HUD SECTION 811 PR A

Project Rental Assistance Program

Process 

Evaluation

U.S. Department of Housing and Urban Development | Office of Policy Development and Research 
Visit PD&R’s website

huduser.gov

to find this report and others sponsored by HUD’s Office of Policy Development and Research (PD&R). 

Other services of HUD User, PD&R’s research information service, include listservs, special interest 

reports, bimonthly publications (best practices, significant studies from other sources), access to public 

use databases, and a hotline (800-245-2691) for help accessing the information you need.
Prepared for

U.S. Department of Housing and Urban Development

Prepared by

Randal Pinkett

Christopher Jones

Kenya Crumel

Jie Dong

BCT Partners

Melissa Vandawalker

Gretchen Locke

Jill Khadduri

Abt Associates Inc.

January 2018

HUD SECTION 811 PR A

Project Rental Assistance Program

Process 

Evaluation
HUD Section 811 PRA Program – Process Evaluation

ii

Acknowledgments

Acknowledgments

This Process Evaluation Report is the last of two major deliverables of the first phase of the 

Section 811 Project Rental Assistance Demonstration Program evaluation. BCT Partners gratefully 

acknowledges the talented efforts of many individuals and organizations that assisted in this work. 

These organizations include the U.S. Department of Housing and Development (HUD), Technical 

Assistance Collaborative (TAC), and Centers for Medicare and Medicaid Services (CMS).

We also acknowledge and are grateful for input from the following 2012 811 PRA program grantees: 

• California Grantee Partnership: California Housing Finance Agency, California Department of 

Health Care Services, California Department of Housing and Community Development, Tax 

Credit Allocation Committee, and California Department of Developmental Services. 

• Delaware Grantee Partnership: Delaware State Housing Authority and Delaware Department of 

Health and Social Services.

• Georgia Grantee Partnership: Georgia Housing and Finance Authority Department of Community 

Affairs, Georgia Department of Community Health, Georgia Department of Behavioral and 

Health Developmental Disabilities, Georgia Department of Human Services Area Agency on 

Aging, and Gateway Partners.

• Illinois Grantee Partnership: Illinois Housing Development Authority, Illinois Department of 

Healthcare and Family Services, Illinois Department of Human Services, Illinois Department of 

Aging, and the Office of the Governor.

• Louisiana Grantee Partnership: Louisiana Housing Corporation, Louisiana Housing Authority, 

and Louisiana Department of Health and Hospitals.

• Maryland Grantee Partnership: Maryland Department of Housing and Community Development, 

Maryland Department of Health and Mental Hygiene, and Maryland Department of Disabilities.

• Massachusetts Grantee Partnership: Massachusetts Department of Housing and Community 

Development (Division of Housing Development), Massachusetts Department of Housing 

and Community Development (Bureau of Rental Assistance), Massachusetts Rehabilitation 

Commission, and Executive Office of Health and Human Services and MassHealth.

• Minnesota Grantee Partnership: Minnesota Housing Finance Agency and Minnesota Department 

of Human Services. 

• Pennsylvania Grantee Partnership: Pennsylvania Housing Finance Agency and Pennsylvania 

Department of Human Services. 

• Texas Grantee Partnership: Texas Department of Housing and Community Affairs, Texas Health 

and Human Services Commission, Texas Department of Aging and Disability Services, Texas 

Department of Family and Protective Services, and Texas Department of State Health Services. 

• Washington Grantee Partnership: Washington Department of Commerce and Washington 

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.
HUD Section 811 PRA Program – Process Evaluation

iii

Contents

Contents

Executive Summary ................................................................................................................................vii

Background of the Section 811 Project Rental Assistance Program and Report Overview.................. 1

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

Section 811 PRA Program Requirements.......................................................................................................................2

Interagency Partnership Agreements .............................................................................................................................................2

Property Selection and Contracting ...............................................................................................................................................2

Section 811 PRA Contract Rents....................................................................................................................................................2

Resident Eligibility ...........................................................................................................................................................................3

Funding Awards Under the 811 PRA Program Demonstration .....................................................................................................3

Evaluation of the Section 811 PRA Program..................................................................................................................3

Process Evaluation Data Sources and Limitations.......................................................................................................4

Organization of This Report.............................................................................................................................................5

Overview of Project Rental Assistance Demonstration Programs ......................................................... 7

Overview of Section 811 PRA Grants ..............................................................................................................................7

Section 811 PRA Program Summaries............................................................................................................................8

Target Populations of the 2012 PRA Grants................................................................................................................. 10

