

Minnesota Housing administers several multifamily

services infrastructure in place to support their participants.

financing programs. Besides providing capital financing

Resources to prevent and end long-term

for rental housing, all these programs also include

homelessness. In addition to the capital programs

supportive housing units. Detailed here are three of the

previously listed, Minnesota Housing has rental

agency’s housing programs that fund supportive housing.

assistance programs and operating assistance funds. A

•  LIHTC. This program is Minnesota Housing’s

discussion of some of these programs fol ows.

largest fund with nearly $600 mil ion in outlays on

•  Long-Term Homeless Rental Assistance and

122 projects from 2006 to 2011. This investment

Operating Support is funded through HTF and ELHIF.

translates to 8,752 units, 8,394 units assisted, and

The two resources provide operating subsidies and

369 supportive housing units. This program provides

rental assistance for permanent, supportive housing

federal income tax credit to owners and investors

for persons experiencing long-term homelessness.

in the construction or acquisition with substantial

Rental assistance is provided to 1,200 households

rehabilitation of housing properties. Properties

annual y and operating assistance is provided to

receiving LIHTC must meet income and rent

1,450 households annual y.

restrictions for at least 30 years. Minnesota Housing

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

•  Bridges Rental Assistance Program grants provide

Plans to end homelessness. Adopted in 2004, the

rental assistance payments to households with at

Business Plan to End Long-Term Homelessness ended in

least one adult with serious mental il ness. Bridges

2013, by which time more than 4,000 opportunities for long-

Rental Assistance Program provides 850 supportive

term households for homeless people had been created.

housing opportunities annual y.

Most of the opportunities have been funded from state-run

Supportive housing programs.  In addition to these

housing financing programs, such as LIHTC, HTF, Housing

varied programs, Minnesota Housing and DHS have

Infrastructure Bonds, and ELHIF. Since 2013, a new state

collaborated in delivering housing programs that assist

plan has been adopted:  Heading Home: Minnesota’s Plan

persons with disabilities—particularly those with a

to Prevent and End Homelessness. In this plan, Minnesota

mental health disability, experiencing homelessness, or

has committed to developing 5,000 new affordable

both. These programs include—

and supportive housing units for extremely low-income

households. The 811 PRA program wil  help Minnesota

•  HSASMI grants and Operating Subsidy Program funds

in its efforts to end homelessness by providing rental

provide operating support to multifamily housing units

subsidies for the long-term homeless target population.

that have integrated supportive service options to

assist individuals with a serious mental il ness.

Additional federal housing programs.  In addition to

state agencies, other entities such as local governments,

•  Bridges Regional Treatment Center Pilot Program is

housing authorities, and private owners develop and

similar to the Bridges Rental Assistance Program but

administer affordable housing in Minnesota for people with

is focused on individuals currently staying at a 175-

disabilities. Table 5.2 provides an overview of the number

bed psychiatric hospital that serves those who have a

of persons served by five major federal y funded housing

mental il ness.

programs. As shown, a nonelderly person with a disability

•  The Minnesota Supplemental Aid (MSA) Shelter

heads about one-half of Public Housing residents and 44

Needy program provides an income supplement for

percent of Section 8 recipients. In addition, Minnesota has

persons with a disability to help make housing in the

640 Non-Elderly Disabled Vouchers.

community more affordable.

Rental Housing Market

•  Group Residential Housing provides income

supplements in certain qualified licensed or

Although the 811 PRA program is statewide, Minnesota’s

registered settings.

initial focus is on obtaining participating properties in

the Twin Cities area. Rents in the Minneapolis-St. Paul

•  The Crisis Housing Fund provides financial assistance

area have risen significantly during the past decade. This

to help recipients with serious and persistent mental

trend poses a challenge to the development of affordable

il ness retain their housing in instances where they

and supportive housing.

need to receive temporary residential treatment.

Table 5.2 : Minnesot a — O ther Federal Programs

Percent With Disabilities

Number of Household

Among Head, Spouse

Percent of All Persons With

Program

Number of Units Available

Members

Aged <62

Disabilities

Public Housing

20,746

36,208

48

31

Housing Choice Vouchers

36,270

86,877

39

20

Project-Based Section 8

30,866

46,866

44

21

202/PRAC

2,419

2,448

95

7

811/PRAC

762

802

99

193

PRAC = Project Rental Assistance Contract.

Source: HUD (2016)

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Chapter 5. Minnesota Section 811 Project Rental Assistance

Program

Rental prices in the Minneapolis-St. Paul area climbed

Figure 5.2 : Minnesot a — Rent al Vacancy Rates in

steadily from 2010 through 2015. According to Minnesota

Twin Cities ( 2010 –2015 )

Housing Partnership, the average market rate rent (a

composite of average rents that incorporates all unit

types) increased from $908 per month in 2010 to $1,055

Vacancy Rates in the Twin Cities, Metro

per month in 2015 (for more detailed information, see

2005-2015, Quarterly

figure 5.1). This change represents an increase of 16

9.0%

percent, or $147 per month during the past 5 years

8.0%

(Minnesota Housing Partnership, 2016).

7.0%

6.0%

Figure 5.1: Minnesota — Average Market

5.0%

Rents in Twin Cities ( 2010 –2015 )

4.0%

2.9%

3.0%

2.3%

2.0%

1.7%

1.0%

0.0%

Twin Cities Average Rent

2010

2011

2012

2013

2014

2015

2010-2015, Annual Average

Vacancy Rate

Vacancy Rate, $1000 or Less

Quarterly Unemployment Rate

$908

$927

$957

$981

$1,021

$1,055

Source: Minnesota Housing Partnership (2016)

Service Provision and Healthcare

Minnesota has programs individual y dedicated to each

target population. 811 PRA participants entering the

program through Money Fol ows the Person receive

targeted support from the state’s MFP program.

These services include person-centered planning,

2010

2011

2012

2013

2014

2015

transition, and coordination services, access to assistive

Source: Minnesota Housing Partnership (2016)

technology, and personal emergency monitoring, as well

as assistance with moving costs, such as transportation,

Minnesota Housing Partnership noted that the increase

furnishings, and groceries.

in demand and the shortage in supply are the main

PATH participants are recruited for the 811 PRA program

drivers of the increase in rental costs. Vacancy rates in

by outreach workers employed by local lead agencies.

the Twin Cities are at their lowest levels in decades. As

811 PRA participants entering the program through PATH

figure 5.2 demonstrates, vacancy rates in the area have

have access to PATH-supported programs and services.

steadily declined during the past 10 years, from roughly 6

These services include case management, screening

percent in 2005 to 2.3 percent in 2015.

and diagnostic treatment, community mental health,

The increase in rental prices throughout the Twin Cities

alcohol or drug treatment, support and supervision in

metro area is a real problem for the supportive housing

residential settings, as well as referrals and assistance

development, in general, and for the 811 PRA program,

with accessing financial and health benefits.

in particular. As noted previously, the average rent for a

In addition to targeted services supporting each

one-bedroom unit in the Twin Cities is $859. This price is

target population, as previously outlined, 811 PRA

much higher than the $743 contract rent per month at 50

participants will have access to other DHS programs.

percent of Area Median Income, as estimated by Minnesota

DHS administers a variety of federal y funded healthcare

Housing, or the $796 that is al owable for this unit type

services, including Minnesota’s Medicaid program, as

under HUD’s FY 2015 Fair Market Rent requirement for the

well as other state- and grant-funded services. These

Minneapolis-St. Paul-Bloomington MSA. To circumvent this

services are highlighted in table 5.3. Please see the

issue, Minneapolis Housing identified units in its existing

section on Service Provision and Coordination for a more

portfolio with rents limited to 50 percent AMI so that owners

detailed description of these services.

did not have to lower rents to participate in 811 PRA.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

Table 5.3 : Minnesot a — Ser vices Available to 811 Project Rent al A ssist ance Par ticipant s Medicaid Services

State- and Grant-Funded Services

•  1915(c) waivers for persons with disabilities, or developmentally disabled,

traumatic brain injury, Community Access for Disability Inclusion, Community

•  Adult Mental Health Community Support Program

Alternative Care.

•  Medicaid Home Care Services.

•  Minnesota’s state-funded Long Term Homelessness Supportive Services.

•  Medicaid Adult Rehabilitative Mental Health Services.

•  Housing With Supports for Adults With Serious Mental Illness.

•  Department of Human Services is proposing a new Medicaid service to add.

Tenancy Support Services using a Critical Time Intervention model.

•  1915(i) to support individuals with mental illness.

Changes in Medicaid Resources

3.  Housing and services. This topic area contains

Between 2008 and 2014, total Medicaid spending

goals aimed at moving people with disabilities out of

increased from about $7 bil ion to about $10 bil ion

institutional settings.

statewide, a 43.6-percent increase (Eiken et al., 2015; KFF,

4.  Supports (transportation, health care, positive support,

2017). Funding for long-term services and supports rose

crises services, assistive technology, and abuse and

from approximately $3.4 bil ion in 2008 to $3.9 bil ion in

neglect prevention). This area focuses on building

2013 (Eiken et al., 2015). Home- and community-based

program capacity and on increasing the resources that

services, as a portion of LTSS, also increased during

will support people with disabilities as they live, work,

this period, continuing a trend of decreased funding

and learn in the settings that they choose.

for institutionalized care and increased funding for

5.  Community engagement. This topic focuses on

community-based services and supports. HCBS funding

engaging people with disabilities.

increased from 68 percent of LTSS in 2008 to 73.6 percent

in 2013, significantly more than the national average of

The state has set very ambitious goals in its Olmstead

51.3 percent (Eiken et al., 2015). Minnesota has been

plan. The overarching goal of housing services is

at the forefront of supporting HCBS funding and ranks

to assist people with disabilities to live in the most

second in the nation for allocating the highest amount of

integrated setting of their choice and receive person-

its LTSS funds to HCBS (Eiken et al., 2015).

centered planning. DHS’s transition service providers

seek to significantly increase the number of people

Olmstead Settlement

with disabilities who live in their communities of choice

Minnesota has an Olmstead plan to settle a class action

and receive financial assistance. The specific goal is

lawsuit in U.S. District Court ( Jensen v.  Minnesota

to increase assistance to people from 6,017 in 2015 to

Department of Human Services). In 2011, that case was

11,564 by 2019, an increase of 5,547 or 92 percent. The

resolved through a settlement agreement, but it took

811 PRA program will help Minnesota meet some of its

nearly 4 years for the state to develop a comprehensive

Olmstead goals, particularly as it relates to housing and

plan that was accepted by the U.S. District Court on

transition services.

September 29, 2015. Governor Mark Dayton appointed

Population Served

an Olmstead Subcabinet, now chaired by Minnesota

Housing, to develop the plan and carry it out.

Initial eligibility under the Minnesota 811 PRA program

The plan has five main topic areas.

meets the criteria set forth by HUD under the Notice

of Funding Availability, which includes single adults or

1.  Person-centered planning. This topic area is

families. 811 PRA eligible households are those who—

focused on listening to individual preferences and

valuing their choices.

1.  Are extremely low income (30 percent AMI or less).

2.  Services.  This topic area is focused on transition

2.  Are eligible for community-based, long-term services

services, housing, employment, learning, and waiting

funded through Medicaid or state funding sources.

lists.

3.  Have a disability and are at least 18, but less than

62 years of age at the time of admission, or who are

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

members of a family who has at least one member

Outreach, Referral, and Application

who has a disability and is at least 18, but less than

62 years of age at the time of admission.

Outreach

In its 811 PRA application, Minnesota designated two

The Minnesota 811 PRA program will use a combination of

target populations to be served under the 811 PRA

existing resources for outreach services (see figure 5.3).

program. The identification of the two fol owing target

PATH outreach workers will do extensive outreach on the

populations was designed to leverage current efforts in

streets and in institutions. Their goal will be to connect

two statewide initiatives: MFP and Minnesota’s Plan to

with people who are both experiencing homelessness and

Prevent and End Homelessness.

having a serious mental il ness or other disability. For MFP,

1.  Individuals experiencing long-term homelessness

case managers at institutions will identify potential 811

who have a serious mental il ness.

PRA participants and refer them to transition coordinators.

2.  Individuals with physical or mental disability who are

MFP Outreach

exiting institutional settings after a long-term stay (90

As part of the required annual assessment, case

days or more) and are assisted by MFP.

managers at DHS facilities must ask whether an individual

No changes to the target population served have occurred

in their care is interested in moving from the facility to a

since the submission of the 2012 811 PRA application.

community setting. For individuals who wish to move to

Units are offered on an alternating basis between the two

a community setting, the case manager will develop an

target populations previously cited, based on the date and

application for MFP or for a relocation service coordinator.

time applications are received. Participants are asked to

If the client chooses MFP, MFP staff will verify eligibility

indicate their location preferences.

and once the individual signs a consent form, wil  enroll

When units become available, 811 PRA participants

the individual in the MFP program. Once individuals are

are referred to the property owner based on (1) the

accepted into MFP, they are provided the opportunity

participant’s place on the waiting list, (2) the participant’s

to select a lead agency that then assigns a transition

indicated preference to live in the community where the

coordinator. Transition coordinators wil  assess each

unit is located, and (3) whether the available unit fits the

individual’s housing needs and connect with the housing

requirements of the 811 PRA participants, in terms of

coordinator to check for housing opportunities in the 811

characteristics, such as bedroom types and accessibility.

PRA program. The housing coordinator places applicants

on the waiting list.

Figure 5.3 : Minnesota — 811 Project Rental Assistance Outreach

Operations

Housing Coordinator

Program

PATH

MFP

Target Population

LTH

Exiting an institution

Sources

Outreach

Outreach in Shelters,

Nursing Homes, ICF-DD, Community

on Streets

Hospitals, Jails

Behavioral Health Hospitals, etc.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

The Housing Coordinator also conducts research and

managers.” For PATH outreach workers employed by

outreach in the community to find out about institutions

social service agencies, connecting individuals to LTSS

and nursing homes that may be closing or residents

often involves making inhouse referrals, as the agency

looking for housing in community-based settings.

already provides many of these services. The supervisor

Minnesota statute requires a 60-day public notice

previously quoted further indicated having a permanent

requirement to announce the closing of an institution.

housing resource is critical to the ongoing provision of

Embedded within this process is the requirement that

services for the target population. If consumers do not

families be informed of the impending closure before

have permanent housing, they may become transient and

the public announcement. The Housing Coordinator is

then lost to the case workers. Hence, having permanent

also given notice of this termination and reaches out

housing options raises the likelihood target populations

to the families after they have been formally notified by

will get the services they need.

the institution.

Referral and Application

DHS will also conduct outreach to eligible individuals

A key Minnesota 811 PRA program feature is the

through periodic mailings and other outreach activities.

centralized coordination of all outreach, referrals, and

MFP is developing a plan to have consumers, who have

management of the 811 PRA waiting list. The Housing

successful y transitioned from institutional placements to

Coordinator performs these centralized functions.

community residences, do outreach on its behalf. MFP

According to the 2015 fourth-quarter 811 PRA report, 70

believes that this peer-to-peer marketing strategy will be

applicants were placed on the waiting list.

successful in generating interest.

MFP transition coordinators and PATH outreach workers

PATH Long-Term Homelessness Outreach

determine eligibility and submit 811 PRA applications

PATH outreach workers will connect with individuals

directly to the Housing Coordinator, who reviews the

on the street and in more stable settings (like shelters,

applications and places applicants on the waiting list.

treatment centers, or correctional facilities) to identify,

The waiting list is a Microsoft Excel workbook with some

engage with, and enroll PATH-eligible clients. PATH

functionality built in for reporting.

outreach workers have dedicated office hours in shelters

According to the fourth-quarter 811 PRA report, 88

within their service area. They also will conduct outreach

referrals were to the Minnesota 811 PRA program during

to other areas with a high concentration of long-term

2015. Of those, 12 were institutionalized, 3 were at risk

homeless population, such as hospitals, libraries, and

of institutionalization, and 73 were homeless. Most of

even county jails.

those referred to the 811 PRA program, 76 people, had a

The housing needs and preferences of PATH clients are

mental health disability, and 11 had a physical disability.

assessed by the PATH outreach workers. These workers

At the end of 2015, out of 88 referrals, 70 applicants were

will identify individuals who are 811 PRA-eligible and help

on the 811 PRA waiting list, 12 were found ineligible for

them apply to the program. PATH staff will communicate

the 811 PRA program, 4 were referred to units, and 1

via email or phone with the Housing Coordinator to

applicant was housed in a 811 PRA unit.

submit the individual’s application to the 811 PRA

Implications

program. The Housing Coordinator reviews and verifies

this application. If accepted, the Housing Coordinator

Centralized design lends itself to program size. The

places the applicant on the waiting list.

centralized nature of the program seems to complement

program design. Overly centralized programs often

PATH staff will assist with the tenant transition to housing.

run into issues in larger-scale operations. Centralized

County-operated PATH outreach workers wil  then

programs when faced with a lot of activity either

connect the individual with ongoing supports and services

experience bottlenecks or suffer from quality when

before ending the transitional efforts. These services are

staff get overwhelmed. However, given the size of

contracted out to third-party social service agencies.

Minnesota’s 811 PRA program, this centralized design

The 811 PRA program has been very well received by

seems to fit very wel .

the PATH program staff in Hennepin County. A PATH

Implications of unit location and amenities

outreach team supervisor commented, “[811 PRA] offers

preference. As noted previously in this section, a key

a huge opportunity. We haven’t had a housing tool in our

feature of the referral process is the match between the

bucket before to offer people. We can attract people into

location and amenities of a unit and the preferences of

our program by providing long-term supports and case

the 811 PRA applicant. One aspect of this process that

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

requires special attention is the way in which the PATH

exist. If people have been placed away from their

outreach workers and MFP transition coordinators enter

institution, they may choose to locate back where they

this information on the program application.

came from,” the official concluded.

It would be easy for a savvy 811 PRA participant or

DHS determined where its institutionalized participants

referring provider to indicate a preference for all areas

came from using nursing home and institution data.

of the state to increase the chances of being selected

“That’s what we used to focus on: the high-need

for a unit. The Hennepin PATH providers were selecting

counties and communities that had regional HUBs that

the entire state initial y, without consulting the applicant,

had good access to services,” noted a DHS staff.

thinking they would acquire a unit more quickly for their

As a result of its analysis, Minnesota Housing has

participants. Since then, the Housing Coordinator has

established some 811 PRA program participation criteria

worked to educate the referring providers to al ow for

for interested properties. Interested property owners

applicants to select locations where they want to live for

must have the appropriate background and experience

the long term and not merely any location. Minnesota 811

in managing multifamily properties and Section 8 and

PRA staff will have to monitor this situation closely.

Housing Choice Voucher programs. Certain locational

Housing Strategies

criteria also apply. Minnesota Housing requires that

participating properties be in areas that have access

to transportation and service providers, and be in “job

Property and Unit Characteristics

growth communities.” In addition, access to the target

Rents and tenant contributions. Rents for the

populations is important. Properties must either be

Minnesota 811 PRA program are based on 50 percent

in close proximity to target institutions and facilities

AMI. The average contract rent shown in the 811 PRA

that MFP participants may exit from or be close to an

budget is $743 per unit per month, which includes an

identified population of long-term homeless households in

average tenant contribution (rent and utilities) of $240

PATH service areas.

per month. Subtracting the expected average tenant

Property selection methods and financing. Minnesota

contribution from the contract rent, Minnesota Housing

Housing procured 811 PRA units from existing

expects that the average 811 PRA monthly subsidy would

developments in its portfolio, owned by developers

be $503 per month.

with Section 8 experience that already had one- and

Minnesota Housing staff have expressed concern

two-bedroom units rent-restricted to 50 percent AMI.

about how the budgeting for RAC amounts and tenant

Minnesota Housing selected units in these developments

contributions would play out during the life of the grant

for the 811 PRA program that were not already

term, but know that a clearer picture will emerge once

subsidized by other programs.

the program is ful y operational. At this point, staff believe

The logic behind this strategy is simple. Properties that are

that many of the 811 PRA participants will have no

currently in the agency’s LIHTC and Section 8 portfolio are

income when they enter the program. If this assumption

already monitored by Minnesota Housing staff. Moreover,

is correct, this lack of tenant’s contribution will place

these properties are staffed by professionals with federal

a significant strain on 811 PRA program finances.

housing and supportive housing program experience.

