HUD Section 811 PRA Project Rental Assistance Program Phase II Evaluation Final Report Implementation and Short-Term Outcomes
The Section 811 Project Rental Assistance (PRA) Program represents a new approach to providing integrated supportive housing for non-elderly people with disabilities and was authorized by the Frank Melville Supportive Housing Investment Act of 2010. In this second phase of the evaluation of the PRA program, the study examined the effect of the program on residents’ housing tenancy and use of home and community-based services, characteristics of properties and neighborhoods where assisted residents live, and residents’ healthcare diagnoses and utilization. In order to assess the program’s effectiveness, the study compared short-term outcomes of the PRA program against outcomes for similar individuals with disabilities in the traditional Section 811 Capital Advance/Project Rental Assistance Contract program (referred to as PRAC), in the Non-Elderly Disabled (NED) voucher program, in other HUD-assisted programs, and receiving Medicaid but not assisted by HUD. This study focused on six (out of 27) states currently administering PRA grant programs (California, Delaware, Louisiana, Maryland, Minnesota, and Washington). The study’s main data sources include HUD administrative data; Medicaid and Medicare data; interviews with PRA program administrators and program partners; and a survey of approximately 400 residents living in PRA and PRAC properties.
The study found that early evidence that the PRA program has succeeded in targeting the intended population. The study finds that the PRA program is serving a lower-income and higher-need population, with a higher prevalence of disabling conditions, relative to any other HUD program. Early outcomes indicate that the program offers integrated housing, but neighborhood and housing quality indicators are lower for PRA units compared to PRAC units. Residents report high levels of autonomy and independence and overall access to services and supports in both PRA and PRAC programs, with service gaps in some areas. Exits from the program are high in the states included in the study, with about one-fifth of PRA and PRAC residents exiting the program each year in the first three years after move-in. The study was unable to detect statistically significant differences in healthcare utilization between PRA and HUD-assisted residents, but found that PRA residents are more likely to use case management services and less likely to use long-term inpatient care less than one year after entering the program, compared to Medicaid beneficiaries not assisted by HUD. The cost-effectiveness assessment of PRA in relation to other HUD programs that assist people with disabilities find that rental subsidy costs are similar or lower than for other HUD programs but program administrative costs are higher.
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