Project Rental Assistance Partnerships ............................................................................................... 13

Overview of PRA Partnership Organization and Structure ....................................................................................... 13

How 811 PRA Partners Collaborate .............................................................................................................................. 15

Structures To Support Collaboration............................................................................................................................................15

Communication .............................................................................................................................................................................16

Cross-Agency Entities for Program Coordination........................................................................................................................16

Financial and Staffing Resources .................................................................................................................................................16

Conclusion........................................................................................................................................................................ 17

Property Selection................................................................................................................................. 19

Property Targeting Approaches: New Versus Existing Properties .......................................................................... 19

Strategies To Recruit Owners of New Properties .......................................................................................................20

Incentives for Tax Credits and Other Housing Funding Awards ..................................................................................................20

Adding New QAP Incentives for PRA ...........................................................................................................................................21

Using Existing QAP and Other Incentives To Encourage PRA Units...........................................................................................21

Challenges to Recruiting Owners Through QAP Incentives .....................................................................................22

Outreach and Marketing Strategies for Existing Properties.....................................................................................23

Procedures for Applying for 811 PRA............................................................................................................................24

Challenges in Identifying Properties for the PRA Program.......................................................................................24

Project Rental Assistance Properties and Units................................................................................... 27

Rental Assistance Contract Requirements .................................................................................................................27

Progress in Achieving PRA Unit Goals .........................................................................................................................27

Financing Sources of Properties...................................................................................................................................28

Characteristics of Units Under RAC .............................................................................................................................29

Vacancy Status .............................................................................................................................................................................29

Number of Units per RAC .............................................................................................................................................................30

Unit Bedroom Size ........................................................................................................................................................................30

Unit Accessibility...........................................................................................................................................................................31

Unit Rent and Subsidy Levels ........................................................................................................................................32

Targeted Rent Levels.....................................................................................................................................................................32
HUD Section 811 PRA Program – Process Evaluation

iv

Contents

Contract Rent and Rental Assistance Payments by Bedroom Size ............................................................................................32

Differences in Estimated and Actual Rental Assistance Payments.............................................................................................33

Leveraging Set-Asides of Housing Choice Vouchers .................................................................................................34

Conclusion .......................................................................................................................................................................34

Identifying Project Rental Assistance Residents and Matching Them to PRA Units........................... 37

Outreach to PRA’s Program Target Population ..........................................................................................................37

Overview of PRA Program Outreach and Referral Methods........................................................................................................37

Oversight and Coordination of Outreach and Referrals...............................................................................................................38

Outreach and Referral Agencies ..................................................................................................................................................39

Outreach Models Adapted From Existing Housing Programs for People With Disabilities ........................................................39

Outreach Approaches Based on Target Population.....................................................................................................................39

PRA Resident Application Approaches .......................................................................................................................40

Centralized and Targeted Outreach and Application Models ......................................................................................................40

Use of Waiting Lists for the PRA Program....................................................................................................................................40

Implications of Different Application Practices ...........................................................................................................................41

PRA Program Eligibility Determination ........................................................................................................................ 41

Eligibility Based on Age and Eligibility for Medicaid Services .....................................................................................................42

Eligibility Based on Income...........................................................................................................................................................42

Oversight of Eligibility Determination............................................................................................................................................42

When To Conduct PRA Program Eligibility...................................................................................................................................42

Applicants Determined Ineligible for the PRA Program.............................................................................................42

Matching Applicants to Available Units........................................................................................................................43

Applicants Referred to PRA Units.................................................................................................................................................43

Applicants Who Did Not Meet Property Leasing Requirements..................................................................................................44

Reasons Applicants Were Ineligible .............................................................................................................................................44

Conclusion .......................................................................................................................................................................45

Characteristics of Project Rental Assistance Applicants and Residents ............................................ 47

PRA Applicants ................................................................................................................................................................47

Applicants by Referral Source ......................................................................................................................................................47

Applicants by Housing Status ......................................................................................................................................................48

Applicants by Disability Type........................................................................................................................................................49

Profile of PRA Residents ................................................................................................................................................49

Characteristics of PRA Households .............................................................................................................................50

Household Composition ...............................................................................................................................................................50

Household Income and Assets.....................................................................................................................................................51

Tenancy of PRA Residents............................................................................................................................................................52

Transfers With Program and Program Exits .................................................................................................................................52

Service Provision and Coordination...................................................................................................... 53

What Does Medicaid Cover and for Whom? ................................................................................................................53

Expected Services and Supports for PRA Residents.................................................................................................54