Minnesota Housing staff acknowledge that incomes

will fluctuate over time; thus the real average tenant

Minnesota Housing conducted extensive outreach to

contribution will not be known for some time.

owners to gauge their interest in the 811 PRA program

Minnesota Housing started with properties that were

Urban versus rural. In administering a statewide 811

previously financed under its multifamily programs (such

PRA program, Minnesota Housing determined the Twin

as LIHTC, HTF, and Affordable Rental Investment Fund)

Cities metro area and northeast, west central, central,

from the agency. From this list, they targeted only

and southeast Minnesota as priority regions. Minnesota

properties that had units with rent levels set at 50

Housing, with assistance from DHS, prioritized 811

percent AMI or units with no rent restrictions but were

PRA developments that are in regional hub cities,

affordable to households at or below 50 percent AMI.

which thereby are close to necessary services and

Minnesota Housing targeted this segment of units to

other amenities. “Our strategy was that half of the units

expand the number of housing units that would be

would be in the metro area,” stated a senior Minnesota

affordable to extremely low-income households.

Housing staff member. “We focused on the ‘bright

However, only a portion of Minnesota Housing’s LIHTC

lights,’ places where participants wil  have access to

properties had units that fit these criteria. Most of

services. In rural areas, less access to services may

Minnesota Housing’s LIHTC properties have units with

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

rent levels that are set at 60 percent AMI.11 By targeting

At each of these Clearinghouse Committee meetings, the

only properties with rent levels set at 50 percent AMI or

811 PRA program Manager gives a presentation on the

were natural y affordable to households at 50 percent

owner and property. At the start of the 811 PRA program,

AMI, Minnesota Housing was limited in the number of

these presentations took approximately 20 to 30 minutes

properties from which it could choose.

each, al owing for time to discuss many aspects of the

Minnesota Housing narrowed the list further by taking

811 PRA program. Now the presentations take less

out developments that were already restricted to long-

time as only the specific development is discussed in

term homeless or persons with disabilities. Placing 811

detail, not aspects of the entire 811 PRA program. After

PRA units in the developments already serving persons

the presentations, the Clearinghouse Committee then

with disabilities would likely cause the property to exceed

approves or disapproves the selections.

the 25-percent limit of supportive units for low-income

Once an application receives Clearinghouse approval,

nonelderly people with disabilities.

the application is presented to the Minnesota Housing

However, this approach did have its downsides.

Board, the final approving authority, during the regularly

Minnesota Housing had difficulty recruiting owners with

scheduled monthly meeting.

existing rental properties that fit the previous criteria.

Once approved, owners are given 30 days to provide the

Intense marketing and educational efforts by Minnesota

required documentation and paperwork (the checklist

Housing staff have helped to mitigate some of the initial

items). Minnesota Housing then has up to 15 days to

reticence of some property owners about the 811 PRA

review this information. The checklist items form the

program. One of the factors creating difficulties was the

basis of the closing documents.

lack of financial incentive for owners. Little to no financial

Current status.  In 2015, Minnesota Housing executed

reward exists for owners to accept the 811 PRA program

five Rental Assistance Contracts, with a total of 67 units.

at their existing properties. The program comes with

Minnesota’s 811 PRA program goal for 2015 was 35 units

extra restrictions that add to already complex funding and

under RAC, so it exceeded its goal by 32 units and is only

compliance measures for their properties. Partners and

18 units short of meeting its goal for the entire 85-unit

investors have concerns about how two restrictions (on

program. However, Minnesota has occupied only one

long-term rent levels and on 30-year use) will affect the

unit to date; 66 of its 67 811 PRA units are not available

property’s long-term financial viability and marketability.

because they are currently occupied. Minnesota Housing

Additional y, owners who are inexperienced in serving the

col ects turnover rate estimates from each property owner

target populations may have felt that it was too risky to

based on historical data, then estimates when 811 units

pursue without any compensating financial reward.

will be fil ed. The agency then updates quarterly its lease

Once owners indicate an interest in participating in 811

up tracking based on actual lease ups so that they can

PRA, they are asked to complete an application, which

project turnover as accurately as possible.

gives Minnesota Housing basic information about the

property, rents, the ramp-up schedule, location, access

Determining the Initial Rent Level

to services, and amenities. Minnesota Housing uses a

Minnesota Housing used the FMR for a one-bedroom

25-question form to review the application.

unit in the Minneapolis-St. Paul metro area to develop

The 811 Application Review Committee reviews every

its 811 PRA rent projection. However, the average

application, then assigns an individual or a cohort

tenant contribution was determined by HUD’s published

to review specific sections of the application. These

guidelines for tenant contribution, which were higher than

sections include program administration, income and

the grantee’s calculations.

rent, experience, service and location, accessibility

The 811 PRA Budget for Minnesota’s Programs indicates

features, and environmental requirements.

that the 811 PRA rental assistance budget is set at

Once the selection is approved by the 811 review

50 percent of AMI. The section on Rents and Tenant

committee, its recommendation is forwarded to the

Contributions provides information on average contract

Clearinghouse Committee, a decisionmaking group

rent, subsidy and tenant payments.

made up of a core staff drawn from all Minnesota

Housing divisions.

11

Minnesota Housing did not target units with rents set at 30 percent AMI, because these units were already affordable to extremely low-income households.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

Unit and Tenant Turnover

•  Minnesota’s state-funded Long-Term Homelessness

Minnesota has not experienced any unit turnover yet. As

Supportive Services provide services that can be

mentioned previously, one applicant was recently housed

tailored to individual needs. The program is designed

in an 811 PRA unit.

to maximize independent living. Services include

intensive case management, advocacy support,

Service Provision and Coordination

support through treatment and recovery (including

aftercare), and helping people get access to benefits.

Service Provision

Lastly, recognizing the need for additional services to

The types of services available to 811 PRA participants

support this population and program participants, in

vary based on the program they enter. For instance,

particular, DHS proposes to expand Medicaid funding to

although both PATH and MFP provide transition services

increase services in the fol owing programs.

in the form of downpayment assistance and moving

•  Housing Stability Services provide additional outreach

costs, MFP participants also receive funds to purchase

capacity, as well as tenancy support services,

furniture, groceries, and other household supplies.

community living assistance, and service coordination.

In addition, although both PATH and MFP participants

•  PATH Critical Time Intervention uses a time-limited

receive ongoing services, such as case management,

case management model designed to prevent

MFP participants will receive targeted home- and

homelessness for people with mental il ness following

community-based services for 60 days after they move

their discharge from institutions. It focuses its

from the institution to ensure their successful transition.

intervention during that critical transition period to help

DHS administers a variety of federal y funded healthcare

individuals get settled in a more stable living situation.

services and other state and grant funded services

•  1915(i) to support individuals with mental il ness

that will be made available to all 811 PRA participants,

provides indepth assessment as well as clinical

regardless of target population.

direction of services, development of recovery-

811 PRA program participants will have access to the

oriented service plans, and other supports that foster

fol owing Medicaid services.

independent community living.

•  1915(c) waivers for persons with disabilities provide

Coordination of Services

a range of services, such as adult day care, assisted

Participants can enter the 811 PRA program from either

living, personal care assistant, transitional services,

MFP or PATH programs. The sequence of steps and

and transportation. Examples of waivers include

coordination of service providers varies between the

Developmentally Disabled, Traumatic Brain Injury,

two programs.

and Community Access for Disability Inclusion, and

Community Alternative Care.

MFP.  Once participants are accepted into MFP, the case

manager at the facility works with them to select a local

•  Medicaid Home Care Services provide equipment

lead agency for transition services.12 Local lead agencies

and supplies and other home-based services,

then assign an MFP transition coordinator to help the MFP

including home health aides (HHA), personal care

participants access transition services, including applying

assistance (PCA), and private duty nursing.

for the 811 PRA program (through the Housing

•  Medicaid Adult Rehabilitative Mental Health Services

Coordinator). If an 811 PRA unit becomes available, the

provide a comprehensive set of mental health

MFP transition coordinator works with the Housing

services, including Assertive Community Treatment

Coordinator in assisting the MFP participant with the

and Targeted Case Management.

application to the unit. If the participant is accepted to the

Program participants will also have access to the

unit, the MFP transition coordinator assists the participant

following state- and grant-funded services.

with the logistics of the move, including arranging for

transportation, making downpayment assistance, and

•  Adult Mental Health Community Support Program

helping purchase groceries, furniture, and supplies.

provides a wide range of services focused on

connecting people with resources, such as housing,

Once participants are moved into the 811 PRA unit,

health insurance, and employment support.

an MFP case manager is assigned to the participants

to ensure they receive appropriate ongoing services

12

Local lead agencies working on MFP are typically private social services organizations, while PATH services are usually carried out by county governments or contracted service organizations.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

and supports. The MFP case manager is employed by

The 2013 round of funding wil —

local lead agencies; sometimes both the MFP transition

•  Provide services to the same target populations as

coordinator and the MFP case manager are employed by

in the 2012 funding round (long-term homeless with

the same local lead agencies. The MFP case manager

severe mental il ness and MFP populations).

is available to provide intensive case management for

at least 60 days after the move-in date. This service is a

•  Focus on the same statewide geographic areas.

voluntary option for participants. If a participant selects

•  Leverage the same support services and staffing

this service, the MFP Case Manager conducts a person-

arrangements.

centered assessment of the participant and assists him

The difference between the first and second round of 811

or her in accessing HCBS. Ongoing case management,

PRA grants is the manner in which Minnesota Housing

after the initial 60-day period, is also available for up to

will identify and develop potential 811 PRA units. For

365 days, if needed. HCBS continues for as long as the

its 2012 program, Minnesota Housing had proposed to

participant requests it.

obtain 85 811 PRA units through existing properties.

PATH. Compared with MFP participants, the process is

For its 2013 program, Minnesota Housing proposes to

somewhat simpler for PATH participants. PATH outreach

develop 75 units through the annual Multifamily Request

workers identify long-term homeless individuals who are

for Proposal for new construction projects and draw on

eligible for the 811 PRA program. Those interested in the

applications from the existing portfolio.

program are referred to the Housing Coordinator. The

PATH outreach worker assists the PATH participant with

Leveraging

the application. If an 811 PRA unit becomes available,

the PATH outreach worker col aborates with the Housing

Housing Choice Vouchers

Coordinator in assisting the PATH participant with the

The St. Paul Public Housing Agency (PHA) and Metro

application to the unit. If the participant is accepted

Housing and Redevelopment Authority (HRA) each

to the unit, the PATH outreach worker then assists the

agreed to set aside 30 vouchers for 60 housing choice

participant with the logistics of the move, including

vouchers set aside for the target population as part of the

arranging for transportation, making downpayment

811 PRA program. The St. Paul PHA serves only the City

assistance, and helping purchase groceries and supplies.

of St. Paul. The Metro HRA is a PHA that serves Anoka,

Once a participant is moved into the 811 PRA unit, PATH

Ramsey, Hennepin, and Carver Counties, excluding the

outreach worker transitions out and a case manager

cities of St. Paul, Minneapolis, Plymouth, Richfield, St.

is assigned to the participant to conduct a needs

Louis Park, and Bloomington.

assessment, develop a plan of service, and ensure he or

Both PHAs agreed to do a one-time set-aside of HCVs

she receives ongoing services and supports.

for the target population. An HCV will be set aside for

As a general observation, although participants entering

the target population once it becomes available through

the 811 PRA program from either program receive

turnover. However, after HCVs provided to individuals

HCBS, typical y 811 PRA participants that come in

from the target population turnover, the HCVs will no

through MFP will have access to a wider range of

longer be set-aside for the program. HCVs will not be

services and supports.

al ocated all at once. PHAs will build up to the 60 voucher

commitments over time. Minnesota Housing expects

2013 811 PRA Application

that the HCVs set aside for the target population will be

al ocated within a year. Minnesota Housing reported that

HUD also awarded Minnesota Housing $3 mil ion in a

24 HCVs were issued to the target population in 2015.

second round of 811 PRA funding in 2013 to develop

an additional 75 units from new construction or for

Other Sources Leveraged

use at existing developments. Picking the size of the

second round funding request was easier for Minnesota

Minnesota Housing set aside $50,000 in grant funds from

Housing due to the experience it gained during the 2012

its operating budget. The funds were earmarked to fund

application process. By the time of the application for the

environmental reviews that may be triggered as a result

second round, the agency better understood its property

of an owner exploring options to participate in the 811

owners’ interest in the program, and it used historical

PRA program. Minnesota Housing and Department of

application data to identify potential y eligible properties

Human Services committed to leveraging $350,000 and

and units that would fit the program criteria.

$385,848 in salary costs, respectively, as noted in the

section titled Program Funding.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

Program Administration,

in the electronic Line of Credit Control System. LOCCS

Assessment, Information Systems,

then transfers the payment to Minnesota Housing.

The agency then processes the funds and distributes

and Data Infrastructure

payment to each property electronical y.

Program Administration

Information Systems

Minnesota Housing and DHS co-manage the

Minnesota Housing and DHS measure and track the

implementation and administration of the Minnesota

performance of the 811 PRA program by using a variety

811 PRA program. Minnesota Housing enters into RACs

of HUD, Minnesota Housing, and DHS systems. The

and monitors for federal regulation and compliance.

fol owing describes the systems used to col ect data and

DHS coordinates referrals and manages the waiting list.

measure outcomes of the 811 PRA program.

DHS also manages HCBS and makes sure that each

HUD systems—

participant’s preferences are consistently central to

•  TRACS is a web-based database col ecting data

housing and services decisions.

files that support the certification, recertification, and

To monitor program performance, the 811 PRA program

subsidy bil ing for HUD multifamily projects. TRACS

manager, employed by Minnesota Housing, works

provides authorized users with summary and status

closely with the Housing Coordinator, employed by

data on submitted vouchers. Minnesota Housing will

DHS. Together, the Program Manager and the Housing

use TRACS to accept, process, approve, and submit

Coordinator work on—

voucher payment requests for all 811 PRA program

•  Development of policies and procedures for housing

projects. TRACS will also be monitored to ensure

coordination and program performance.

data compliance thresholds are met and all errors

requiring correction are addressed by owners and

○ This collaboration includes developing policies and

their agents. Existing Minnesota Housing automated

procedures for managing the waiting list, status of

and accounting systems interface with TRACS and

referrals, availability of units, housing placement,

LOCCS to provide timely payments to owners.

and service connections.

•  LOCCS is HUD’s primary grant disbursement system,

•  Quality assurance, collecting and analyzing feedback

handling disbursements for most of HUD programs.

from participants as well as housing and service

Once voucher data are submitted to TRACS

providers.

and approved for payment, a LOCCS payment

•  Program evaluation, implementing system

is triggered. On receipt of a LOCCS notification

improvement initiatives, training and technical

email, a pending State Warrant is prepared from the

assistance, and reporting.

payment detail that is uploaded from the LOCCS

The Housing Coordinator is the central referral source

email notification and sent to the State of Minnesota’s

for 811 PRA units and works with service coordinators to

Disbursement System. Once the funds noted in

ensure access to housing and connections to services.

the LOCCS email have been received in Minnesota

Housing’s bank account, the State’s Disbursement

Financial Management

System sends an Electronic Funds Transfer to the

owner’s account on the same day. As described more

Minnesota Housing leverages its Performance Based

completely in the section titled Minnesota Housing

Contract Administration and Traditional Contract

Systems, the Tracker system is an internal system that

Administration (TCA) payment infrastructure to process

keeps a complete record of the LOCCS deposits and

811 PRA vouchers. The process for payment begins

voucher payments made on behalf of each contract.

when the property owners or their agents submit

the voucher and tenant data to Minnesota Housing

•  Enterprise Income Verification is a web-based

through Tenant Rental Assistance Certification System.

database containing employment and income

Minnesota Housing reviews this information, bundles all

information about participants in HUD’s rental

the property owner submission under its parent account,

assistance programs. This information is made

and sends the data to HUD via TRACS.13 If HUD accepts

available to ensure “the right benefits go to the right

the submission, the total amount for payment is reserved

persons.” The income information displayed in this

system is supported through a matching agreement

13

Parent account refers to the “parent voucher” for the entire state. Each individual Section 811 PRA property within the state that has a “child voucher.”

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

between HUD, National Directory of New Hires and

program. Col ected in MMIS are data elements from

Department of Health & Human Services, and the

data authorizations and paid claims, including data

Social Security Administration. Minnesota Housing

that will enable assessment of service usage and

will use EIV to monitor the number and type of

costs for healthcare and long-term services.

discrepancies associated with the 811 PRA Demo

Certain data elements are regularly extracted from MMIS

project and will assist projects in investigating and

and maintained in a data warehouse for internal users.

resolving errors with either tenant identifiers or

For example, DHS uses MMIS to look up the current

income data entered into TRACS.

service provider for a tenant.

Minnesota housing systems—

•  Federal Minimum Data Set is maintained by the

•  Tracker is an integrated database linked to Housing

Minnesota Department of Health and contains

and Development Software and Minnesota Housing’s

diagnosis, health, and functioning status.

accounting software. Tracker is the core tool

•  Disability Linkage Line tracks referrals and services

Minnesota Housing will use to manage, measure, and

for all cal ers in its database.

drive performance of 811 PRA Demo requirements,

including all dates, tasks, and outcomes (such as

•  Waiting lists, surveys, and specialized data col ection

RACs completed, inspection scheduled, inspections

will be developed and used by DHS as needed.

completed, rents paid, tenant income, and so on).

•  For example, the Housing Coordinator at DHS will

Tracker enables staff to easily pull all required HUD

maintain a waiting list in Excel for all 811 PRA Demo

quarterly program and budget data.

participants. DHS wil  also track housing needs

•  Housing and Development Software is what

and barriers for MFP participants. MFP participants

Minnesota Housing uses—for Section 8 purposes—

will also be asked to regularly join in a participant

to receive, review, and complete final submission of

experience survey.

TRACS files and monthly voucher payment requests.

Including certifications, recertifications, terminations,

Successes and Challenges

all tenant data files are logged into this Housing and

Development Software database, as are Special

Successes

Claims. TRACS data housed in this system can be

Reaching unit goals under RAC.  Despite initial

queried and provided in several report formats.

difficulties and with great effort, through 2015, Minnesota

•  Surveys and other specialized data col ection will be

has 67 811 PRA units under a RAC and expects to have

designed, as needed, to support the performance

all 85 units under a RAC by June 30, 2016. Although

measurements required to analyze the program

Minnesota still aims to reach the initial goal of 100 percent

internal y and to report external y to HUD, DHS, and

of the units leased by October 2016, achieving that goal

other appropriate parties.

seems unlikely as only one unit is occupied and 66 of its

67 units are currently “not available.” Turnover rates vary at

DHS systems—

each property and are estimated based on historical data,

•  Homeless Management Information System, or HMIS,

but until vacancy occurs at turnover, 811 PRA applicants

is used by Minnesota for all homelessness assistance

will not have access to most of the units under RAC.

programs, including supportive housing. With HMIS,

However, given the limitations of this pilot program and

PATH providers can enter data and provide reports on

other market factors, this progress should be considered

the PATH services received by the persons they assist

successful as Minnesota had the second highest number

in 811 PRA program units.

of units under RAC at year-end of all 2012 grantees.

•  MAXIS is a computer system used by state and county

Utilizing existing developments and finding good

workers to determine eligibility for public assistance

partners. Minnesota created a successful strategy

and health care. For cash assistance and food support

for identifying 811 units. First, it utilized developments

programs, MAXIS also determines the appropriate

with rent-restricted units or existing unsubsidized units

benefit level and issues benefits. Certain data elements

within Minnesota Housing’s Section 8 portfolio. The

are regularly extracted from MAXIS and maintained in

properties were already staffed with people who have

a data warehouse for internal users.

administered federal housing programs, including staff

that has coordinated supportive housing. Additional y,

•  MMIS is a claims-based system that will be used to

Minnesota Housing pursues partnerships with nonprofit

look at service and health cost data to evaluate the

property owners. Of the 10 property owners they were

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

in conversation with during the site visit, 9 are nonprofits

challenges—HUD procedural delays, the booming rental

and only 1 is for profit. In Minnesota, nonprofit owners are

market in the Twin Cities, and property owner resistance.

more likely to want to participate in the 811 PRA program.

