Evaluation of the HOPE for Elderly Independence Demonstration: Final Report

This is the final report from the evaluation of the HOPE for Elderly Independence Demonstration (HOPE IV) program conducted for the U.S. Department of Housing and Urban Development (HUD). HOPE IV combines HUD Section 8 rental assistance with case management and supportive services to low-income elderly persons (62 and older) with limitations in three or more personal care and home management activities, such as bathing, dressing, and housekeeping. The purpose of HOPE IV, administered by local Public Housing Agencies (PHAs), is to expand access to Section 8 rental assistance by a frail elderly tenant population and help participants avoid nursing home placement or other restrictive settings when home and community-based options are appropriate. In addition to rental assistance, as vouchers for private-market housing, HUD pays 40 percent of the supportive services costs, the grantees pay 50 percent, and participants, except for those with very low incomes, pay 10 percent.

A key feature of HOPE IV is the establishment of a Service Coordinator position within the PHA with responsibilities for the design and implementation of an integrated system of case management, personal care, and home management services for frail elderly Section 8 tenants. Of particular importance is the coordination of traditional Section 8 staff activities with the new case management and services components of HOPE IV. In addition, the Service Coordinator is responsible for forging relationships with other agencies and organization in the community with resources and responsibilities for programs on aging, including purchase-of-services arrangements with existing providers. Supporting the Service Coordinator is a Professional Assessment Committee (PAC) responsible for screening applicants for frailty and documenting need for services, in accordance with the HUD HOPE IV regulations. The PAC must include at least one medical professional and at least two other members with various health or social services backgrounds.

During the first round of HOPE IV funding (February 1993), the focus of this evaluation, HUD awarded grants to 16 agencies for demonstration projects ranging from 25 to 150 persons for a five-year period. The grants collectively totaled $9.9 million for the supportive services component and an additional $29.6 million for rental assistance.

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