Early Lessons on Service Delivery for PRA Residents ..............................................................................................56

Conclusions and Implications for Future Research.............................................................................. 57

Grantee Partnerships and Organizational Structures................................................................................................57

Target Populations .........................................................................................................................................................57

Outreach and Referral Processes.................................................................................................................................58

Housing Strategies .........................................................................................................................................................58

Service Provision and Coordination ............................................................................................................................59

Looking Ahead to Future Research and Practice ......................................................................................................59

References ............................................................................................................................................ 61
HUD Section 811 PRA Program – Process Evaluation

v

List of Tables

List of Tables

Table 2.1: Overview of 2012 Section 811 PRA Grant Awards .....................................................................................................7

Table 2.2: Target Populations of 2012 PRA Demonstration Programs.......................................................................................11

Table 3.1: Standard Division of PRA Program Responsibilities Between State Housing and Medicaid Agencies....................13

Table 3.2: Grantee and Partnering Agencies and Their Previous Experience ...........................................................................14

Table 4.1: Targeted Versus Actual Property Recruitment Strategies..........................................................................................19

Table 4.2: QAP Preferences and Strategies To Improve Unit Production .................................................................................20

Table 5.1: Status of Section 811 PRA Program Implementation, June 2016.............................................................................28

Table 5.2: RACs by Property’s Primary Financing Mechanism, as of June 2016.......................................................................29

Table 5.3: Occupancy and Vacancy Status of Section 811 PRA Units by Grantee, June 2016 ................................................30

Table 5.4: Section 811 PRA Units Under RAC and Under Lease by Bedroom Size, June 2016 ...............................................31

Table 5.5: Accessibility of Section 811 PRA Units Under RAC, as of June 2016 ......................................................................31

Table 5.6: Contract Rent and Rental Assistance Payment by Bedroom Size, June 2016 .........................................................32

Table 5.7: Difference Between Average Section 811 PRA Rental Assistance From Cooperative Agreements 

and Actual Rental Assistance, as of June 2016 .......................................................................................................33

Table 5.8: Level of Commitment to Leveraging HCVs by State, as of June 2016.....................................................................34

Table 6.1: Outreach and Referral Model by State ......................................................................................................................38

Table 6.2: Applicants Determined Ineligible for the Section 811 PRA Program by Reason, as of June 2016...........................42

Table 6.3: Applicants Determined Ineligible for the Section 811 PRA Program by Housing Status, as of June 2016...............43

Table 6.4: Households That Owners Screened Out by Housing Status, as of June 2016.........................................................44

Table 7.1: PRA Applicants by Referral Source, as of June 2016 ...............................................................................................47

Table 7.2: PRA Applicants by Housing Status, as of June 2016................................................................................................48

Table 7.3: PRA Residents as of June 2016 ................................................................................................................................49

Table 7.4: PRA Residents by Prior Housing Status, June 2016.................................................................................................50

Table 7.5: Household Composition of Section 811 PRA Residents, June 2016........................................................................50

Table 7.6: Characteristics of Section 811 PRA Heads of Household, June 2016......................................................................51

Table 7.7: PRA Household Sources of Income, June 2016........................................................................................................52

Table 7.8: PRA Participants by Tenancy, June 2016 ..................................................................................................................52

Table 8.1: Funding Sources for Services for PRA Residents .....................................................................................................54
HUD Section 811 PRA Program – Process Evaluation

vi
HUD Section 811 PRA Program – Process Evaluation

vii

Executive Summary

Executive Summary

This report presents the results of a process evaluation 

of 12 states’ experiences implementing the Section 811 

Project Rental Assistance (811 PRA) program, a new 

approach to providing affordable rental housing for 

extremely low-income nonelderly people with disabilities. 

Background on HUD’s Section 811 

PRA Program

Since 1991, the U.S. Department of Housing and Urban 

Development (HUD) has administered the Section 811 

Supportive Housing for Persons with Disabilities program, 

providing interest-free capital advances and Project Rental 

Assistance Contract (PRAC) funds to nonprofit sponsors 

to develop and operate group homes, independent living 

projects, and condominiums for very low-income people 

with disabilities. Some 35,000 households receive rental 

assistance under the Section 811 PRAC program.

The Frank Melville Supportive Housing Investment Act of 

2010, or Melville Act, introduced several reforms to the 

Section 811 program, including the PRA option. The 811 

PRA option connects services and expands affordable 

housing options for nonelderly people with disabilities 

who have extremely low-income. The 811 PRA option 

provides subsidies for scattered site units in affordable 

housing developments financed by other funding sources 

and occupied by people with and without disabilities. It 

creates or builds on incentives for owners and developers 

to create additional supportive housing by tapping 

available Medicaid funding streams. It also forms service 

partnerships and develops referral networks to identify 

eligible households that need service-enriched housing. 