A major chal enge in implementing this program has arisen

Minnesota Housing has found that nonprofit owners are

from HUD’s delays in (1) developing program guidelines

mission driven and are already targeting their housing to

and materials; (2) adjusting its data systems to work for

the 811 PRA’s population.

the 811 PRA program, such as LOCCS and TRACS; and

Minnesota Housing has found a partner in Aeon

(3) giving clear guidance on the program requirements

Properties, a large nonprofit developer operating in the

prior to receiving the cooperative agreement and program

Twin Cities region. The agency secured three RACs

regulations (for example, program design, environmental

with Aeon that will make 55 units available to 811 PRA.

requirements, the use agreement, budgeting parameters,

Aeon currently administers about 1,200 units targeted

completing the AFHMP, and how payments would be

to reach and support homeless persons and persons

made in HUD systems). It took more than 18 months from

with disabilities. It currently participates in DHS’s Group

the initial award for HUD to issue program materials and

Residential Housing program and Hennepin County’s

the cooperative agreement.

Housing First program.

The rental housing market in the Twin Cities

Developing organizational structure for program and

(Minneapolis-St. Paul and the surrounding communities)

improving agency efficiency.  As mentioned previously,

is on an upswing similar to that in many other metro

given the small size of Minnesota’s 811 PRA program, its

areas around the country. According to  StarTribune

centralized design seems to fit its operations very wel .

(Minneapolis’ biggest newspaper), the average rent for

The DHS Housing Coordinator is an integral key to

a one-bedroom unit in the metro area was $859 in 2014

program success. The coordinator has developed

(higher in cities of Minneapolis and St. Paul;  StarTribune,

systems and processes to work with the referring

2014). This rent is much higher than the $740 figure that

providers, applicants, and housing providers. Most

would be al owable given the FMR requirement. Property

importantly, the coordinator has established relationships

owners are easily able to get market-rate rents for their

with transition coordinators, PATH providers, and

units, so Minnesota Housing chooses units that already

property managers to quickly fill units as they become

have rent restrictions so owners are not accepting lower

available and to work on process improvements.

rents when they participate in 811 PRA.

Minnesota Housing and DHS meet monthly to

When implementing the 811 PRA program, Minnesota

develop program implementation, check on progress,

Housing has met significant resistance from property

and address issues as needed. The DHS Housing

owners. The requirement to enter into a 30-year use

Coordinator and 811 PRA program Manager consult

agreement and 20-year RAC, with 811 PRA funding

regularly on an array of daily operational and

guaranteed only for the first 5 years, proved to be difficult

implementation issues.

for owners to accept. Most owners of tax credit properties

have partners and investors who are concerned about the

As a current PBCA, Minnesota Housing has very

bottom line, long-term sustainability, and the future real

experienced staff in place, which has proven to be a

estate market.

great advantage for program administration. Minnesota

Housing’s experience has also provided the advantage of

Under these long-term agreements, which are longer

having systems in place to process payment vouchers and

than the 15-year use restrictions for tax credit properties,

receive payments from HUD. The agency has adapted an

owners have a limited ability to increase rents to cover

internal database structure used for PBCA to use for 811

rising expenses or go to the market rate in the future.

PRA program job tasks, data tracking, and reporting.

These agreements also limit owners’ ability to sell the

property with the use restriction attached. Gaining buy-in

DHS accesses multiple existing agency databases to

from owners in these situations may require multiple

verify applicant income and disability and track services

discussions with investors and lawyers.

provided to tenants.

Also owners have been reluctant to take on renters who

Challenges

are new to them or are from unknown populations. The

unknown factors can be many. To cite three examples,

Securing units and attracting property owners to

applicants may—

program due to HUD Section 811 PRA restrictions

and requirements. Those implementing the 811 PRA

•  Be referred from numerous types of institutions.

program in Minnesota have faced at least three major

•  Have lived lives of long-term homelessness.

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Chapter 5. Minnesota Section 811 Project Rental Assistance Program

•  Have complex or unfamiliar disabilities and service

needs.

With the 811 PRA program, owners will not have a

contractual relationship with the service provider, and

each household could potential y have more than one

service provider. Owners need assurance that they can

contact someone if tenants are having a problem or need

assistance to maintain their housing. Having the DHS

Housing Coordinator as a central contact has helped to

al eviate this concern.

Many owners have become comfortable (over time)

providing supportive housing units for long-term

homeless individuals and families using the current

funding model, which requires the owner to have a

partnership with a designated service provider. Owners

are reminded that it is likely that they already have quite

a few tenants with disabilities and receiving HCBS; they

merely are not aware of it and do not need to be.

Educating and negotiating with property owners takes

considerable time, and Minnesota Housing is trying to

meet the 24-month timeline to have all 811 PRA units

leased. Reaching ful , stabilized occupancy will also

take considerable time as 99 percent of the properties

currently under RAC are occupied and will not be

available for 811 PRA tenants until turnover.

Minnesota Housing has leveraged existing relationships

with mission-driven developers who work with Minnesota

Housing as partners to address the needs of low-income

people in the state. These developers are wil ing to take

the risk to embark on this new program, knowing they

will have agency support to address issues as they

arise. However, Minnesota Housing staff also note that

they have had conversations with supportive housing

property owners who expressed interest in adding more

units for the target population to their properties but

found out they were not eligible. Their participation would

have exceeded the 25-percent limit for units targeted

to nonelderly people with disabilities in a particular

property.

Staff turnover. Staff turnover in the 811 PRA program

has occurred, especial y on the services side. The current

housing coordinator is the third person to assume this

position. The staff member joined DHS in January on

loan from one of the county governments. Moreover,

considerations exist for funding this position during the

long term. The housing coordinator position is funded

through MFP, which is in year 2 of a 5-year grant. The

Minnesota 811 PRA program will have to find other sources

of funding for this position or restructure its program.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

Pennsylvania Section

the PBCA for the Commonwealth of Pennsylvania,

administering Section 8 contracts representing 45,000

811 Project Rental

units across the Commonwealth. PHFA al ocates LIHTCs

and administers Tenant-Based Rental Assistance (TBRA)

programs statewide.

Assistance Program

DHS, the key state-level supportive services partner

in the 811 PRA program, administers Medicaid for the

Commonwealth, one of the country’s largest Medicaid

programs. DHS had built up supportive housing experience

prior to the 811 PRA program award. Within DHS, four

Introduction

agencies play key roles in the funding or provision of

services to the 811 PRA program target populations.

HUD awarded Pennsylvania $5,870,880 to administer

•  The Office of Mental Health and Substance

a Section 811 Project Rental Assistance program in the

Abuse Services (OMHSAS), an office within DHS,

2012 funding round. The ful y executed Cooperative

administers programs for people with serious mental

Agreement was not received from HUD until October

illness, as well as the Medical Assistance Program,

30, 2014. Under this program, the Pennsylvania Housing

which covers both mental health and co-occurring

Finance Agency (PHFA) and its partner, the Pennsylvania

disorders. OMHSAS also manages a small number

Department of Human Services (DHS), anticipate

of state-run psychiatric hospitals and monitors

housing nonelderly adults with disabilities in 200 housing

funding to counties administering services through

units. The units wil  be located statewide throughout 34

block grants, coordinates other funding sources

regions served by local lead agencies. These regions

to provide education, and services for people

are mostly single counties, but in three cases the

transitioning into community-based settings. In

regions are composed of multiple counties. Beyond the

many cases, OMHSAS will also coordinate services

statutory eligibility requirements of the 811 PRA program,

for people after their placement.

Pennsylvania prioritizes—

•  The Office of Developmental Programs (ODP)

1.  Individuals living in institutions who are able to live in

administers programs that provide supportive

the community with permanent supportive housing.

services and care for people with cognitive and

2.  Individuals at risk of institutionalization without PSH.

intel ectual disabilities (including persons with

3.  Individuals living in congregate settings who desire to

autism), and people with physical disabilities. ODP

move to the community.

manages five state-operated intermediate care

facilities for people with intel ectual disabilities. ODP

At the time of the site visit in October 2015, only 1 of

provides funding, coordination, and transition support

34 local lead agencies had begun implementation.

for people with intel ectual disabilities in the 811 PRA

Pennsylvania chose Dauphin County to act as a pilot site,

program. It will also provide continuing services to

helping to test and refine the 811 PRA program.

individuals after they have moved into the unit.

As of October 2015, no individuals had been housed

•  The Office of Long-Term Living (OLTL) helps identify

through the program. However, by the close of 2015, one

housing solutions for people with disabilities who

RAC had been signed, representing two units, and one

currently reside in institutions. OLTL provides community

unit was occupied.

transition services, including financial assistance, for

Grantee Partnership, Organizational

people moving to community-based settings.

Structure, and Management

•  The Office of Medical Assistance Programs (OMAP)

purchases health care for more than 2.3 mil ion

people in Pennsylvania, administering the Medicaid

Partnerships and Organizational Structure

program. OMAP works with providers to process

PHFA is Pennsylvania’s 811 PRA program grantee.

claims, establish rates and fees, and contract with

For the past 40 years, PHFA implemented and

managed care organizations.

operated programs to increase affordable housing

available to low- and moderate-income households.

Programs include multifamily rental and single-family

homeownership programs. PHFA also serves as

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

Partnership Between PHFA and DHS

PHFA and DHS continue to perform their roles and

PHFA and DHS have developed partnerships around

responsibilities as were original y described in the

supportive housing programs for both elderly and

program application and detailed in table 6.1.

nonelderly people with disabilities, most notably

Pennsylvania’s 811 PRA program relies on a system of

through the Rental Subsidy Fund initiated in 2005.

community-based organizations that serve as local lead

Pennsylvania’s 811 PRA program is modeled after this

agencies in each county or for multiple counties. DHS

program, through which PHFA uses developer fees to

recruits and cultivates relationships with community-

create units affordable to households with incomes at

based organizations in each county and approves them

or below 20 percent of AMI. These units are dedicated

to serve as local lead agencies. Various agencies can and

to extremely low-income people with disabilities. DHS

do serve as local lead agencies, including county human

coordinates services for people with disabilities residing

services departments, behavioral health departments,

in the units. Because this structure already existed,

Community Action Agencies, local service provider

Pennsylvania made progress implementing the 811 PRA

organizations, and other nonprofit groups. This system

program despite key staff turnover in the years fol owing

has been used in Pennsylvania for the Rental Subsidy

submission of the 811 PRA program grant application.

Fund program, another supportive housing program using

PHFA and DHS worked together as partners on the

LIHTC-financed units affordable to people with disabilities

application approach and program design and structure,

who are at or below 20 percent Area Median Income. DHS

and they col aborated on decisions related to 811 PRA

expects to hire a staff person to act as a ful -time liaison

program implementation. In addition, both agencies

with all 34 local lead agencies involved in the program.

conducted outreach and marketing to encourage 811

Local lead agencies engage service providers, creating

PRA program participation. As a result, PHFA and DHS

formal referral relationships with chosen property

feel a shared responsibility over the role of “grantee,”

managers and landlords, and coordinate housing

meeting weekly to review issues and track 811 PRA

transition and services for participants. Designated local

program progress.

lead agencies in each of the participating counties wil

Overview of 811 PRA program structure.

serve as the single point of contact and central intake for

Pennsylvania’s 811 PRA program is expected to

the 811 PRA program serving their area.

operate statewide, with nearly all counties (58 out of 67)

Although the 811 PRA program is still in the early

participating. The organizational structure and design

implementation stage in Pennsylvania, the partners expect

features have not changed since Pennsylvania submitted

the model will rely on local lead agencies to organize a

the program application to HUD in 2012.

group of stakeholders that serve their target populations.

These stakeholders will serve as referral sources to link

Table 6.1: Pennsylvania — 811 P R A Program Roles and Responsibilities

Pennsylvania Housing Finance Agency

Department of Human Services

•

•

Recruit and collaborate with local lead agencies responsible for implementing

Identify or finance eligible units for 811 PRA program.

the program.

•  Execute Rental Agreement Contracts with property owners.

•  Oversee referral process in collaboration with local lead agencies.

•  Perform outreach to developers, landlords, and property owners.

•  Provide outreach, training, and technical assistance to local lead agencies.

•  Monitor 811 PRA program unit occupancy and compliance with eligibility

•  Monitor local lead agencies processes on prioritizing individuals for housing

requirements.

placement.

•

•

Monitor local lead agencies processes, ensuring tenants have necessary access

Make rental payments to property owners.

to housing and support services.

•  Collect and report required occupancy and financial information.

•  Collect and report data on service delivery, costs, and outcomes.

•  Provide ongoing communication with Department of Human Services, local lead  •  Provide ongoing communication with Pennsylvania Housing Finance Agency, agencies, and housing providers.

local lead agencies, and housing providers.

PRA = Project Rental Assistance.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

eligible persons to the 811 PRA program. Local lead

for eligible activities, such as outreach and engagement

agencies will review units chosen by PHFA and DHS and

of local lead agencies and data collection on tenant

refer potential eligible tenants to property managers with

outcomes. All fees must be documented, and PHFA wil

vacant 811 PRA program units.

col ect and retain records on administrative costs.

With assistance and oversight from DHS and PHFA,

local lead agencies wil  manage the outreach and

State Context: Housing Programs

referral process, oversee the waiting list for program

Each State administers a number of key waivers that are

participation, provide housing assistance, and ensure

critical to the functioning of the program. The key waivers

coordination of support services. Local lead agencies

by state fol ow.

will sign a memorandum of understanding with each of

the community stakeholders and properties, outlining

Housing

each party’s commitment to the tenants of the 811 PRA

Pennsylvania operates its housing and social services

program. This county-based program model aligns with

programs in a decentralized way, with programmatic

the Commonwealth’s overall decentralized model of

and policy decisions often made at the county level.

housing and service provision.

PHFA and Department of Community and Economic

Pennsylvania began program implementation with

Development (DCED), the two primary agencies

Dauphin County, the home to Harrisburg, the state capital.

that administer housing programs, provide funding

The county is geographical y diverse, with both urban

to initiatives designed at a local or county level.

and rural areas; it has some areas near to service hubs

Pennsylvania has some of the most urban counties in the

and transportation (such as downtown Harrisburg) and

country, but also large regions of rural counties (most

other areas not as connected to service centers or public

notably the “Rural T,” positioned in the middle of the

transportation. Furthermore, PHFA has a wel -established

state), resulting in a range of housing needs and local

relationship with Pennrose Properties, LLC, a large

priorities. In this way, implementing the 811 PRA program

property developer with available units in Dauphin County.

across the Commonwealth, with its requirement for local

adherence to a single set of eligibility requirements and

Dauphin County was selected as the first pilot local lead

program features, would be an achievement.

agencies because it met the following criteria.

Existing housing programs for nonelderly people

•  Local lead agencies has signed memorandum of

with disabilities. PHFA is a state-affiliated agency

understandings or anticipated memorandum of

that administers programs and funds on behalf of the

understandings with property owners or property

Commonwealth government and the federal government.

developers.

For more than 10 years, PHFA has committed

•  Local lead agencies has met with and signed

considerable resources toward supportive housing

memorandum of understandings with service

initiatives. In 2005, DHS and PHFA implemented the

agencies.

Rental Subsidy Fund to help move extremely low-income

•  Local lead agencies has conducted outreach to

people with disabilities out of nursing homes and into

institutional staff and outreach staff to obtain priority

housing in the community. PHFA has not created a

one referrals.

specific budget for this program, but instead includes it

as a preference in the annual LIHTC al ocation. Funded

•  Local lead agencies has provided a sufficient

through developer fees, this program has subsidized

level of communication with the Regional Housing

rents in approximately 570 supportive housing set-asides

Coordinator (RHC).

to provide affordable housing for people with disabilities.

•  Local lead agencies has developed and managed

In 2008, PHFA expanded its commitment to community-

waiting lists.

based housing for people with disabilities by setting aside

Program financial structure. The 811 PRA program

5 percent of tax credits for properties with supportive

budget provides $434,880 in administrative funds, or 8

housing units. To qualify, properties must set aside no

percent of the total rental subsidy amount. For the first 6

more than 25 percent of units in a single property for

months, PHFA and DHS each receive 50 percent of the

supportive housing target populations (including people

al owable administrative fees to cover the startup costs

experiencing homelessness or at risk of homelessness,

associated with the program. After the first 6 months,

people with disabilities, people with HIV, and veterans),

PHFA and DHS agreed that PHFA will receive 90 percent

Rents could not exceed 30 percent of tenant income.

of the administrative grant fees, with DHS using 10 percent

Beginning in 2009, PHFA required that any developer

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

seeking LIHTCs for multifamily rental housing must

Federal y funded public housing and Section 8 housing

set aside 10 percent of units for households with

vouchers are also important sources of affordable

incomes at or below 20 percent of AMI, including DHS

housing for people with disabilities in Pennsylvania.

target populations, such as people living in or at risk

Pennsylvania has 61,290 units of public housing,

of institutionalization, people with disabilities who are

90,002 HCVs, and 59,656 units of Section 8 housing.

homeless or at risk of homelessness, adults with autism,

Approximately 42 percent of nonelderly households,

and youth aging out of foster care. As a result of this

in which the head or spouse is under age 62, residing

provision, from 2009-2015, PHFA has added 1,425 set-

in public housing units have a disability (HUD, 2016).

aside units for households at or below 20 percent of AMI.

The head of household or spouse has a disability in 42

Pennsylvania anticipated that the 811 PRA program

percent of nonelderly households housed through HCVs

would provide additional long-term rental subsidies for

and 39 percent in Section 8 housing (HUD, 2016).

nonelderly people with disabilities. In this way, the 811

Of the HCV inventory, between 1997 and 2009,

PRA program would serve to expand the Rental Subsidy

Pennsylvania was awarded 2,054 vouchers across the

Fund Program, although for a more targeted population

Commonwealth under the Non-Elderly Disabled Category 1

as the 811 PRA program requires.

Voucher program. The Dauphin County Housing Authority

Other affordable housing programs in Pennsylvania that

was awarded 10 vouchers under NED2 in 2010. The

may also serve persons with disabilities are—

first NED program al ocated vouchers to Public Housing

Authorities (PHAs) to provide to nonelderly people with

•  HOME TBRA.  PHFA administers two similar TBRA

disabilities who wanted to access affordable housing in

programs, one of which is only for households with a

the private market; NED Category 2 program is specifical y

person with a disability. HOME TBRA aims to hasten

intended to enable nonelderly people with disabilities living

access to community-based housing through rent

in institutions to move into private housing. Both NED

subsidies. The amount of rental assistance is based on

programs are designed to provide supportive services for

Fair Market Rent using the appropriate bedroom size for

those persons utilizing the vouchers (HUD, n.d.).

the household. The maximum subsidy is the difference

between 30 percent of the household’s adjusted

The other state agency that administers housing programs

income and the FMR for the county. From program

and funds for low-income populations is the DCED. This

inception (2008) to the time of the site visit, PHFA has

agency administers the Emergency Solutions Grants

housed 150 households through this program.

Program, which provides funding for services and

facilities serving people experiencing homelessness, al

•  Supportive Housing Set-Aside. This effort by

whom have extremely low incomes and many of whom

PHFA sets aside 5 percent of LIHTC funds to develop

have a disability. In addition, DCED administers funds for

community-based supportive housing and has

specialized programs for homeless populations, such as

produced nearly 550 units of housing since 2008. This

the Supportive Services for Veteran Families program, a

program is separate and distinct from the 10-percent

new rapid rehousing pilot program, targeted to homeless or

set-aside previously mentioned.

at-risk veterans and their families. Although DCED does not

•  Homeless Assistance Program (HAP). HAP

participate in the 811 PRA program, PHFA indicated that

is administered by DHS and provides people

DCED is wel -informed and supportive of the initiative.

experiencing homelessness or at risk of becoming

Trends in the production of supportive housing.

homeless with financial assistance for rent and utility

Since the early 2000s, Pennsylvania has implemented

assistance and case management to help move them

policies that expanded options for people with disabilities.

toward self-sufficiency.

PHFA provides incentives to produce community-based

•  Emergency Shelter Allowance (ESA).  This DHS

housing for people with disabilities in the Commonwealth.

program works with low-income families and

Pennsylvania has established a priority for the allocation

individuals—including extremely low-income people

of LIHTCs in its Qualified Al ocation Plan to properties

with disabilities—who are experiencing homelessness

that include units for extremely low-income people

or at risk of homelessness to help them avoid

with disabilities. A top concern in state housing policy

eviction or secure housing. The county department

is to move people from institutions to community-

administering the funds coordinates with HAP to

based settings, and people with disabilities are a

combine HAP’s funds with ESA’s to prevent or end the

priority population in the DHS’s forthcoming housing

household’s housing crisis.

plan. Although the policy shift is recent, PHFA began

committing considerable resources to supportive housing

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

initiatives more than a decade ago. PHFA also gave robust

occupancy was not available. Services should be reviewed

preferences for new construction of supportive housing

to determine if a link exists between specific types of

through the QAP, to expand the inventory of units set aside

services and successful long-term occupancy of 811 PRA

for people with disabilities. According to Pennsylvania’s

units. Given that one of the chal enges noted by grantees

2012 811 PRA program application, PHFA has financed

is the uneven provision of services throughout the states,

more than 1,250 units of accessible and affordable

service mapping would be a useful tool in developing

housing (including some supportive housing) to extremely

individual service plans for potential tenants in locations

low-income populations during the past decade.

where services are less abundant.

At the time of the site visit in October 2015, the state

DHS has worked on supportive housing initiatives with

budget was not enacted, and the state’s Housing Trust

PHFA for the past decade. DHS has developed capacity for

Fund only had revenue to support housing activities in

supportive housing through a series of initiatives targeted

communities with active Marcel us Shale wel s. (Marcel us

to institutionalized populations and people with disabilities.

Shale is sedimentary rock buried thousands of feet

During the past 5 years, DHS built and supported the local

that runs north, south, and through Pennsylvania.) In

lead agencies infrastructure and initiated a RHC Program,

November 2015, Governor Tom Wolf signed Act 58

as explained in Existing Efforts section that fol ows. The

into law, which dedicates a portion of the increase in

811 PRA program was designed and implemented using

the Realty Transfer Tax into the Pennsylvania Housing

the local lead agencies model as its foundation.

Affordability and Rehabilitation Enhancement (PHARE)

Fund, the Commonwealth’s HTF. PHARE provides a

Policy and Funding: Prioritization of Medicaid

mechanism by which al ocated Commonwealth and

Resources Toward Home- and Community-

federal funds can be used to create or rehabilitate

based Services

affordable housing for Commonwealth residents,

Between 2008 and 2014, total Medicaid spending

including very low-income seniors and people with

increased from about $16 bil ion to $23.6 bil ion statewide,

disabilities. The only specific legislative requirement of

a 45.4-percent increase. Funding for long-term services

PHARE is that 30 percent of the funds benefit households

and supports went from approximately $7 bil ion in 2008 to

with incomes below 50 percent of AMI.

$8.3 bil ion in 2013 (Eiken et al., 2015; KFF, 2017). HCBS,

Rental housing market. The rental housing market across

as a portion of LTSS also increased during this period,

Pennsylvania varies. Although the rental housing market

indicating the continuing trend of decreased funding for

is tight (less than 5 percent of vacant units) in the urban

institutionalized care and increased funding for community-

areas, in the more rural areas of the Commonwealth, plenty

based services and supports. HCBS funding increased

of rental vacancies exist. Housing affordability also varies

from about 30 percent of LTSS in 2008 to 41.9 percent in

by county, with fewer affordable units in the tighter rental

2013; however, this increase is below the national average

markets. The National Low Income Housing Coalition

of 51.3 percent (Eiken et al., 2015). Between 2008 and

(NLIHC) estimated that a statewide shortage exists of more

2013, overall funding for HCBS increased 64.2 percent,

than 280,000 affordable units for extremely low-income

and funding for institutional Long Term Support Services

populations (NLIHC, 2016a). Although rental housing is

decreased nearly 2 percent. This shift in funding again

available in most rural areas, access to transportation

shows the Commonwealth’s priority toward community-

and services are often problematic, causing people to

based services (Eiken et al., 2015).

travel long distances to access services. Furthermore,

Despite the overal  Medicaid spending increase, waiting

NLIHC’s research found that many units in Pennsylvania,

lists exists for some of the Medicaid waivers that help serve

“…particularly in areas with high vacancy rates, that may

nonelderly people with disabilities, although Money Follows

rent for affordable prices may be in such poor condition

the Person helped to reduce some waiting lists.14 The

that they are not suitable living environments” (Mierzwa,

various agencies serving nonelderly people with disabilities

Nelson, and Newburger, 2010).

noted an expansion of need, which has put a strain on the

pool of available direct service providers. At the time of the

Service Provision and Healthcare

site visit in October 2015, the state budget had not been

Access to services is necessary for the successful

passed. The funding for services expected to be used

transition to community-based living. Due to the smal

in the 811 PRA program was largely through Medicaid

number of occupants at the time of the site visits, specific

(Home- and Community-Based Waiver), MFP, and other

data on service mix and the role services play in continued

rebalancing funds.

14

From 2008 to the fall of 2015, 2,136 people have transitioned out of institutions through MFP.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

Existing Efforts

•  Projects for Assistance in Transition from

DHS has programs that support community-based-

Homelessness (PATH).  The PATH program provides

living housing and moving people from institutions to

funding for services to individuals who have a mental

community-based settings. The following programs wil  be

il ness or a co-occurring substance abuse disorder

involved in providing assistance in the 811 PRA program.

and who are experiencing homelessness or are at-risk

of homelessness.

•  Regional Housing Coordinator Program. This

initiative is a state program that funds 10 housing

•  Home Modification and Assistive Technology

experts statewide to act as liaisons between the

Initiative.  Funded through OLTL, this initiative targets

housing and service systems, working with housing

seniors and people with disabilities served by OLTL

providers and Nursing Home Transition (NHT)

waiver programs. Its aim is to increase the number

Program coordinators to help people with disabilities

of people who are living safely and independently

achieve their housing goals. Implemented in 2003,

in their own homes by improving the quality of

this program, partially funded through MFP, has

their homes. This increase is achieved by providing

resulted in the widespread use of the Prepared

funding to make home modifications or secure

Renters Program (PREP), which helps prepare

necessary technical resources.

people in institutions to become successful renters.

•  SSI/SSDI, Outreach, Access, and Recovery

In some counties, RHC Program secured local PHA

(SOAR).  The SOAR program helps people who

preferences for people with disabilities.

are experiencing homelessness or at-risk of

•  Nursing Home Transition Program.  This program

homelessness and who have a mental il ness or

provides financial assistance (up to $4,000) and

co-occurring disorder access Supplemental Security

transition support services to people moving from

Income or Social Security Disability Insurance

nursing homes to community-based housing. The

benefits, which may lead to eligibility for Medicaid and

Commonwealth launched this program in 2008 and

access to supportive housing.

funds it annual y. There are 52 Nursing Home Transition

Olmstead Plan and Settlements

partners serving people ages 60 and over, and 13

Nursing Home Transition partners serve people under

In 2011, Pennsylvania’s OMHSAS proactively developed

the age of 60. Area Agencies on Aging are the 52

an Olmstead plan for the State Mental Health System.

organizations serving the over-60 population.

Updated in 2015 and undergoing an internal review

process, Pennsylvania reissued the plan in 2016. The

Other programs that serve people with disabilities, and

state-level plan targets individuals with mental il ness,

therefore may also serve the 811 PRA program target

focusing on diversion and transitioning people out of

populations, include the following.

state psychiatric hospitals and into community settings.

•  OMHSAS and HealthChoices.  Since 2008,

Toward the goal of deinstitutionalization, Pennsylvania

OMHSAS and the county-based behavioral health

has closed three state hospitals between 2006 and 2010.

HealthChoices Medicaid managed care contractors

The updated Olmstead plan identifies the 811 PRA

have al ocated more than $130 mil ion in Medicaid

program as a new funding source for integrated housing

reinvestment (savings) funds to develop supportive

in the Commonwealth. The plan’s priorities are consistent

housing and related programs. HealthChoices

with Pennsylvania’s 811 PRA program priorities, making

programs are given options to target funds into

the 811 PRA program an excel ent resource for furthering

Project Based Operating Assistance (managed

Pennsylvania’s efforts to provide housing and supports

through agreements with PHFA, bridge rental

in the most integrated setting possible for people with

subsidy programs, target capital funds, local housing

disabilities identified with serious mental il ness.

clearinghouses, contingency funds, master leasing,

and housing support services. Most programs

The plan references the six PHAs in Pennsylvania that

allocate funds across multiple categories.

committed a col ective 151 HCV or public housing units

for people with serious mental il ness. The plan also

•  Community Hospital Integration Projects

requires that counties have local Olmstead plans specific

Program. This program is a state initiative that

to the mental health system, either on their own or in

partners with local county mental health agencies

partnership with other counties in their region. Each local

to help transition people in state hospitals who have

plan will specify the support services and infrastructure

extended lengths of stay or complex service needs to

need to be developed to meet the needs of people being

community-based programs and supports.

discharged from state hospitals. Counties that host the

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

six PHAs that committed units to the 811 PRA program

and administer. Once Pennsylvania determines how and

are aware of the preference for people with serious

if it will al ocate 811 PRA program units geographical y, it

mental il ness and understand their role in making

will be easier to predict how this program will unfold and

referrals and providing supportive services to individuals

how production goals will be met.

as they move into integrated housing.

Also, three Olmstead-related lawsuits have been filed,

Population Served

one with OMHSAS and two with the ODP. As a result,

Pennsylvania’s 811 PRA program serves the population

three settlements were enacted, resulting in Pennsylvania

in accordance with HUD-established criteria, such

undertaking major remediation actions by moving

as: extremely low-income people between the ages

people from institutions to community-based settings.

of 18 and 61 who have a disability and are eligible for

OMHSAS’s settlement is known local y as “Fred L.

Medicaid services. Pennsylvania further prioritizes

Settlement” and ODP’s two settlements are known as

people with physical disabilities, intel ectual disabilities,

the “Jimmie Settlement” and the “Benjamin Settlement.”

and mental il ness disabilities. Pennsylvania targets the

•  Fred L. Settlement.  The case was filed in September

811 PRA program’s resources by prioritizing the three

2000. The result was an agreement in 2004 to

subpopulations described.

conduct 210 discharges during a 4-year period at

•  The Priority 1 population consists of people who

Norristown State Psychiatric Hospital. The discharges

are institutionalized, but who are able to live in the

were conducted in phases of 30, 30, 60, and 90

community in PSH. Institutions include, but are not

people being discharged at a time. All 210 discharges

limited to, mental health hospitals, nursing facilities,

were completed by 2012.

and immediate care facilities for persons with

•  Jimmie Settlement. This case was a class action

intellectual disabilities.

lawsuit challenging the unnecessary segregation of

•  The Priority 2 population consists of people who

individuals with a dual diagnosis of serious mental

are at risk of institutionalization in the absence of

il ness and intel ectual disability in state psychiatric

PSH. This population includes, but is not limited to,

beds. This settlement resulted in the provision of

people who are living with elderly caregivers or in

discharge planning for class action lawsuit members

unstable situations; homeless; aging out of the Early

over the course of 3 years.

and Periodic Screening, Diagnosis and Treatment

•  Benjamin Settlement. This settlement resolves

Program with no family support; and individuals aging

a class action lawsuit filed against DHS al eging

out of foster care.

that DHS unnecessarily segregated people in state

•  The Priority 3 population consists of people who

Intermediate Care Facilities for Individuals with

are currently residing in congregate settings who

Intel ectual Disabilities. The settlement requires DHS

want to move into the community. This population

to provide community placements to class members

includes, but is not limited to, people in community

to move to and stay in the community (should they

residential rehabilitation facilities, long-term structured

choose to do so) by June 30, 2018.

residences, personal care homes, and domiciliary care.

Pennsylvania has completed the Jimmie Settlement

Local lead agencies will have some discretion over

discharge planning. In the 18 months since the Benjamin

additional eligibility criteria for the 811 PRA program,

Settlement was enacted, Pennsylvania has moved 46

depending on local needs and priorities. For people to

people from state institutions to the community or to

be considered eligible for the Dauphin County 811 PRA

group homes, with considerable help from ODP.

program pilot (the only site implemented as of October

At the time of the site visit, the Pennsylvania 811 PRA

2015), they must meet the basic criteria for the 811 PRA

program was in the beginning stages of implementation.

program and be receiving medical assistance for one of

As planned, the program could involve 58 of the

the following disability categories.

Commonwealth’s 67 counties. The effort required to

•  Adults with autism.

implement an involved program like the 811 PRA program

•  Intellectual disabilities.

across such a large geographic area is enormous,

especial y because each county has its own unique

•  Physical disabilities.

characteristics and issues. Also, working with the wide

•  Serious mental il ness.

network of local lead agencies and their service provider,

partners makes this program challenging to implement

•  Transitional age youth with disabilities.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

At the time of the site visit, Pennsylvania had not yet

service providers, assisting people with disabilities that

housed anyone through the Dauphin County pilot

fall into one of the three priority populations, but local lead

program, but conversations with both PHFA and DHS

agencies ensure that sufficient stakeholders are involved

indicate that the actual population served will be the

to represent all disability groups and priority populations

same as the population proposed in Pennsylvania’s 811

for the 811 PRA program. The service providers conduct

PRA program application.

outreach to people who are already in existing programs,

A potential issue that may arise with the targeted

such as nursing home facilities, or by RHC Programs

population relates to geography. It was not clear if enough

through the NHT Program. People who are ready to live in

people or units in each county across the Commonwealth

a community-based setting or are about to be discharged

were going to meet the criteria for the 811 PRA program.

are prescreened by the service provider, who helps

PHFA and DHS seemed certain that units in Philadelphia

interested applicants to secure necessary documentation.

and Pittsburgh could be fil ed quickly given the number

Once referral source representatives confirm a potential

of nonelderly people with disabilities currently served by

tenant is interested in participating in the program, the

nursing homes and other institutional settings in those

service provider assists the individual in fil ing out an

areas who are ready to move to a community setting.

application for the 811 PRA program and other area

However, in more rural parts of the state, it was less clear

supportive housing. Pennsylvania plans to use the web-

if they were going to have the right number of people to

based SocialServe system as its applicant tracking,

match the number of units.

waiting list and reporting system; however, the system is

Another potential issue that arose is mismatch between

not yet ful y implemented. Once the system is operational,

the size of the available units (based on bedroom

information, such as the priority population the individual

size) and the needs of the target population, which is

fal s into, federal housing eligibility information,

composed mostly of individuals needing one-bedroom

demographic information, disability information, and

units. Although only one Rental Assistance Contract for

income information, will be entered into SocialServe and

two units had been executed in Dauphin County thus

the local lead agencies will be notified of the referral.

far, the RAC is for two-bedroom units because those

When the application is complete and the referral

were the unit sizes available. According to PHFA and

is determined to be eligible, CACH then reviews the

DHS, this issue may also be present in other areas of the

information for completeness, and the referral is

Commonwealth as wel .

brought to the monthly stakeholder meeting. CACH

presents the referral to the entire group, and together

Outreach, Referral, and Application

the stakeholders make a determination on eligibility.

Once the application is complete and the referral is

Because Dauphin County is the only site that has begun

determined eligible, CACH places the individual on a

implementing the program, this section reviews its client

waiting list and notifies the individual and the referring

flow processes. Although representatives from the

agency of his or her acceptance. The SocialServe

Mental Health and Intel ectual Disabilities office, NHT,

software will contain an automated waiting list function

and RHC likely will be in most or all local lead agencies

in the future. For the time being, CACH will develop and

across the Commonwealth, the direct service providers

maintain its own waiting list.

likely will vary based on the service area.

When a unit becomes available, CACH inspects the

Although other local lead agencies may do things slightly

unit to determine whether it will meet the needs of the

differently than Dauphin County, PHFA and DHS expect

person next on the waiting list, such as wide doorways

Dauphin County’s implementation processes to be a

or an accessible shower. If the unit is appropriate, the

model for other local lead agencies.

individual visits the unit (or more than one if more than

In Dauphin County, the Capital Area Coalition on

one unit is available), chooses a unit, and applies for

Homelessness (CACH) serves as its local lead agencies.

housing. The property manager or owner wil  determine

Outreach to potential applicants and referrals occur at

applicant eligibility for the unit. Once the application is

the county level. CACH entered into memorandum of

approved, the individual moves into the unit. The referring

understandings with al  collaborating agencies (called

agency helps the potential tenant visit the unit, complete

stakeholders) in the county. Stakeholders include the

the application, and coordinate the physical move. The

county’s Mental Health and Intel ectual Disabilities office,

program under which the individual receives services may

NHT coordinator, RHC, and other direct service providers

have a set-aside of funds to assist with move-in costs and

serving the target population. Most stakeholders are direct

security deposits.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

As of June 2015, three referrals were to this site; however,

Mental Health and Developmental Services programs.

two of the referrals (both persons who were homeless)

The service provider voiced concerned about having to

were deemed ineligible. The third person was referred from

absorb increased costs if applicants move in from another

a nursing home and moved into a unit in December 2015.

county and request services in the new county. Referrals

The memorandum of understanding details the roles and

from other counties could increase the caseload of their

responsibilities of al  stakeholders, including the local lead

staff and pose an administrative and service coordination

agencies. Those responsibilities are described in table 6.2.

burden on the local lead agencies. This decentralized

approach can be difficult to coordinate at times, but is

One issue that the Dauphin County local lead agencies

beneficial with regard to the local lead agency being very

noted was the potential for the temporary loss of services

familiar with their clients, the area, and the local providers

if an applicant moves across counties to participate

so that they ensure each applicant’s needs are met.

in the 811 PRA program. If an individual is receiving

services through medical assistance, then the individual

Housing Strategies

is enrol ed with medical assistance and the transfer

between HealthChoices plans should not result in an

PHFA did considerable outreach and marketing to both

administrative drop in services. However, if the individual

existing landlords and to developers to encourage 811

needs to transfer to a new provider as a result of the

PRA program participation. The housing component of

move, any drop in service will be consistent with the time

Pennsylvania’s 811 PRA program is currently composed

it takes to select the new provider and establish the first

of new development and rehabilitation. Although

appointment. Continuity of Care agreements are in place

PHFA intends to expand its outreach to existing units,

between HealthChoices County or Behavioral Health

initial y the National Environmental Policy Act’s rules

Managed Care Organizations for Medicaid Managed

created some confusion, so PHFA focused on new

Care, and eligible individuals who are awaiting medical

construction and rehabilitated units. In addition, most

assistance enrol ment should require only county-funded

of the one-bedroom units in existing properties that

services for a short period of time. This coordination

became available were in buildings that already met the

helps to ensure individuals are transferred to a new

25-percent limit on the percentage of supportive housing

service provider in the county of the location where the

units for people with disabilities, exempting them from

individual is moving.

program participation. Moving forward, PHFA estimates

that people will be housed through new construction and

Although Medicaid-funded services are distributed at the

existing units and will focus on landlord recruitment to

state-level with no geographic restrictions, many broad

expand housing choices for program participants.

community-based services are funded through county

Table 6.2 : Pennsylvania — Responsibilities of Local Lead Agencies and S t akeholder s

Local Lead Agencies

Stakeholders

•  Serving as Single Point of Contact for the 811 PRA program.

•  Conducting outreach to potential applicants.

•  Tracking the availability of 811 PRA program units.

•  Prescreening potential tenants prior to referral.

•

•

Referring people with disabilities to the local lead agencies for the 811 PRA

Conducting eligibility assessments using SocialServe.

program.

•  Monitoring tenant selection.

•  Assisting referred applicants in securing the necessary paperwork.

•  Maintaining all referral and application information.

•  Conducting a supportive services needs assessment.

•  Matching potential tenants to units, managing the referral process.

•  Providing transition assistance and moving assistance.

•

•

Coordinating support services to tenants in the program by identifying

Establishing a stakeholder group.

community-based services.

•  Promoting local government participation in the 811 PRA program.

•  Providing services to tenants once in housing.

•  Working with property manager on emergent issues.

•  Participating in meetings with the local lead agencies and other stakeholders.

PRA = Project Rental Assistance.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

Property and Unit Characteristics

2.  PHFA maintains close contact with the developer

At the time of the site visit in October 2015, the one

throughout the process.

property under RAC at that time, Felton Lofts, was

3.  PHFA ensures that the set-asides for people with

financed with LIHTCs. Felton Lofts applied for and signed

disabilities in the building have not already been met

a RAC for two, two-bedroom units in Dauphin County.

and then works with the local lead agency to approve

Felton Lofts is a mixed-income property developed by

the property.

Pennrose Properties, LLC, a developer with whom PHFA

4.  If the local lead agency does not believe the property

has worked in the past on the Rental Subsidy Fund

would be a good fit for the population, PHFA will not

Program and numerous LIHTC projects. These units were

move forward with the property.

vacant at the time of the site visit.

Implementation Schedule

Property Selection Methods and Financing

Pennsylvania’s 811 PRA program budget indicates that it

Prior to engaging property developers, PHFA examined

expects to support 200 units of affordable rental housing

the inventory of properties and screened out all ineligible

with 811 PRA subsidies over the grant period. Starting in

properties, such as buildings for people aged 62 and older.