Households eligible for the 811 PRA must be extremely 

low-income, nonelderly persons with disabilities between 

the ages of 18 and 61 at the time of admission and who 

are eligible for Medicaid or a similar program offering 

community-based, long-term services and supports. PRA 

assistance may be targeted to people who are living in 

institutions, homeless, or at risk of institutionalization or 

homelessness. States had flexibility to further target or 

prioritize groups within this target population, based on 

the local needs of persons with disabilities. 

One goal of the Section 811 PRA option is to bring 

affordable rental housing for persons with disabilities to 

1 The Supreme Court’s 1999 decision in Olmstead v. L.C. established that segregating people with disabilities in institutional settings constitutes 

discrimination under the Americans with Disabilities Act. The court held that public entities must provide community-based services in the least 

restrictive setting that meets the person’s needs and preferences. 

occupancy more quickly than was possible under the 

Section 811 PRAC program. The new option also gives 

states opportunities to respond to incentives from the 

Affordable Care Act that encourage community-based 

housing and care. The 811 PRA program could also 

contribute to state efforts to end homelessness and to 

respond to the goals of the U.S. Supreme Court’s 1999 

Olmstead decision that established the right of people 

with disabilities to live in the least restrictive settings 

possible that meet their needs and preferences.1

In February 2013, HUD awarded a demonstration round 

of PRA grants totaling $98 million to 13 states to assist 

an estimated 3,350 units. By early 2015, 12 grantees had 

executed cooperative agreements with HUD to implement 

the 811 PRA program under its inaugural funding round. 

In March 2015, HUD awarded a second round of PRA 

funding to 25 state housing agencies for approximately 

$150 million. 

Goals of the Section 811 PRA 

Process Evaluation 

The Melville Act mandates an evaluation of the Section 

811 PRA program. In 2015, HUD’s Office of Policy 

Development and Research issued a contract to a 

research team to carry out the Phase I evaluation. The 

Phase I evaluation focused on the 2012 demonstration 

round of funding. This process evaluation report is the third 

report produced by the Phase I evaluation and provides an 

aggregate summary of 811 PRA implementation in the 12 

states funded in the initial round of grants. 

The primary goal of the Section 811 PRA process 

evaluation is to describe the implementation of the PRA 

program and the partnerships in the 12 initial states. The 

report draws on grantee funding applications and program 

documents, HUD administrative data, and in-person 

interviews with staff from state housing agencies, state 

Medicaid agencies, and other program partners. The 

evaluation captures the early implementation successes 

and challenges of the PRA demonstration funding round 

between October 2014, when HUD and grantees signed 

the first cooperative agreements to begin administering 

the PRA grant, and June 2016, the end of data collection 

for the evaluation. This report covers approximately the 

first 18 months of program implementation, as HUD 

and grantees signed cooperative agreements between 

October 2014 and May 2015. 

The process evaluation describes the state agency 

partnerships, procedures developed to implement the 
HUD Section 811 PRA Program – Process Evaluation

viii

Executive Summary

811 PRA, and progress toward the goals of securing 

units under contract for PRA subsidies, matching eligible 

households to available units, and ensuring households 

access to appropriate services and supports. In addition, 

the process evaluation identifies the successes and 

challenges encountered by the early grantees, the 

strategies they developed to adapt programs to address 

arising challenges, and the early lessons from grantees’ 

experiences for programs and policies. 

Lessons From the Process 

Evaluation

The 811 PRA option represented an entirely new approach 

to providing rental assistance to people with disabilities. 

During the initial 18 months after grant awards, the 

grantees and their partners (with assistance from HUD) 

devoted much of their effort to startup activities and to 

putting systems and procedures in place to support this 

new subsidy program. Key activities in the first 1 1/2 years 

of the 2012 PRA grant included solidifying the roles and 

responsibilities between housing and Medicaid partner 

agencies, conducting outreach to owners to identify 

candidate properties for PRA units, and establishing 

outreach and referral procedures to identify individuals 

and match them with PRA-subsidized units.

The following are lessons learned from the process 

evaluation about grantee and Medicaid agencies’ early 

experiences with the Section 811 PRA program.