2014, Pennsylvania’s annual goal was to place 50 units

At that point, they screened for newer construction (2011 and

under RAC each year for 4 years. At the end of 2015,

newer) due to the environmental requirements of the grant.

however, only two units were under a RAC and one unit

PHFA held two regional meetings to explain and market

was occupied.

the program to property owners and landlords. In addition,

PHFA issued press releases on the program and sent out

Implementation has lagged due to a number of factors,

mass emails to eligible property owners to get the word out.

including the loss of key Department of Human Services

and PHFA staff during early program startup, the

Original y, Pennsylvania’s 811 PRA program application

geographic breadth of the program, identifying Dauphin

stated that it intended to obtain units for its 811 PRA

County as its pilot site where not many properties are

program from units newly developed using LIHTC

available, and delays around HUD’s approval of the

al ocations from the 2011 to 2013 al ocation rounds. In other

Cooperative Agreement, which was not sent by HUD

words, a mix of both “existing,” already developed units,

until October 30, 2014. Additional y, PHFA had difficulty

and “new,” recently constructed units, would be utilized

engaging interested developers and landlords to commit

for the 811 PRA program. PHFA discovered that far fewer

units to the 811 PRA program. However, PHFA and DHS

developers were interested in participating in the program

expect the Philadelphia metro area to implement the

than PHFA had expected. In addition, during 2015, the

811 PRA program next. Program implementation in the

developers that were interested were only able to commit

Philadelphia area will result in considerable progress

to two-bedroom units due to a limited availability of one-

toward the program goals of placing 50 units under RAC

bedroom units in the pilot area, Dauphin County. Because

each year. Once the program is under way in Philadelphia,

of this outcome, PHFA is now reaching out to all potential y

two other pilot sites (to be determined) will begin as wel .

eligible properties regardless of when LIHTCs were awarded

PHFA and DHS expect that by 2017, most local lead

in an effort to al ocate the 2012 811 PRA subsidy funds. In

agencies will begin implementing the 811 PRA program.

addition, PHFA implemented preferences in its QAP for the

most recent round of tax credit awards. Although PHFA is

Rent and Subsidy Levels

not technical y awarding “points,” if two developers had

Participants in the program will pay no more than

applications that scored exactly the same and one had

30 percent of their adjusted monthly income toward

identified an interest in the 811 PRA program, that developer

rent. Income will be recertified annual y. The two units

would be given preference in receiving LIHTCs and would

currently set aside by Pennrose for the 811 PRA program

be required to provide units for 811 PRA program tenants.

will have rents affordable at 50 percent of the AMI as

Dauphin County used the fol owing process to identify

required in the cooperative agreement. The budget in

an appropriate property for the 811 PRA program. This

Pennsylvania’s cooperative agreement indicates an

process will be replicated as the program is extended to

anticipated average contract rent of $678 per unit per

other areas in the Commonwealth.

month, with an average tenant payment of $300. The

1.  When a developer expresses interest in the 811 PRA

average 811 PRA program subsidy is anticipated to be

program through conversations with PHFA, PHFA

$378 per unit per month, as provided by the 811 PRA

sends the developer an informational packet with al

program budget for 200 units.

the necessary paperwork, including a RAC template.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

Unit and Tenant Turnover

Coordination of Services and Housing

Pennsylvania had not encountered any unit or tenant

The local lead agencies serves as the coordinating

turnover at the time of the site visit. However, PHFA, the

entity in each implementation area. DHS supports

local lead agencies, and the property owner believed

local lead agencies and provides technical assistance

that the process would work much like it does for the

as necessary, but the coordination piece occurs at

Rental Subsidy Fund program. Once a tenant leaves

the county level. The local lead agencies engages

the unit, the property manager wil  notify the local lead

and recruits service providers, bringing them into

agencies to alert the agency of the vacancy. At that

the stakeholder group, and signing memorandum of

point, the local lead agencies wil  begin the placement

understandings with each. The local lead agency’s

process with the next eligible person at the top of the

responsibilities between the time that a referral is made

waiting list, contacting the referral agency and potential

and an individual is housed include—

tenant to have them visit the unit and begin the property

•  Regularly notifying agencies of unit availability based

application process.

on regular contact with property managers.

PHFA reported that it does intend to make vacancy

•  Ensuring the community-based service provider helps

payments to property owners when a resident moves

the prospective tenant visit an available unit.

out. The owner is eligible for 80 percent of the contract

rent for up to 60 days after the unit is ready for

•  Working with the primary service provider to help

occupancy. Property owners have 180 days to submit a

potential tenants gather paperwork and apply for the

special claim request, and on approval or adjustment of

unit.

the request, PHFA will notify the owner in writing.

•  Working with the primary service provider if issues

related to tenancy arise.

Service Provision and Coordination

•  Serving as the tenant services liaison to property

Service Models

owners and managers.

DHS will work directly with local lead agencies to

•  Tracking referrals, move-ins, and changes of service

individualize supportive services to people referred to

providers, and reporting performance to DHS.

the program. Each service provider that refers people

Service Provision (Types, Transition Versus

to the program will identify the service planning needs,

Ongoing, by Target Population, Gaps)

housing needs, and supports necessary for the referred

candidate for housing. Services can then be tailored to

The types of services available to 811 PRA program

the needs of the individual.

tenants vary by both their specific needs and their desire

for services. At the point of tenancy, all services become

Stakeholders or service providers in the community

voluntary. The service provider attached to the potential

serving participants are already providing services to the

tenant at the time of referral is responsible for the

individual. The services provided to program participants

transition services. If services are funded through MFP,

are largely individualized based on their needs and

potential tenants receive 180 days of transition services.

referral source. All participants are eligible to apply

for Medicaid. When individuals indicate they want to

Services provided to people through the ODP are

participate in the 811 PRA program, and it is determined

provided by “support coordinators” who help provide

they are not enrol ed in Medicaid, the referral entity

support services, identify funds to help with unit startup

immediately assists them with the application to enrol

costs (such as linens, pots, pans and other necessities),

in Medicaid. All agencies provide intensive services to

home modifications if necessary, and furniture. For

potential participants during the outreach, application,

individuals receiving services through the OLTL and the

and referral processes.

Office of OMHSAS, those services are similarly available.

A service coordinator provides services, and an OLTL

Participants are also provided housing transition

$4,000 lifetime cap is on the amount an individual can

assistance by their case manager or the service

receive through the Community Transition Funds.

coordinator from their referring agency. However, once

participants are housed, services are voluntary. Tenants

NHT coordinators also provide transition services to

are not required to participate in any services to continue

people exiting nursing home facilities. Like support

receiving housing assistance.

coordinators and service coordinators, NHT coordinators

will tailor transition services to individual needs. Through

the independent enrol ment broker, consumers can

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

choose an ongoing service provider (service coordination

DHS are attuned to each part of program administration

agency). The NHT coordinators will fol ow up with noncare

and work together to deal with any issues that may arise.

managed individuals for 1 year fol owing transition.

PHFA Program Monitoring

Most tenants will be able to continue with their existing

primary service provider for ongoing support services.

PHFA is the Performance Based Contract Administration

Individual service plans are created for the tenant at the time

for the state and administers contracts in Pennsylvania

of discharge and assess each person’s individual needs.

that cover more than 45,000 units of housing. PHFA also

Service needs are reassessed annual y by the tenants’

administers various other programs that provide rental

service provider to identify any changes or additional needs.

assistance for lower-income renters with disabilities as

described in the section titled Service Provision and

2013 811 PRA Application

Healthcare. As a result of its administration of other

affordable rental programs, PHFA already has a financial

In the 2012 and the 2013–2014 811 PRA program

management system in place that is used across al

application rounds, HUD awarded Pennsylvania funding to

programs and will be used for 811 PRA program grant

provide subsidy for 200 units in each round, for 400 units.

management.

Funding per application varied substantial y. $5,870,880

was awarded for the 2012 program and $8,557,014 was

In addition to managing grant status, PHFA developed

awarded for the 2013–2014 program. The higher funding

quality control mechanisms that will ensure accurate and

amount can partial y be attributed to the grantee’s

timely fund disbursement to 811 PRA program property

anticipation of rent increases and market changes. No

owners. These mechanisms include verifying the accuracy

major policy shifts were in the 2013–2014 application,

of monthly vouchers, rent adjustments, and mechanisms

and Pennsylvania indicated that it intended to continue

around tenant health, safety, and housing maintenance.

its statewide program for the same target population as it

PHFA will also submit monthly tenant certifications to the

established in its 2012 811 PRA program application.

Tenant Rental Assistance Certification System. To monitor

and implement annual increases in rent (and utilities where

Leveraging

appropriate), PHFA will use the Integrated Real Estate

Management System to record and track annual increases.

PHFA worked with public housing authorities to provide a

In addition to HUD systems, PHFA has multiple inhouse

leverage commitment of 151 housing choice vouchers for

tracking systems for its programs. Systems track tenant

nonelderly people with disabilities. Prior to application,

characteristics of each program, with built-in systems

most or all Pennsylvania’s public housing authorities

to check income and make sure tenant income meets

were in full support of the 811 PRA program application

the restrictions. In addition, PHFA and DHS developed a

for funding, and several committed resources to support

series of performance measurements that they will use

the effort. In total, six Public Housing Agencies (PHAs)

to monitor program implementation. These performance

committed 151 HCVs or public housing units to the effort.

measurements include—

At the time of the October 2015 site visit, none of the

•  Rate at which 811 PRA program units are occupied.

HCVs had been utilized. During a startup meeting

with Philadelphia, the housing authority committed 50

•  Percent of units occupied with eligible tenants.

vouchers, but had not initial y targeted Olmstead-related

•  Percent of rental payments made on time.

populations. PHFA was working through the issues,

•  Percent of referrals made by local lead agencies to

ensuring that Priority 1 populations (those transitioning

property owners.

from nursing homes) were being targeted and that the

public housing agency had formal processes in place to

•  Percent of tenants who retain units for 1 or more years.

track the vouchers.

•  Satisfaction of 811 PRA program tenants.

Program Administration,

•  Satisfaction of property owners.

Assessment, Information Systems,

PHFA also oversees housing construction. A dedicated

full-time staff person conducts the environmental reviews

and Data Infrastructure

for all the projects during construction, after construction,

PHFA and DHS work cooperatively to oversee program

and after occupancy to ensure that the property meets

implementation, and to make sure program components

housing quality standards, accessibility standards, and

are administered as designed. Meeting weekly, PHFA and

environmental standards. The staff person wil  also be

assigned to oversee 811 PRA program development.

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Chapter 6. Pennsylvania Section 811 Project Rental Assistance Program

DHS Program Monitoring

Challenges

Statewide DHS is implementing SocialServe, a web-based

tool that service providers will use to log the service needs

Securing One-Bedroom Units

of individuals and submit referrals. The system is not yet

Thus far, Pennsylvania’s primary chal enge has been

implemented, so for the pilot local lead agencies, Dauphin

securing the right type of housing units for the program

County, referrals are done through completing a form and

in Dauphin County. In the one RAC signed thus far, two-

submitting it by email to the local lead agencies. The data

bedroom units were available but no one-bedroom units

col ected are kept in a spreadsheet.

were identified for the program. PHFA, which has done

considerable outreach to developers, is concerned about

Successes

the lack of existing landlords agreeing to participate and

new developers having no one-bedroom units available

Strong Partnerships

in properties that did not already meet the maximum

DHS, PHFA, and the stakeholders interviewed in Dauphin

threshold of 25 percent.

County all pointed to the strength in the partnerships as

Staff Turnover

the biggest program success to date. DHS and PHFA

built on an existing partnership, strengthening it through

Another chal enge faced by both PHFA and DHS was

shared responsibility and trust. Meeting weekly and

staff turnover. Key staff members involved in writing the

keeping each other informed of progress has proven

grant application were no longer with the departments.

beneficial for this program and others they administer

Although this turnover resulted in some loss of

together. Pennsylvania is also proud of its networks of

institutional knowledge and initial groundwork, both

local lead agencies that perform outreach and referrals

departments filled those vacancies quickly with qualified

for 811 PRA program housing and services. However, the

staff.

program was still in the implementation process at the

pilot site during the time of the site visit, so not a lot of

Breadth of Geographic Differences

evaluative information was available.

Moving forward, the program’s geographic reach may

Dauphin County, the pilot site, similarly believed that

be a chal enge. Both DHS and PHFA are confident

the partnerships between the stakeholders have been

that the program will be implemented well across

the biggest success so far. The local lead agencies

the Commonwealth, but they also recognize that the

stakeholder team for the program is composed of people

decentralized approach to implementation will be

with substantial experience and knowledge. Meeting

a considerable undertaking given the difficulties of

frequently has helped the program, but it has also helped

coordination. Furthermore, it is not clear whether or not

better serve the community. Stakeholders were forced to

Pennsylvania can match the right number of people to

think outside their own service systems and look at the

the number of units, particularly in the rural counties.

community needs holistical y. The Dauphin County local

Shift in Housing Strategy

lead agencies also believes it was critical to have the

right stakeholders involved.

As discussed previously, Pennsylvania had to pivot

from its plan of focusing on existing properties. With

Leveraging Existing Programs

a 25-percent limit on the percentage of supportive

DHS’s existing Regional Housing Coordinator initiative

housing units for people with disabilities, many existing

and Nursing Home Transition program are key to

properties could not participate in the 811 PRA.

Pennsylvania being able to quickly serve the target

Coupled with confusion over the environmental review

population. These two programs are already familiar with

rules, Pennsylvania had to increase its focus on new

the target population’s needs and the available housing

construction and rehabilitated properties.

transition services. This familiarity eliminates a need for

training and reduces the learning curve for implementing

811 PRA services.

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Chapter 7. Washington Section 811 Project Rental Assistance Program

Washington Section

significant demand for rental subsidies for the 811 PRA

target population. The 811 PRA program provided an

811 Project Rental

opportunity to increase rental subsidies for people with

disabilities and increase the availability of dedicated

housing inventory for this population. DSHS also had

Assistance Program

already developed outreach and referral mechanisms for

transitioning people out of institutional care and could

utilize those same procedures for the 811 PRA program.

Commerce submitted its 811 PRA application in August

2012 and HUD awarded 811 PRA funds in February 2013.

Introduction

HUD signed the Cooperative Agreement with Commerce

on October 30, 2014.

HUD awarded the Washington Department of Commerce

Partnerships and Organizational Structure

(Commerce) $5,739,717 in Section 811 Project Rental

Assistance program funding in the 2012 funding round.

The Washington Department of Commerce operates more

Commerce partnered with the Washington State

than 100 programs for businesses, local governments,

Department of Social and Health Services (DSHS) to apply

and communities and makes both direct and indirect

for the 811 PRA funding and implement the demonstration.

funding available for more than 6,000 grants, loans, or

The 811 PRA funding is estimated to provide rental

contracts a year. Commerce also oversees the state’s HTF

subsidies for up to 215 units. The target populations

for the development of affordable multifamily housing and

served by the 811 PRA program are extremely low-

administers several federal and state programs for people

income, nonelderly adults with developmental disabilities,

who are homeless or at risk of homelessness.

functional disabilities, or mental il ness, or are individuals

Commerce operates the 811 PRA program in its Housing

participating in the Roads to Community Living (RCL)

Assistance unit within the Community Services and

program, which serves individuals who have complex,

Housing Division. Commerce’s 811 PRA program

long-term care needs and want to move from institutional

responsibilities include marketing the program to

settings to a community living setting.

owners of state-financed properties, reviewing owner

Evaluators conducted a site visit in November 2015 to

applications for 811 PRA funding, and executing the

learn how the two agencies and their partners were

RAC with owners. Commerce staff also monitor ongoing

implementing the 811 PRA program. At the time of the

owner compliance. As the grantee, Commerce monitors

visit, Commerce had executed RACs for 26 units at

the performance of DSHS and its partners and submits

four different developments throughout the state. Nine

quarterly reports to HUD.

residents were living in 811 PRA-funded units. The

Commerce administers the 811 PRA program in

evaluators also visited Channel Cove in La Conner, the first

partnership with the DSHS, the state human services

property in Washington to receive the 811 PRA subsidy

agency. DSHS provides long-term care services for

and the home of two 811 PRA participants at the time of

persons with disabilities through its Aging and Long-

the visit. At the end of 2015, 32 units were under RAC, and

Term Support Administration (ALTSA). ALTSA, through

11 units were occupied.

its Home and Community Services Division, administers

Grantee Partnerships

the RCL program, the state’s Money Fol ows the Person

Rebalancing Demonstration program for persons with

Organizational Structure, and

disabilities exiting from institutions. Those targeted to

Management

receive 811 PRA subsidies are DSHS clients enrol ed in the

RCL program, consumers served by other programs in the

Application Background

Home and Community Services Division, and individuals

served by the Developmental Disabilities and Behavioral

Commerce and DSHS applied for 811 PRA funding to

Health and Recovery divisions.

increase the inventory of affordable housing for low-

DSHS, through contracted service providers, conducts

income residents, specifically for people with disabilities.

outreach to and screening of potential applicants for the

DSHS had previous experience coordinating housing

811 PRA program, referring eligible applicants to available

resources with local public housing authorities for federal y

units and overseeing contracted service providers to

funded vouchers for nonelderly people with disabilities.

ensure residents have ongoing connection to the services

The high utilization of these vouchers demonstrated the

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Chapter 7. Washington Section 811 Project Rental Assistance Program

they need. Service provider case managers identify and

Washington State Health Care Authority is the state

screen their clients who are living in institutional settings

Medicaid Agency and coordinates with DSHS to provide

or other residential settings who are eligible for the 811

Medicaid services. WSHFC and Health Care Authority

PRA program. RCL housing program managers coordinate

signed as parties to the 2012 application but do not play

housing referrals within the three regions of the state and

active roles in 811 PRA program administration.

market the 811 PRA program to owners and properties in

Table 7.1 summarizes the agencies’ respective roles in the

their regions.

811 PRA program. The agency roles are the same as those

The Bremerton Housing Authority, through its Contract

proposed in the 2012 funding application.

Management Services Division, is the PBCA for

Commerce and the 811 PRA program. As a PBCA, the

Program Financial Structure

authority obtains tenant data from owners, reviews and

The 811 PRA program is supported through the

enters the data in HUD’s tenant data reporting system,

Section 811 administrative grant fees and from in-kind

TRACS, and submits the vouchers to HUD for payment.

contributions of staff time. Administrative funding from the

Bremerton Housing Authority acted as a PBCA since 2000

811 PRA award is 8 percent of the awarded rental subsidy

and administers more than 9,000 PBCA contracts in four

amount, or $425,165. An administrative fee is passed

states—Hawai , Nebraska, Utah, and Washington.

through to the Bremerton Housing Authority to pay for

Two other state agencies play indirect roles in the 811

voucher processing. All 811 PRA functions at Commerce

PRA program. The Washington State Housing Finance

and DSHS have been absorbed by existing staff and

Commission (WSHFC) is the state’s housing finance

funded through other programs. Within Commerce, the

agency. WSHFC allocates federal Low-Income Housing

direct and indirect costs for staff and tasks related to the

Tax Credits and tax-exempt bonds for the development

811 PRA program are absorbed by Commerce. DSHS

of affordable, multifamily housing. Properties funded by

staff positions for the 811 PRA program are paid through

WSHFC are eligible to apply for 811 PRA units. WSHFC

the MFP Demonstration project administrative funds,

asset management staff monitor tax credit properties,

which are funded through 2020.

including those that have 811 PRA-funded units. The

Table 7.1: Washington S t ate — Agency Roles in the 811 P R A Program

Washington State Department

Department of Social and

Washington State Housing

of Commerce

Health Services

Finance Commission

Bremerton Housing Authority

•  State grantee or state housing

•  State health and human services

•

•

Performance-Based Contract

State housing finance agency

authority.

agency.

Administrator.

•  Issue Low-Income Housing Tax

•  Perform 811 PRA program planning. •  Perform 811 PRA program planning.

Credit (dedicated financing source

•  Obtain tenant data from owners.

for 811 PRA units).

•

•

•

Inspect and monitor 811 PRA

Submit vouchers to HUD for

Market 811 PRA to owners.

•  Market 811 PRA to owners.

properties.

payment.

•  Review owner applications.

•  Review owner applications.

•  Administer Rental Assistance

•  Coordinate 811 PRA referrals.

Contract and subsidy payments.

•

•

Oversee coordination of services by

Produce HUD quarterly reporting.

contracted service providers.

•  Provide Owner Notice of Funding

•  Produce HUD quarterly reporting.

Availability development.

•

•

Washington State Health Care

Review owner applications.

Authority

•  Inspect and monitor 811 PRA

•  State Medicaid agency.

properties.

PRA = Project Rental Assistance.

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Chapter 7. Washington Section 811 Project Rental Assistance Program

In the 2012 funding application, Commerce estimated a

income is Social Security Disability Insurance to spend

total staff burden of about a third of one ful -time equivalent

104 percent of their income to rent a one-bedroom unit

(0.35 FTE) for administering the 811 PRA program,

(Social Security Administration, 2014b). The amount of

including the 811 PRA program manager (0.15 FTE), Policy

Supplemental Security Income benefits in Washington

and Data Analyst (0.10 FTE), and Contracts Specialist (0.10

State varies by location but does not exceed the poverty

FTE). Commerce staff report that they spent considerably

level income for the state.

more time on implementing the 811 PRA program in the

State agencies are committed to securing housing

first year than they initial y had expected; a significant

resources for people with disabilities in Washington.

portion of that time was spent marketing the program

Commerce manages five major housing programs

to potential owners. Although the time estimate for the

that provide permanent supportive housing for people

Policy and Data Analyst and Contracts Specialist has been

with disabilities, including programs that finance the

relatively accurate, the 811 PRA program manager has

development of affordable housing and programs that

routinely spent about two-thirds of her or his time on the

provide rental subsidies for low-income households.

811 PRA program to date, more than four times as much

WSHFC also finances development of affordable

time as planned. In addition, a supporting staff member in

multifamily housing with incentives to develop supportive

the Housing Assistance unit has also spent about .65 FTE

housing units and for serving people with disabilities. Since

on the program. Overal , Commerce staff time spent on the

2007, DSHS has provided tenant support services for its

program thus far has exceeded the proposed staffing plan

Medicaid consumers through the MFP program. Many

by more than one FTE.

other low-income individuals with disabilities receive rental

DSHS committed one-third of the time of each of its three

subsidies through federal y funded programs administered

regional Housing Program Managers for a total of one

by local housing authorities.

ful -time staff position dedicated to the 811 PRA program.

In addition to the three regional managers, DSHS expected

Existing Housing Programs That Serve

that the RCL project director would spend a nominal

People With Disabilities

amount of time overseeing the overall 811 PRA program

The 2015 Housing Needs Assessment report estimated

implementation and coordination of program referrals and

that, as of December 2013, more than 118,000 hard units of

services. Although DSHS did not commit any substantial

subsidized rental housing that had been built using federal,

time of the RCL project director in the funding application,

state, and local funds, and 40,000 households accessing

this staff person has spent about one-third of staff time

affordable housing through tenant-based rental subsidies

administering the 811 PRA program to date.

(AHAB, 2015). The fol owing are descriptions of the major

housing programs that are administered in Washington

State Context: Housing Programs

that support people with disabilities of all ages.

Housing Programs and Funding

Commerce Housing Programs. Commerce operates

several housing programs that serve people with

The State of Washington has a significant need for

disabilities. These programs include both financing for

affordable and suitable housing for people with disabilities.

multifamily rental housing and rental assistance funding for

The state’s Affordable Housing Advisory Board issued

low-income households.

a Housing Needs Assessment Report in 2015, which

estimated that 36 percent (936,000 households) are

Commerce administers one program that provides housing

cost-burdened and pay more than 30 percent of their

targeted specifical y to people with disabilities of all ages.

income toward rent. The report also noted that more than

The Washington State Housing Trust Fund finances

390,000 households are severely cost-burdened and pay

affordable housing projects for households earning up

more than 50 percent of their income toward rent (AHAB,

to 80 percent of Area Median Income, but mostly serves

2015). Low-income people with disabilities may have an

households earning up to 30 percent of AMI. Since

especial y difficult time obtaining affordable housing.

1987, HTF has awarded nearly $1 bil ion in funding that

The 2013 American Community Survey estimated that

has helped create 40,000 affordable housing units. The

about 12 percent of the state population, or more than

application for HTF funding is competitive, and most units

400,000 people, have a disability (Census Bureau, 2013).

are set aside to serve specific special-needs populations,

In 2014, nearly 100,000 people were receiving Social

including people with disabilities. However, other special

Security payments for disability in Washington State. The

populations are served, such as homeless families and

average Social Security Disability Insurance payment

youth, farmworkers, people with chronic mental il ness,

in Washington was $767, requiring those whose sole

and veterans. Al ocations for special populations are set by

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the legislature and vary by year. In 2015, the HTF awarded

The state’s QAP lays out the criteria for competitive tax

$47 mil ion toward the development of 1,369 housing units.

credits. Between 10 and 35 priority points are awarded for

Of these units, 176 are specifical y set aside for persons

serving various special populations, including people with

with disabilities.

disabilities, elderly people, homeless families, and large

In addition to unit set-asides in the HTF, Commerce also

households. Properties that provide at least 20 percent

operates programs targeted to people who are homeless

of the total units as housing for persons with disabilities

or at risk for homelessness that includes people with

receive 10 points. Properties that set aside at least 75

disabilities.

percent of the total housing units for supportive housing

units for people who are homeless receive the maximum

•  The HOME Tenant-Based Rental Assistance programs

35 points. Projects receiving tax credits typical y receive

provide homeless and low-income households with

points for serving more than one special population. (For

security and utility deposits and rent assistance for up

example, properties for seniors typical y also receive

to 24 months. The TBRA programs serve approximately

points for serving people with disabilities). WSHFC did not

620 households annual y in 25 counties.

consider adding priority points specifical y for the 811 PRA

•  Commerce al ocates federal Continuum of Care

program because priority points are already established

grant funds to 33 counties. With annual funding of

for serving people with disabilities within the special

approximately $5 mil ion, Continuum of Care funding

population’s set-aside.

has financed more than 20 permanent, supportive

Aging and Long-Term Support Administration housing

housing projects and provided 536 beds (units) for

programs. The ALTSA administers long-term services for

homeless persons with disabilities.

more than 60,000 seniors and persons with disabilities.

•  Commerce administers $2.5 mil ion annual y in Federal

ALTSA administers the federal y funded MFP program,

Emergency Solutions Grant funds that provide funding to

RCL and Washington Roads, a state-funded supplemental

counties for a variety of services to prevent homelessness

program, within the Home and Community Services

or rapidly rehousing persons who are homeless.

Division. The RCL program provides services and supports

for individuals interested in moving from institutional

•  Through its state Homeless Assistance Programs,

settings, such as from skil ed nursing facilities to

Commerce has created 2,074 PSH beds.

community settings. To be eligible for services, individuals

•  The Consolidated Homeless Grant is a state-

must have resided in institutional care for at least 90 days.

funded program which helps fund approximately

Participants receive assistance locating and transitioning

300 emergency shelter, transitional housing, rapid

to new housing, along with case management services

rehousing, and PSH programs throughout the state.

and other services for a year after moving.

Although these homeless programs are not targeted

The MFP program also provides funding to states for

specifical y to people with disabilities, the programs serve

their LTSS systems by devoting a greater proportion of

many of those in the 811 PRA target population. Another

Medicaid spending to home- and community-based

federal program that Commerce administers, which serves

services instead of institutional care. DSHS uses its MFP

people with disabilities, is the Housing Opportunities

rebalancing funds to create a temporary rental subsidy

for People With AIDS Program. The program serves

program for people transitioning from institutional care.

approximately 200 households annual y with HIV/AIDS,

The housing Bridges program provides up to 24 months

including 87 with tenant-based rental assistance.

of rental subsidy. Participants must apply for affordable

Low-Income Housing Tax Credits. The WSHFC awards 9

housing and reasonably expect to be housed within 2

percent competitive and 4 percent noncompetitive federal

years. Bridges program subsidies are also available to

LIHTC. WSHFC also administers the Multifamily Housing

individuals who do not qualify for MFP. As of late 2015,

Bonds Program that provides developers access to bond

26 individuals were utilizing Bridge subsidies. Through

financing for affordable housing for people typical y earning

2018, the program is 100 percent state funded through

50 to 60 percent of AMI. Currently, more than 57,000 units

rebalancing funds.

exist throughout the state that were developed using

DSHS coordinated with five public housing authorities

federal tax credits. Between 2011 and 2015, the WSHFC

to apply for and administer 215 NED Category 2 HCVs

awarded nearly $900 mil ion in LIHTCs for 88 projects

beginning in 2011. NED Category 2 is a joint effort

totaling 5,390 housing units. Of awards made between

between HUD and Centers for Medicare and Medicaid

2011 and 2015, 12 percent (655 units) of the units were set

Services and provides rental subsidies for housing for

aside specifically for persons with disabilities.

low-income, nonelderly people with disabilities residing

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in institutional care settings. DSHS was responsible

rental subsidy resource in the state specifical y set aside

for helping residents transition out of institutions and

for this population. Although NED Category 2 vouchers

coordinating necessary service supports. All NED

are specifical y set aside for nonelderly people with

Category 2 vouchers were leased within 18 months and

disabilities, only people transitioning from institutional

have served nearly 400 households in the subsequent 4

care are eligible, whereas the 811 PRA units target a

years. Approximately 70 percent of households under the

broader range of people with disabilities living in other

program are stil  being housed using their original voucher.

residential settings and who are homeless.

In addition to NED Category 2 vouchers administered

811 PRA subsidies support one additional permanent

in conjunction with DSHS, public housing authorities

housing resource that DSHS case managers can use to

administer 4,603 Category 1 NED Vouchers throughout

help their nonelderly clients locate affordable housing

the state. Category 1 NED Vouchers are available to

in the community and prevent them from unnecessarily

al  eligible low-income, nonelderly households with a

living in institutional care. HOME TBRA and Bridge funds

person with a disability, regardless of whether they move

can only be used for up to 2 years, although 811 PRA

from institutional settings.

subsidies will be available for 5 to 20 years. Most PSH

developed under the LIHTC program is specifical y for

Additional Federal Housing Programs

formerly homeless people, which may include people

In addition to state agencies, local governments,

with disabilities, but are not specifical y set aside for

housing authorities, and private owners develop and

that population. In addition, supportive housing priority

administer affordable housing in Washington for people

points are awarded only when owners set aside at least

with disabilities. Table 7.2 provides an overview of the

75 percent of units in a property for supportive housing,

number of persons served by six major federal y funded

exceeding the 811 PRA program regulation that limits

housing programs. As shown, about one-half of public

the number of supportive housing units for people with

housing households and HCV recipients are headed by a

disabilities to 25 percent for one property.

nonelderly person with a disability.

Rental Housing Market

How the 811 PRA Program Fits With Other

The rental housing market in Washington varies by

State Housing Programs

region, with the most expensive and tightest market in

The 811 PRA program fil s a need for rental subsidies

and near the Seattle metropolitan area. Table 7.3 shows

specifically for nonelderly people with disabilities. Several

characteristics of the rental market in three areas where

housing programs in Washington—including public

811 PRA units are under contract. Median Family Income

housing, HCVs, and other state and federal housing

and Fair Market Rents vary throughout the state but is

programs—serve people with disabilities, but Non-

highest on the coast. The rental vacancy rate varies by

Elderly Disabled Vouchers are the only other existing

region but is 3.9 percent for the state overall for the fourth

quarter of 2015.

Table 7.2 : Washington S t ate — Over view of Major Federal Housing Programs

Percent With

Disabilities Among

Number of Household

Percent Extremely

Head, Spouse

Percent of All Persons

Program

Units Available

Members

Low-Income

Aged <62

With Disability

Public Housing

12,292

23,849

79

49

28

Housing Choice Voucher

56,136

123,687

79

49

29

Moderate Rehabilitation

998

1,212

92

66

49

Project-Based Section 8

15,305

22,098

80

51

25

202/PRAC

2,540

2,821

79

– 1

16

811/PRAC

603

624

87

100

89

PRAC = Project Rental Assistance Contract.

Source: HUD (2016)

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Table 7.3 : Washington S t ate — Rent al Housing Market s

Percent of MFI Needed To

Geographic Area

Population

MFI

One-Bedroom FMR

Afford One-Bedroom FMR

Seattle Urbanized Area

3,075,787

$88,000

$912

59.2

Olympia-Lacey Area

177,704

$75,000

$703

54.6

Skagit County

117,087

$65,900

$742

64.3

FMR = Fair Market Rent. MFI = Median Family Income.

Source: Affordable Housing Advisory Board (2015)

Service Provision and Healthcare

Trends in funding for institutional care and home- and

community- based services reflect DSHS’s goals away

Current Status of Service and Healthcare

from unnecessary institutional care. Between 1992 and

Programs That Support Community Living

2015, the percentage of long-term ALTSA clients served

in home- and community-based settings increased from

DSHS administers waiver programs that provide HCBS.

53 to 84 percent. DSHS has placed a heavy focus on

HCBS waivers and State Plan Programs support

transitioning individuals with disabilities out of institutions

participants in their home or community-based setting

and into community-based housing settings since the early

as an alternative to care in a nursing facility or institution.

1990s. At the same time, the percentage of clients living

Each of the waivers provides an array of services tailored

in nursing homes decreased from 47 to 16 percent. Since

to the specific populations they serve.

2007, DSHS has helped transition more than 6,000 people

ALTSA administers two HCBS waivers for people

from institutional settings to residential settings in the

with functional disabilities—the Community Options

community through the RCL program.

Program Entry System, or COPES, waiver and the

Changes to Medicaid eligibility criteria.  Washington

New Freedom Waiver. The Developmental Disabilities

expanded Medicaid eligibility criteria under the Affordable

Administration within DSHS offers five HCBS waivers

Care Act. As of November 2015, nearly 1.8 mil ion state

for people with developmental disabilities—Basic Plus

residents were enrol ed in Medicaid, including about

Waiver, Children’s Intensive In-home Behavioral Supports

150,000 people with disabilities.

Waiver, Community Protection Waiver, Core Waiver, and

the Individual and Family Services Waiver. DSHS also

Washington’s Olmstead Plan

administers State Plan Programs that support community

living, including Community First Choice, Program of Al -

When the Supreme Court ruled on  Olmstead  v.  L.C.

Inclusive Care of the Elderly, and Private Duty Nursing.

in 1999, DSHS was already well into the process of

transitioning individuals with disabilities out of institutions

Changes in Medicaid resources away from

into community-based residential settings. As such, the

institutional settings and toward community living.

Olmstead decision was not a major driver in state plans to

Between 2008 and 2014, total Medicaid spending in

serve people with disabilities. No lawsuits have been related

Washington State increased from $6.3 bil ion to $10.4

to the Olmstead decision in Washington. The state created

bil ion, a 63.4-percent increase. Funding for long-term

its Olmstead plan voluntarily in 2005 and does not have any

services and supports went from $2.2 bil ion in 2008 to

plans to update it. The plan is general in nature and does not

nearly $2.5 bil ion in 2013 (Eiken et al., 2015; KFF, 2017).

include any numerical goals related to the development of

HCBS as a portion of LTSS also increased during this

affordable housing for people with disabilities.

period, indicating the continuing trend of decreased

funding for institutionalized care and increased funding

Local Issues: Homelessness

for community-based services and supports. HCBS

Homelessness is a significant issue in Washington State.

funding increased from 59.7 percent of LTSS in 2008 to

The 2014 homeless annual point-in-time count identified

64.4 percent in 2013, which is significantly more than the

18,839 people who are homeless, including 6,289

national average of 51.3 percent (Eiken et al., 2015). In

unsheltered. As previously noted, Commerce administers

fact, Washington ranks the sixth highest in the nation for

state and federal programs that serve people who are

its percentage of Medicaid funds spent on HCBS (Eiken

homeless or at risk for homelessness, and WSHFC’s

et al., 2015).

LIHTC program awards the most special population priority

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points to properties serving homeless families. In the past

Outreach, Referral, and Application

10 years, the state has placed a considerable focus on

reducing the number of homeless people in Washington.

This section focuses on the outreach and referral methods

The state legislature passed The Homelessness Housing

for individuals served through the HCS Division who are

and Assistance Act in 2005 to require counties and state

expected to make up most of 811 PRA applicants.

agencies to undertake efforts to address homelessness.

Participant Outreach and Referral Process

The state’s Interagency Council on Homelessness and

Affordable Housing Advisory Board developed a 10-year

For participants in the RCL program, 811 PRA units are

plan to reduce homelessness by 50 percent by 2015.

one option for low-income Medicaid consumers seeking

Although the 50 percent goal was not met, the results of

alternatives to institutional care. Transition coordinators,

local, state, and federal investments have resulted in a

case managers, and nurses who work with HCBS

14-percent decline in homelessness since 2006.

Medicaid waiver consumers identify individuals among

their caseloads who are interested in applying for 811

Population Served

PRA units. Individuals could reside in a variety of settings,

including nursing facilities, assisted living centers, group

To be eligible for the 811 PRA program, applicants must be

homes, or in their own family homes.

persons with disabilities, between the ages of 18 and 61 at

move in, have incomes at or below 30 percent of AMI, and

Other potential 811 PRA participants include other

receive or be eligible to receive Medicaid services through

consumers in the HCS Division and individuals (served by

ALTSA. Beyond these general program requirements,

the Developmental Disabilities Division and the Division

individuals eligible for 811 PRA units include the fol owing

of Behavioral Health and Recovery) who learn about the

subpopulations of ALTSA consumers.

availability of 811 PRA funds through their case manager.

All recipients of HCBS waiver services are assigned a

•  Individuals served through the RCL program.

case manager. Case managers work with consumers at

•  Individuals with developmental disabilities served

nursing facilities to actively work with participants toward

through the Developmental Disabilities Division.

discharge. They also work with individuals in their own

•  Individuals with functional disabilities served through

homes or other residential settings to support staying in

the Home and Community Service (HCS) Division.15

their current home. Case managers identify eligible 811

PRA participants within their caseload and screen them for

•  Individuals with mental il nesses served through the

initial eligibility for the 811 PRA program.

Division of Behavioral Health and Recovery (DBHR). A

person whose sole impairment is alcoholism or drug

Participant Screening and Eligibility

addiction is not eligible for 811 PRA units.

Case managers use an online assessment tool to

The state tries to target 811 PRA units to areas that most

determine clients’ service needs as they transition to

need affordable housing for persons with disabilities.

and live in 811 PRA-funded housing. The transition

Applicants can apply statewide as long as they meet

assessment is part of a single comprehensive

eligibility criteria. ALTSA and Commerce have not made

assessment tool that DSHS uses for determining eligibility

any changes to the 811 PRA program’s target population

and service needs for many of their consumers, including

as described in their funding application.

those served by HCBS waivers. The tool, Comprehensive

Through December 2015, 27 individuals had been referred

Assessment Reporting Evaluation, or CARE, assesses

to the 811 PRA program and 14 individuals had been

individuals in a number of areas, including activities

referred to available 811 PRA units. At the end of the year,

of daily living, treatments and medication, cognitive

11 households were living in units with 811 PRA rental

capacity, and family supports. The tool determines

subsidies. Of these households, 10 included individuals

service needs and waiver eligibility. The CARE database

had physical disabilities and were referred to the program

is used for persons with functional disabilities and

through ALTSA.

with developmental disabilities. Individuals receiving

behavioral health services have their own assessment tool

to determine eligibility for their programs.

Case managers evaluate clients to determine their service

needs when they first are admitted into nursing facilities

15

Functional eligibility is based on a person’s unmet needs for personal care. A social worker, case manager, or nurse authorizes the number of service hours based on the person’s unmet needs. Functional eligibility requirements vary between funding sources.

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or into inhome or residential long-term care services, and

Implications of Target Population and

on a regularly thereafter. When a case manager learns

Outreach and Referral Methods

a person is interested in moving out of a nursing facility

Referrals are tracked by date of application for each 811 PRA

or requires support to avoid institutionalization, he or

opening as it occurs. In the event of multiple applications for

she assesses the individual for the ability to succeed in

limited units, the following priorities wil  apply.

community settings with supportive services, develops

service plans, and coordinates transition services.

•  First priority is individuals living in institutional settings

or those that are homeless.

Referring 811 PRA Applicants to Available

•  Second priority is individuals wishing to move from

Units

residential settings.

Commerce notifies the RCL program manager that a

•  Third priority is inhome clients needing other housing.

811 PRA unit will become available. The RCL housing

program manager of the region where the unit is

Property owners also establish their own waiting list per

located sends out an email to the DSHS network and

property. Although individual case managers may establish

contracted service provider organizations in the region

their own waiting lists, no centralized waiting list exists for

with information about the property and unit. The email

persons interested in obtaining 811 PRA subsidies. Those

is sent to organizations serving applicants within HCS,

interested in 811 PRA units learn about the program and

Developmental Disabilities Administration, and DBHR.

availability of 811 PRA units through their case manager.

Case managers within the divisions with an individual

Case managers vary in their knowledge and experience

in their caseload interested in the 811 PRA unit at that

of housing options and specifical y the 811 PRA program

property forwards their client’s information to the housing

and the speed in which they inform their client. These

manager. The housing manager reviews the client’s CARE

differences may lead to some eligible individuals having

file to determine 811 PRA program eligibility.

access to 811 PRA units sooner than others.

Housing managers send referrals to property managers

Housing Strategies

on a first-come, first-served basis as applicants are found

eligible for 811 PRA. DSHS has no maximum number of

Property and Unit Characteristics

referrals that it sends to properties, although it has learned

from experience with NED Category 2 that two to three

Commerce signed its first RAC in April 2015 for a total of

referrals are typical y needed for each available unit.

four 811 PRA units. The first 811 PRA unit was occupied in

April 2015. As of December 2015, Commerce had entered

811 PRA tenants must complete the rental application

into RACs with five different owners to provide rental

and meet the owners’ requirements, the same as for

assistance to 32 811 PRA units. Of these units, 11 were

any other applicant to the property. Individual property

leased to 811 PRA participants and 21 were not available

owners establish their own rental criteria, including rental

because they were occupied by other non-811 PRA

history, credit, and criminal background checks. DSHS

participants. As existing tenants move out, the units wil

staff state that they try to work with property owners

become available for 811 PRA participants.

and managers to make reasonable modifications to

their resident eligibility criteria to accommodate some

Table 7.4 shows the characteristics of the five properties

of their clients. DSHS staff have reported that they

under contract with Commerce as of December 2015. Al

are not always successful in these efforts. They also

properties are existing properties. Of the 32 units under

reported difficulty in getting property owners to accept

contract, 5 are studios, 24 are one-bedroom units, and 3

participants’ medical deductions when determining

are two-bedroom units. The existing portfolio of bedroom

financial eligibility. As a result, some property owners

size under contracts matches the demand, because most

have been turning away otherwise-qualified individuals.

of the target population are one-person households. Seven

units, or 22 percent, are identified as being accessible for

Waitlists are maintained by the 811 PRA site if it receives

persons with mobility impairments.

more applicants than it can accept. Each regional housing

specialist maintains a waiting list for 811 PRA units in their

811 PRA Units at Channel Cove

region. The waitlist is organized by region and managed by

As part of the evaluation site visit, the study team visited

the regional housing specialist. Through December 2015,

Channel Cove, a property with 811 PRA units in La Conner,

eight individuals were on a waiting list for 811 PRA units.

a seaside town north of Seattle. HOME Trust of Skagit

was the first owner in Washington State to sign a Rental

Assistance Contract with Commerce for four 811

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Table 7.4 : Washington S t ate — Characteristics of Proper ties With

811 P R A Rent al A ssist ance C ontract s

Property Name

City and County

811 PRA Units

Total Units

Percent of Total Units

Initial Occupancy Date

Mill Creek

Battle Ground

5

50

10

TBD

Channel Cove

La Conner

4

21

19

4/2015

Boylston-Howel

Seattle

7

30

23

5/2015

Aspen Grove

Spokane

10

40

25

7/2015

El Estero

Spokane

6

123

5

TBD

PRA = Project Rental Assistance. TBD = to be determined.

Source: Internal grantee report

PRA units. Home Trust is a nonprofit organization with a

units, 26 of which were under RAC at the time of the site

mission to secure long-term, affordable housing. Channel

visit. The additional 72 units will be fil ed as vacancies

Cove is an Housing Trust Fund-funded property with

occur, assuming these other projects receive funding for

rents restricted at 50 percent of AMI. Channel Cove has a

construction and continue to be eligible for 811.

combination of affordable rental units and privately owned

Outreach to owners.  Both Commerce and DSHS staff

homes; many of its residents are long-time occupants.

have extensively marketed the availability of 811 PRA units

The Skagit Housing Authority had been managing the

to developers and owners of state-funded units. Staff at

affordable rental units of the property, but HOME Trust

Commerce analyzed HTF-funded properties and owners

planned to take over this responsibility in January 2016.

that would be good candidates for the 811 PRA program,

HOME Trust learned about the availability of 811 PRA

including properties with 40 or more units or high numbers

units through its relationship with the RCL regional

of accessible units. The 811 PRA program staff attended

program manager. A resident had resided at Channel

local housing conferences and met with regional support

Cove with rent subsidized through the Bridge Program

network providers and homeless assistance providers.

and the 24-month period was running out. HOME Trust

Through November 2015, Commerce staff estimated they

believed in the program goal and wanted to help the

had spoken to approximately 50 owners.

tenant remain in place.

Owner application process. Owners can download

HOME Trust signed an RAC for four units in April 2015;

the application for funding on Commerce’s website and

as of November 2015, two units had been occupied. Both

submit their application by email. Commerce and DSHS

occupied 811 PRA units are mobility accessible. Home

staff developed the application process. The application

Trust made some accessibility modifications to the units,

is designed to help the owner determine if the property

paid for out of its own funds. A tenant leaving a nursing

is eligible for the 811 PRA program and how many 811

facility fil ed one of the two occupied units. The remaining

PRA units the property could support. No formal or

two units are currently occupied and will be occupied

written policies exist for reviewing or evaluating 811 PRA

on turnover. However, availability of the two units may

applications from owners. Applications are reviewed

take 1 to 2 years, which is the average number of annual

as they are received. Staff from both agencies review

vacancies at Channel Cove.

applications for eligibility based on the number of units

in the property, the 811 PRA units requested, and the

Property Selection Methods

types of subsidy already attached to units at the property.

The 811 PRA program application period began in April

Commerce and DSHS staff also review the owner for

2015 and is continuously open until all 811 PRA funds are

organizational capacity and the property’s proximity to

awarded. Through November 2015, Commerce received

transportation and services.

18 applications for 811 PRA units. Four applicants were

Commerce staff provide technical assistance to owners

ineligible for the program, because the number of units set

throughout the application process, and applications are

aside for supportive housing or persons with disabilities

usual y submitted after several conversations are held

exceeded 25 percent of the total number of units. The

between owners and Commerce staff.

eligible applications included 14 properties with 98

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Chapter 7. Washington Section 811 Project Rental Assistance Program

Financing. The financing programs utilized for properties

Unit and Tenant Turnover

eligible for 811 PRA funds are primarily the HTF and LIHTC.

As of November 2015, no units had turnover. If 811 PRA

Neither of these financing methods have set-asides or

tenants are interested in moving to another unit within

priority points specifical y for the 811 PRA units, but both

the same property, they must follow the owner’s regular

have priority points for developing housing for populations

turnover policies.

that include people with disabilities.

Implementation Schedule

Service Provision and Coordination

In its 811 PRA application, Commerce had expected to

The exact services 811 PRA participants receive depends

occupy all 811 PRA units within 24 months of award. In its

on their individual needs and the waiver services for which

Cooperative Agreement Budget, Commerce planned to have

they are eligible. Case managers work with consumers

65 units under RAC by the close of year one and all 215 units

within their division and develop person-centered plans that

fil ed by the close of year 4. Commerce did not meet its 2015

outline individual consumer medical and service needs.

goal as it had 32 units under RAC at the end of the year.

ALTSA waiver services include the fol owing services,

The challenges Commerce experienced in recruiting owner

which are available to 811 PRA participants according to

participation in the program and in accessing vacant units

their person-centered plan.

are explained in the section titled Successes and Challenges

that fol ows and account for why the first year RAC goal

•  Personal care.

was not met. Despite production lagging somewhat in

•  Adult day care and day health.

2015, Commerce also had several other properties in their

•  Environmental modifications.

application pipeline and expected to execute contracts with

nine other properties for 66 811 PRA units. Combined, as of

•  Home delivered meals.

November 2015, Commerce hoped to have at least 98 811

•  Home health aide.

PRA units under lease by the end of 2016.

•  Personal emergency response system.

Rent and Subsidy Levels

•  Skil ed nursing.

Commerce initial y applied for funding for 275 811 PRA

•  Medical equipment and supplies.

units, determining this target by surveying housing providers

•  Client support training.

who might be interested in participating in the 811 PRA

program. Commerce found evidence that developers would

•  Transportation.

accept 185 units in 45 properties. Commerce expected that

•  Nursing services.

811 PRA units would turn over every 1.5 years, resulting

in a request for 275 units. Commerce ultimately signed

•  Community transition services.

a Cooperative Agreement with HUD for funding for 215

•  Health care for workers with disabilities.

units. The number of units was downgraded in response to

Persons with developmental disabilities and served by

adjusted expectations of owner interest in the program and

Developmental Disabilities Administration through the

advice from HUD on how to calculate the 811 PRA budget.

five Developmental y Disabled Waivers can access the

Commerce had based its budget on the expectation that

fol owing services.

the number of 811 PRA units under contract would increase

over time, although HUD required a budget for 60 months of

•  Behavior health stabilization services.

subsidy for each 811 PRA unit.

•  Behavior support and consultation.

Commerce established initial 811 PRA rents based on

•  Behavioral health crisis diversion bed services.

50 percent of AMI. It selected the maximum rent level

•  Client support training.

it could set for the funding application. The executed

811 PRA budget assumes an average monthly contract

•  Community access.

rent of $589, which is comprised of an average tenant

•  Community guide.

contribution of $235 and an average 811 PRA subsidy of

$354. This amount happens to be the lowest level of rent

•  Emergency assistance.

for all six case studies. Given the difficulty Commerce

•  Environmental modifications.

had finding units at this rent level, it eventual y requested

•  Extended state plan services.

and received from HUD a waiver that enables units to

rent at FMR or 50 percent AMI, whichever is higher.

•  Prevocational services.

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Chapter 7. Washington Section 811 Project Rental Assistance Program

•  Respite care.

not yet received an executed Cooperative Agreement from

•  Skil ed nursing.

HUD. Washington decided it would not apply for an award

by the 2013–2014 811 PRA funding round as it wanted

•  Specialized medical equipment and supplies.

to work out any program chal enges it encountered in

•  Specialized psychiatric services.

implementing its 2012 811 PRA program before applying

for more rental assistance.

•  Supported employment.

•  Transportation.

Leveraging

Individuals served through the Division of Behavioral

For the 2012 funding application, Commerce secured a

Health and Recovery can access services for mental

leverage commitment from the Housing Authority of Skagit

il ness and alcohol and substance abuse. Services

County for nine HCV set aside for nonelderly people with

vary based on individual assessments, but may

disabilities. At the time of the visit, the Housing Authority of

include assessment services, treatment services, crisis

Skagit County had not issued any HCVs.

intervention and stabilization, case management, peer

support, and residential mental health services.

Program Administration,

Transitional Services

Assessment, Information Systems,

Transitional services, including housing setup costs,

and Data Infrastructure

security deposits, and other moving expenses, vary

As grantee, Commerce administers the 811 PRA program

according to need and waiver or state plan eligibility.

and reporting program outcomes to HUD. In 811 practice,

Individuals enrolled in the RCL program have additional

Commerce and DSHS administer the program jointly

transitional services available to them that are not

and work together to address issues that may arise. Staff

available to other ALTSA consumers. For consumers with

from the two agencies communicate regularly by phone

developmental y disabilities, transitional services can be

and email and utilize a secure, shared website to store

provided as long as they are in an individual’s service plan.

and share program data with one another. Although the

Transitional services may be provided to an individual, at

program is still in the initial stages, in general, Commerce

the discretion of his or her case manager, by contracted

asset management staff report that managing the

Community Choice Guide. Community Choice Guides are

contracting process for the first few properties has not

funded by a combination of state and federal funding and

been difficult aside from some chal enges in working with

provide short-term services. Community Choice Guide

HUD data systems as discussed in the fol owing sections.

transition services for individuals moving into 811 PRA

Commerce and DSHS have an existing agreement to

units include help locating housing, moving, obtaining

share participant data with each other. In 2009, Commerce

furniture and household goods, and other support needed

entered into an agreement with the DSHS Research and

to ensure a successful transition to new housing. ALSTA

Data Analysis Division to col ect and share information on

customers may also have access to other state-funded

programs and participants in common. Commerce tracks

resources that help individuals stabilize in community living

client data through the Homeless Management Information

that vary by waiver. In all three divisions, case managers

Systems. DSHS tracks client data through the CARE data

ensure ongoing connection to services for their clients

system. The agencies plan to integrate the databases to

after individuals move into 811 PRA units.

track participant characteristics and outcomes, but did not

Gaps in Services

have a timeline for this integration as of November 2015.

Gaps in services may occur because different services are

In addition to the number of 811 PRA units leased

available in different locations of the state. For example,

and individuals served through the 811 PRA program,

rural areas have less access to services. Individuals who

Washington’s 811 PRA program goals include an increase in

do not meet the 90-day institutional stay criteria do not

the use of HCBS and a decrease in the use of institutional y

qualify for services funded through MFP.

based services. At the time of the evaluation site visit,

Commerce and DSHS had not developed any specific

2013 811 PRA Application

numerical targets for the reduction in use of institutional care

or developed other 811 PRA program goals.

At the time that HUD published its 2013–2014 Notice

of Funding Availability on March 4, 2014, with funding

applications due on May 5, 2014, the 2012 grantees had

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C a s e S t u d i e s – H U D S e c t i o n 811 P R A P ro g r a m

Chapter 7. Washington Section 811 Project Rental Assistance Program

Successes and Challenges

Other reasons that owners have for not applying for

811 PRA funds include inexperience with HUD housing

Program staff from Commerce, DSHS, and their

programs and data systems, not wanting to be the first

contracted partners discussed the initial successes and

owners to try out a new program, and the requirement to

challenges they have experienced in implementing the

sign a 30-year agreement with Commerce when 811 PRA

811 PRA program. The 811 PRA program staff reported

subsidies are funded only for 5 years.

some challenges in the initial program administration

involving constraints of the 811 PRA program requirements

Although the property recruitment process has been

or structures. The evaluation team also identified some

time-consuming and labor intensive, the strategies have

program areas that could have an effect on the efficiency

been successful in gaining owner interest in the program

and effectiveness of the 811 PRA program.

and in raising program awareness. Staff point to in-person

meetings with owners as the most beneficial method

Program Successes and Replicable

leading to successful owner applications.

Innovations

Challenges in accessing vacant units. Two-thirds of

Housing Bridge Program. DSHS’s Housing Bridge

units under RAC were not available as of December 2015

Program has been a key driver in utilizing 811 PRA funding.

because they were occupied by other tenants when the

The two are a good match because Bridge funding

RAC was executed. Because the units can be fil ed only

provides temporary rental subsidies for up to 24 months,

with 811 PRA participants on turnover, Commerce staff are

and 811 PRA funds are permanent sources of subsidy.

uncertain when the units will be available to be leased by

If property owners currently housing tenants receiving

811 PRA tenants.

Bridge subsidies can enroll in the 811 PRA program

Challenges working with HUD data systems.  Because

and switch the funding mechanisms, tenants can live

Commerce was one of the first states with executed RACs

uninterrupted in stable housing.

and tenants residing in 811 PRA units, staff faced some

Owner application process.  Commerce developed an

challenges in navigating HUD’s data systems. The first

application process for owners that makes it as easy as

resident moved in April 2015, but the owner did not receive

possible for owners to determine if their properties are eligible

the first subsidy payment until September 2015. Voucher

for 811 PRA units. Washington’s owner application forms have

administration has been challenging for the individual

been used as a model by another 2012 grantee that modified

properties and for the contract administrator, Bremerton

the Washington forms for use in its own 811 PRA program.

Housing Authority. Management staff at the 811 PRA

properties had to be trained on how to submit TRACS

Program Challenges

data, leading to delays in submitting the information to

Challenges in recruiting owners.  The most significant

Bremerton Housing Authority. The software program that

chal enge Commerce has faced in the first year of its 811

Bremerton Housing Authority used for voucher processing

PRA program is in recruiting owners to apply for 811 PRA

was not designed to administer 811 PRA subsidies.

funding. Commerce initial y expected that 80 owners

Bremerton Housing Authority staff have to manual y check

would be interested based on the results of a survey it

each voucher invoice before submission, leading to further

conducted prior to the funding application. Some owners

delays in submitting the voucher to HUD for payment.

who were initial y interested had properties that were

Because parent vouchers include voucher data for all 811

incompatible with the 811 PRA program due to the rule

PRA properties, delays in one property submitting data

that limits properties participating in the 811 PRA to have

can hold up the entire parent voucher payment.16,17 The

no more than 25 percent of units set aside for the target

cost of obtaining the software systems necessary to enter

population or for supportive housing.

data into TRACS has also been a barrier for some property

Applicants for 811 PRA grants receive additional points

owners to participate in the 811 PRA program.

if they proposed the rent level. Washington may have

underestimated the extent that a 50-percent AMI

limit would pose on owner interest. (The waiver that

Commerce received that al ows for the higher or FMR or

50 percent AMI, likely will increase owner participation.)

16

Parent account refers to the “parent voucher” for the entire state. Each individual Section 811 PRA property within the state has a “child voucher.”

17   HUD has since provided guidance that incomplete parent vouchers may be submitted to HUD and then revised once all child voucher data are received.

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References

References

National Low Income Housing Coalition (NLIHC). 2016a.

“2016 State Housing Profile: Louisiana.” http://

nlihc.org/involvement/local/state/LA.

——. 2016b. “2016 Congressional District Housing

Profile—Louisiana.” http://nlihc.org/involvement/

Affordable Housing Advisory Board (AHAB). 2015.

local/state/LA.

“State of Washington Housing Needs Assessment.”

http://www.commerce.wa.gov/wp-content/

Plyer, Al ison. 2015. “Facts for Features: Katrina Impact.”

uploads/2016/10/AHAB-Housing-Needs-

http://www.loyno.edu/jsri/news/facts-features-

Assessment.pdf.

katrina-impact.

California Housing Finance Agency. 2016. “Section 811

Social Security Administration. 2014a. “SSI Recipients

Approved Projects. ” http://www.calhfa.ca.gov/

by State and County, 2014—California.” http://

multifamily/section811/projects/approved-

www.ssa.gov/policy/docs/statcomps/ssi_

projects.htm.

sc/2014/ca.html.

Eiken, Steve, Kate Sredl, Brian Burwel , and Paul

——. 2014b. “SSI Recipients by State and County,

Saucier. 2015. Medicaid Expenditures for Long-

2014—Washington.”  http://www.ssa.gov/policy/

Term Services and Supports (LTSS) in FY 2013:

docs/statcomps/ssi_sc/2014/wa.html.

Home and Community-Based Services were a

Sorrel s, Nick. 2015. “2015 Report on the State of

Majority of LTSS Spending. Baltimore, MD: Centers

Affordable Housing in Louisiana.” http://www.

for Medicare & Medicaid Services.

uno.edu/cola/planning-and-urban-studies/docs/

The Henry J. Kaiser Family Foundation (KFF). 2011.

State-of-Housing-in-Louisiana-2015.pdf.

“Kaiser Commission on Key Facts. ” https://

Sweazy, Nicole. 2014. “Ma Maison (My Home):

kaiserfamilyfoundation.files.wordpress.

Louisiana’s Ten Year Plan to End Homelessness.”

com/2013/01/8196.pdf.

Baton Rouge, LA: Louisiana Housing

——. 2017. “Total Medicaid Spending.”  http://kff.org/

Corporation. http://www.lhfa.state.la.us/assets/

medicaid/state-indicator/total-medicaid-spending/.

MaMaisonNicole.pdf.

Legislative Analyst’s Office (LAO). 2015. “California’s

Technical Assistance Col aborative, Inc. (TAC). 2012.

High Housing Costs: Causes and Consequences.”

“Taking Integrated Permanent Supportive Housing

http://www.lao.ca.gov/reports/2015/finance/

(PSH) to Scale: The Louisiana PSH Program.

housing-costs/housing-costs.pdf.

Program Design, Implementation Lessons &

Policy Implications.” http://www.tacinc.org/

Louisiana Department of Health and Hospitals. 2013.

media/10896/Louisiana Brief.pdf.

“Transforming Louisiana’s Longterm Care Supports

and Services System: Initial Program Concept.”

U.S. Census Bureau (Census Bureau). 2013. “2009–

http://www.laddc.org/files/LTSSConceptPaper.pdf.

2013 5-Year American Community Survey. ” https://

——

www.census.gov/data/developers/data-sets/

. 2007. “Louisiana’s Plan for Choice in Long-Term

acs-5year.html.

Care: Comprehensive Long-Term Care Reform

Plan. ” http://new.dhh.louisiana.gov/assets/docs/

U.S. Department of Housing and Urban Development

OAAS/LTCSysChange/ChoiceinLTCPlan.pdf.

(HUD). 2015. “HUD 2015 Continuum of Care

Homeless Assistance Programs Homeless

Mierzwa, Erin, Kathryn P. Nelson, Harriet Newburger.

Populations and Subpopulations.” https://www.

2010. “Chapter 5: Implications for Policymakers

hudexchange.info/resource/reportmanagement/

and Suggested Research.” In  Affordability and

published/CoC_PopSub_State_CA_2015.pdf.

Availability of Rental Housing in Pennsylvania.

Philadelphia, PA: Federal Reserve Bank of

——. 2016. “Picture of Subsidized Households.”

Philadelphia: 41–45. https://www.philadelphiafed.

https://www.huduser.gov/portal/datasets/

org/community-development/publications/

assthsg.html.

special-reports/rental-housing/chapter-5.

——. n.d. “Non-Elderly Disabled (NED) Vouchers.”

Minnesota Housing Partnership. 2016, March 30.

http://portal.hud.gov/hudportal/HUD?src=/

2X4 Report: Issue 2. http://www.mhponline.org/

program_offices/public_indian_housing/

publications/2x4-report

programs/hcv/ned.

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References

Woodward, Alex. 2015. “New Orleans One of the

Worst U.S. Cities for Renters,” Gambit, March 30.

http://www.bestofneworleans.com/gambit/new-

orleans-one-of-the-worst-us-cities-for-renters/

Content?oid=2609106.

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Additional Reading

Additional Reading

Lipsom, Debra, Denise Hoffman, and Matthew Kehn.

2014. “Non-Elderly Disabled Category 2 Housing

Choice Voucher Program: An Implementation and

Impact Analysis.” https://aspe.hhs.gov/system/

files/pdf/76986/Cat2Housing.pdf.

U.S. Department of Housing and Urban Development.

2012. HUD’s Fiscal Year (FY) 2012 Notice of Funding

Availability (NOFA) for Section 811 Supportive

Housing for Persons with Disabilities (Section 811)

Project Rental Assistance Demonstration (811 PRA

Demo) Program. Washington, DC: U.S. Department

of Housing and Urban Development.

——. 2014. Solicitation DU208WP-14-R-0010, Request

for Quotes: Housing for Persons with Disabilities,

Evaluation of the Section 811 Project Rental

Assistance Program – Phase I. Washington, DC: U.S.

Department of Housing and Urban Development.

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U.S. Department of Housing and Urban Development

Office of Policy Development and Research

Washington, DC 20410-6000

January 2018

Document Outline

- Table 1.1: Program Design in the Case Study States

- Table 1.2: Housing Context in the Case Study States

- Table 1.3: Services Context in the Case Study States

- Table 2.1: Agency Roles in the 811 PRA Program

- Table 2.2: California—Planned and Actual Time Spent on 811 PRA Program by Key Staff

- Table 2.3: California—Overview of Major Federal Housing Programs

- Table 2.4: Characteristics of Properties With 811 PRA Units

- Table 3.1: Louisiana Federal Housing Programs

- Table 3.2: Properties Under RAC or Application in Process

- Table 3.3: Louisiana 1915(c) HCBS Waivers

- Table 4.1: Maryland 811 PRA Program Division of Responsibilities

- Table 4.2: Other Federal Housing Programs in Maryland

- Table 4.3: 1915(c) Waivers (Home- and Community-Based Services)

- Table 4.4: Average Rents in Baltimore (2012 Versus 2015)

- Table 4.5: Average Rents in Washington, D.C. (2012 Versus 2015)

- Table 4.6: Leveraged Housing Choice Vouchers

- Table 5.1: Minnesota—811 PRA Program Division of Responsibilities

- Table 5.2: Minnesota—Other Federal Programs

- Table 5.3: Minnesota—Services Available to 811 Project Rental Assistance Participants

- Table 6.1: Pennsylvania—811 PRA Program Roles and Responsibilities

- Table 6.2: Pennsylvania—Responsibilities of Local Lead Agencies and Stakeholders

- Table 7.1: Washington State—Agency Roles in the 811 PRA Program

- Table 7.2: Washington State—Overview of Major Federal Housing Programs

- Table 7.3: Washington State—Rental Housing Markets

- Table 7.4: Washington State—Characteristics of Properties With 811 PRA Rental Assistance Contracts

- Executive Summary

- Background of the Section 811 Project Rental Assistance Program

- The Section 811 and PRA Programs

- Evaluation of the Section 811 PRA Program

- A Descriptive Overview of the Six Case Study States

- 811 Program Designs

- Housing Context

- Services Context

- How Does the Section 811 PRA Model Fit?

- California Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnership, Organizational Structure, and Management

- Background Leading to the 2012 811 PRA Application

- Program Financial Structure

- State Context: Housing Programs

- Housing

- Existing Programs

- How the 811 PRA Program Fits With Other State Programs

- How Major Housing Assistance Programs Are Used To Assist the Target Population

- Local Issues—Housing Affordability and the Rental Market

- Service Provision and Healthcare

- Current Status of Service and Healthcare Programs That Support Community Living

- Recent Changes in Programs That Support Integrated Community Living

- How the 811 PRA Program Fits With the Service and Healthcare Programs That Support Community Living

- California’s Olmstead Plan

- Population Served

- Comparison of Target Populations: Planned Versus Actual

- Skilled Nursing Facilities

- Regional Centers

- Developmental Centers

- Outreach, Referral, and Application

- Outreach, Referral, and Application Process

- Target Population Screening and Eligibility

- Implications of Target Population and Outreach and Referral Methods

- Housing Strategies

- Property and Unit Characteristics

- Property Selection Methods and Financing

- Implementation Schedule

- Rent and Subsidy Levels

- Unit and Tenant Turnover

- Service Provision and Coordination

- Ongoing Services

- Coordination of Services and Housing

- Gaps in Services

- 2013 811 PRA Application

- Leveraging

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- Successes and Challenges

- Factors Contributing to Program Success

- 811 PRA Program Challenges

- Louisiana Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnership, Organizational Structure, and Management

- Background

- Partnerships and Organizational Structure

- Program Financial Structure

- State Context: Housing Programs

- Housing Policy

- Existing Programs

- Rental Housing Market

- Service Provision and Healthcare

- Policy

- Recent Changes Supporting Community Living

- Expansion of Medicaid 1915(c) HCBS Waivers

- Olmstead Plans, Settlements, Consent Decrees

- Population Served

- Outreach, Referral, and Application

- Outreach, Referral, and Application Methods

- Target Population Eligibility

- Implications of Outreach, Referral, and Application Methods on Individuals Referred and Placed

- Housing Strategies

- Property and Unit Characteristics

- Property Selection Methods and Financing

- Property Selection Process

- Implementation Schedule

- Rent and Subsidy Levels

- Unit Offers and Tenant Turnover

- Service Provision and Coordination

- Service Models

- Coordination of Services and Housing

- Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps)

- 2013 811 PRA Application

- Leveraging

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- Successes and Challenges

- Successes

- Challenges

- Maryland Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnership, Organizational Structure, and Management

- Overview

- Maryland Department of Housing and Community Development

- Maryland Department of Health and Mental Hygiene

- Maryland Department of Disabilities

- Partnership

- Design and Structure of Maryland’s 811 PRA Program

- 811 PRA Roles and Responsibilities

- Program Staffing

- State Context: Housing Programs

- Financing

- Supportive Housing Programs

- Additional Federal Housing Programs

- Service Provision and Healthcare

- Funding

- Olmstead Settlement

- Population Served

- Outreach, Referral, and Application

- Outreach

- Referral and Application

- Implications

- Housing Strategies

- Property and Unit Characteristics

- Rent and Subsidy Levels

- Unit and Tenant Turnover

- Service Provision and Coordination

- Service Provision

- Coordination

- 2013 811 PRA Application

- Leveraging

- Housing Choice Vouchers

- Other Sources Leveraged

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- Program Administration

- Financial Management

- Information Systems

- Successes and Challenges

- Challenges

- Successes

- Minnesota Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnership, Organizational Structure, and Management

- Overview

- Minnesota Housing Finance Agency

- Minnesota Department of Human Services

- Minnesota Housing and Department of Human Services Partnership

- Design and Structure of Minnesota’s 811 PRA Program

- 811 PRA Roles and Responsibilities

- Program Funding

- State Context: Housing Programs

- Housing Programs

- Rental Housing Market

- Service Provision and Healthcare

- Changes in Medicaid Resources

- Olmstead Settlement

- Population Served

- Outreach, Referral, and Application

- Outreach

- MFP Outreach

- PATH Long-Term Homelessness Outreach

- Referral and Application

- Implications

- Housing Strategies

- Property and Unit Characteristics

- Determining the Initial Rent Level

- Unit and Tenant Turnover

- Service Provision and Coordination

- Service Provision

- Coordination of Services

- 2013 811 PRA Application

- Leveraging

- Housing Choice Vouchers

- Other Sources Leveraged

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- Program Administration

- Financial Management

- Information Systems

- Successes and Challenges

- Successes

- Challenges

- Pennsylvania Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnership, Organizational Structure, and Management

- Partnerships and Organizational Structure

- Partnership Between PHFA and DHS

- State Context: Housing Programs

- Housing

- Service Provision and Healthcare

- Policy and Funding: Prioritization of Medicaid Resources Toward Home- and Community-based Services

- Existing Efforts

- Olmstead Plan and Settlements

- Population Served

- Outreach, Referral, and Application

- Housing Strategies

- Property and Unit Characteristics

- Property Selection Methods and Financing

- Implementation Schedule

- Rent and Subsidy Levels

- Unit and Tenant Turnover

- Service Provision and Coordination

- Service Models

- Coordination of Services and Housing

- Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps)

- 2013 811 PRA Application

- Leveraging

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- PHFA Program Monitoring

- DHS Program Monitoring

- Successes

- Strong Partnerships

- Leveraging Existing Programs

- Challenges

- Securing One-Bedroom Units

- Staff Turnover

- Breadth of Geographic Differences

- Shift in Housing Strategy

- Washington Section 811 Project Rental Assistance Program

- Introduction

- Grantee Partnerships Organizational Structure, and Management

- Application Background

- Partnerships and Organizational Structure

- Program Financial Structure

- State Context: Housing Programs

- Housing Programs and Funding

- Existing Housing Programs That Serve People With Disabilities

- Additional Federal Housing Programs

- How the 811 PRA Program Fits With Other State Housing Programs

- Rental Housing Market

- Service Provision and Healthcare

- Current Status of Service and Healthcare Programs That Support Community Living

- Washington’s Olmstead Plan

- Local Issues: Homelessness

- Population Served

- Outreach, Referral, and Application

- Participant Outreach and Referral Process

- Participant Screening and Eligibility

- Referring 811 PRA Applicants to Available Units

- Implications of Target Population and Outreach and Referral Methods

- Housing Strategies

- Property and Unit Characteristics

- 811 PRA Units at Channel Cove

- Property Selection Methods

- Implementation Schedule

- Rent and Subsidy Levels

- Unit and Tenant Turnover

- Service Provision and Coordination

- Transitional Services

- Gaps in Services

- 2013 811 PRA Application

- Leveraging

- Program Administration, Assessment, Information Systems, and Data Infrastructure

- Successes and Challenges

- Program Successes and Replicable Innovations

- Program Challenges

- References

- Additional Reading

Table of Contents

Table 1.1: Program Design in the Case Study States

Table 1.2: Housing Context in the Case Study States

Table 1.3: Services Context in the Case Study States

Table 2.1: Agency Roles in the 811 PRA Program

Table 2.2: California—Planned and Actual Time Spent on 811 PRA Program by Key Staff

Table 2.3: California—Overview of Major Federal Housing Programs

Table 2.4: Characteristics of Properties With 811 PRA Units

Table 3.1: Louisiana Federal Housing Programs

Table 3.2: Properties Under RAC or Application in Process

Table 3.3: Louisiana 1915(c) HCBS Waivers

Table 4.1: Maryland 811 PRA Program Division of Responsibilities

Table 4.2: Other Federal Housing Programs in Maryland

Table 4.3: 1915(c) Waivers (Home- and Community-Based Services)

Table 4.4: Average Rents in Baltimore (2012 Versus 2015)

Table 4.5: Average Rents in Washington, D.C. (2012 Versus 2015)

Table 4.6: Leveraged Housing Choice Vouchers

Table 5.1: Minnesota—811 PRA Program Division of Responsibilities

Table 5.2: Minnesota—Other Federal Programs

Table 5.3: Minnesota—Services Available to 811 Project Rental Assistance Participants

Table 6.1: Pennsylvania—811 PRA Program Roles and Responsibilities

Table 6.2: Pennsylvania—Responsibilities of Local Lead Agencies and Stakeholders

Table 7.1: Washington State—Agency Roles in the 811 PRA Program

Table 7.2: Washington State—Overview of Major Federal Housing Programs

Table 7.3: Washington State—Rental Housing Markets

Table 7.4: Washington State—Characteristics of Properties With 811 PRA Rental Assistance Contracts

Executive Summary

Background of the Section 811 Project Rental Assistance Program

The Section 811 and PRA Programs

Evaluation of the Section 811 PRA Program

A Descriptive Overview of the Six Case Study States

811 Program Designs

Housing Context

Services Context

How Does the Section 811 PRA Model Fit?

California Section 811 Project Rental Assistance Program

Introduction

Grantee Partnership, Organizational Structure, and Management

Background Leading to the 2012 811 PRA Application

Program Financial Structure

State Context: Housing Programs

Housing

Existing Programs

How the 811 PRA Program Fits With Other State Programs

How Major Housing Assistance Programs Are Used To Assist the Target Population

Local Issues—Housing Affordability and the Rental Market

Service Provision and Healthcare

Current Status of Service and Healthcare Programs That Support Community Living

Recent Changes in Programs That Support Integrated Community Living

How the 811 PRA Program Fits With the Service and Healthcare Programs That Support Community Living

California’s Olmstead Plan

Population Served

Comparison of Target Populations: Planned Versus Actual

Skilled Nursing Facilities

Regional Centers

Developmental Centers

Outreach, Referral, and Application

Outreach, Referral, and Application Process

Target Population Screening and Eligibility

Implications of Target Population and Outreach and Referral Methods

Housing Strategies

Property and Unit Characteristics

Property Selection Methods and Financing

Implementation Schedule

Rent and Subsidy Levels

Unit and Tenant Turnover

Service Provision and Coordination

Ongoing Services

Coordination of Services and Housing

Gaps in Services

2013 811 PRA Application

Leveraging

Program Administration, Assessment, Information Systems, and Data Infrastructure

Successes and Challenges

Factors Contributing to Program Success

811 PRA Program Challenges

Louisiana Section 811 Project Rental Assistance Program

Introduction

Grantee Partnership, Organizational Structure, and Management

Background

Partnerships and Organizational Structure

Program Financial Structure

State Context: Housing Programs

Housing Policy

Existing Programs

Rental Housing Market

Service Provision and Healthcare

Policy

Recent Changes Supporting Community Living

Expansion of Medicaid 1915(c) HCBS Waivers

Olmstead Plans, Settlements, Consent Decrees

Population Served

Outreach, Referral, and Application

Outreach, Referral, and Application Methods

Target Population Eligibility

Implications of Outreach, Referral, and Application Methods on Individuals Referred and Placed

Housing Strategies

Property and Unit Characteristics

Property Selection Methods and Financing

Property Selection Process

Implementation Schedule

Rent and Subsidy Levels

Unit Offers and Tenant Turnover

Service Provision and Coordination

Service Models

Coordination of Services and Housing

Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps)

2013 811 PRA Application

Leveraging

Program Administration, Assessment, Information Systems, and Data Infrastructure

Successes and Challenges

Successes

Challenges

Maryland Section 811 Project Rental Assistance Program

Introduction

Grantee Partnership, Organizational Structure, and Management

Overview

Maryland Department of Housing and Community Development

Maryland Department of Health and Mental Hygiene

Maryland Department of Disabilities

Partnership

Design and Structure of Maryland’s 811 PRA Program

811 PRA Roles and Responsibilities

Program Staffing

State Context: Housing Programs

Financing

Supportive Housing Programs

Additional Federal Housing Programs

Service Provision and Healthcare

Funding

Olmstead Settlement

Population Served

Outreach, Referral, and Application

Outreach

Referral and Application

Implications

Housing Strategies

Property and Unit Characteristics

Rent and Subsidy Levels

Unit and Tenant Turnover

Service Provision and Coordination

Service Provision

Coordination

2013 811 PRA Application

Leveraging

Housing Choice Vouchers

Other Sources Leveraged

Program Administration, Assessment, Information Systems, and Data Infrastructure

Program Administration

Financial Management

Information Systems

Successes and Challenges

Challenges

Successes

Minnesota Section 811 Project Rental Assistance Program

Introduction

Grantee Partnership, Organizational Structure, and Management

Overview

Minnesota Housing Finance Agency

Minnesota Department of Human Services

Minnesota Housing and Department of Human Services Partnership

Design and Structure of Minnesota’s 811 PRA Program

811 PRA Roles and Responsibilities

Program Funding

State Context: Housing Programs

Housing Programs

Rental Housing Market

Service Provision and Healthcare

Changes in Medicaid Resources

Olmstead Settlement

Population Served

Outreach, Referral, and Application

Outreach

MFP Outreach

PATH Long-Term Homelessness Outreach

Referral and Application

Implications

Housing Strategies

Property and Unit Characteristics

Determining the Initial Rent Level

Unit and Tenant Turnover

Service Provision and Coordination

Service Provision

Coordination of Services

2013 811 PRA Application

Leveraging

Housing Choice Vouchers

Other Sources Leveraged

Program Administration, Assessment, Information Systems, and Data Infrastructure

Program Administration

Financial Management

Information Systems

Successes and Challenges

Successes

Challenges

Pennsylvania Section 811 Project Rental Assistance Program

Introduction

Grantee Partnership, Organizational Structure, and Management

Partnerships and Organizational Structure

Partnership Between PHFA and DHS

State Context: Housing Programs

Housing

Service Provision and Healthcare

Policy and Funding: Prioritization of Medicaid Resources Toward Home- and Community-based Services

Existing Efforts

Olmstead Plan and Settlements

Population Served

Outreach, Referral, and Application

Housing Strategies

Property and Unit Characteristics

Property Selection Methods and Financing

Implementation Schedule

Rent and Subsidy Levels

Unit and Tenant Turnover

Service Provision and Coordination

Service Models

Coordination of Services and Housing

Service Provision (Types, Transition Versus Ongoing, by Target Population, Gaps)

2013 811 PRA Application

Leveraging

Program Administration, Assessment, Information Systems, and Data Infrastructure

PHFA Program Monitoring

DHS Program Monitoring

Successes

Strong Partnerships

Leveraging Existing Programs

Challenges

Securing One-Bedroom Units

Staff Turnover

Breadth of Geographic Differences

Shift in Housing Strategy

Washington Section 811 Project Rental Assistance Program

Introduction

Grantee Partnerships Organizational Structure, and Management

Application Background

Partnerships and Organizational Structure

Program Financial Structure

State Context: Housing Programs

Housing Programs and Funding

Existing Housing Programs That Serve People With Disabilities

Additional Federal Housing Programs

How the 811 PRA Program Fits With Other State Housing Programs

Rental Housing Market

Service Provision and Healthcare

Current Status of Service and Healthcare Programs That Support Community Living

Washington’s Olmstead Plan

Local Issues: Homelessness

Population Served

Outreach, Referral, and Application

Participant Outreach and Referral Process

Participant Screening and Eligibility

Referring 811 PRA Applicants to Available Units

Implications of Target Population and Outreach and Referral Methods

Housing Strategies

Property and Unit Characteristics

811 PRA Units at Channel Cove

Property Selection Methods

Implementation Schedule

Rent and Subsidy Levels

Unit and Tenant Turnover

Service Provision and Coordination

Transitional Services

Gaps in Services

2013 811 PRA Application

Leveraging

Program Administration, Assessment, Information Systems, and Data Infrastructure

Successes and Challenges

Program Successes and Replicable Innovations

Program Challenges

References

Additional Reading