PRA Program Target Populations 

All 12 states are targeting people who are institutionalized, 

a priority target population in 6 states (California, 

Delaware, Illinois, Louisiana, Massachusetts, and 

Pennsylvania). All but 2 grantees (Illinois and Texas) 

targeted people who are at risk of institutionalization. 

All 12 states participate in the Centers for Medicare and 

Medicaid Services’ Money Follows the Person (MFP) 

program, and several states prioritize the availability of 

PRA assistance to individuals participating in MFP. 

All but 3 grantees (California, Illinois, and Texas) target 

people who are experiencing homelessness or at risk of 

homelessness, but only a few states conduct targeted 

outreach to people experiencing homelessness or at risk 

for homelessness. Several states (Delaware, Georgia, 

Illinois, and Maryland) target PRA resources to members 

of groups covered by legal settlements under Olmstead 

or other laws. Most of the 12 grantees targeted multiple 

disability groups—that is, a combination of people with 

physical, developmental, or mental health disabilities.

The target population has implications for the way state 

housing and Medicaid agencies conduct outreach and 

referral procedures. Outreach procedures and transition 

services may also vary depending on whether PRA 

applicants are participants in the state’s MFP program.

Partnerships and Organizational 

Structure

Housing and Medicaid partners with previous experience 

working together had an advantage in launching 

the program more quickly. State agencies that had 

previously worked together to administer supportive 

housing programs typically had established mechanisms 

for communication between agencies, had a greater 

understanding of target populations, and had existing 

outreach procedures, systems, applicant pools, and 

waiting lists adaptable for the PRA program. 

In several states, housing and Medicaid agencies 

undertake 811 PRA program tasks together, necessitating 

learning a common language and training the other 

agency on areas of expertise. PRA program activities that 

staff from state housing and Medicaid agencies jointly 

conduct are outreach to property owners to encourage 

interest in the PRA program, review of owner applications 

for 811 PRA assistance, training to service providers who 

work PRA applicants and residents, and monitoring and 

reporting for grant compliance.

Grantees commonly reported that the program required 

more time and resources than expected, and most 

reported that administrative tasks still took longer than 

expected a year after the start of PRA programs. 

Sustaining program staffing is a concern for Medicaid 

agencies with the expiration of MFP grants that fund staff 

and services in many states that help individuals who are 

transitioning out of institutions into community-based 

housing. To continue funding these activities, states 

may need to consider changing their Medicaid waiver 

programs to make housing-related activities and services 

eligible.

Identifying PRA Units

As of June 2016, all 2012 grantees had units under 

contract with property owners for PRA subsidies. 

Combined, the grantees had 604 PRA units under 

Rental Assistance Contracts (RACs), about one-fourth 

(28 percent) of the total number of estimated PRA units 

funded in this demonstration round. When adding the 

number of units identified under other formal agreements 

or affordable housing competitions, grantees identified 

43 percent of the total estimated 2,193 PRA units 
HUD Section 811 PRA Program – Process Evaluation

ix

Executive Summary

expected to be funded through the 2012 awards. The total 

number of PRA units to eventually be funded under the 

demonstration grants will not be known until all units are 

under lease. The number could be less than 2,193. Most 

grantees underestimated the amount of average rental 

subsidies for PRA residents, and thus, will not be able to 

assist as many units as projected in their notice of funding 

availability responses. 

The overall average number of units under executed RACs 

is 8.6 units per property. The number of units for each 

RAC varies widely from 2 to 21 units per property, based 

on the size of the property and the incentives for PRA 

subsidies. Some states developed a minimum number or 

percent of PRA units that owners must accept to receive 

funding through, or receive priority for, housing assistance 

programs. 

Creating incentives in state Qualified Allocation Plans 

(QAPs) for low-income housing tax credits, or LIHTCs, 

was a primary tool for grantees to secure units under 

contract for PRA. Some states were able to target 

QAP special population priorities to PRA subsidies or 

otherwise provide incentives for developers to set aside a 

percentage of a property’s units specifically for PRA. 

Challenges with owner recruitment included owner 

concerns about the 30-year use agreement, the 20-year 

contract period, and the lower PRA rents that grantees 

established in the grant applications, a particular concern 

in costlier urban areas. Some owners also had to learn to 

use HUD’s subsidy administration and reporting systems, 

which they may not have previously used.

At least three grantees report the lack of one-bedroom 

units in the state’s affordable housing portfolio is a 

challenge in identifying units for the program, although the 

percentage of units leased is generally proportional to the 

breakdown of units under RAC. Some states address this 

concern by encouraging the production of one-bedroom 

units in future affordable housing developments. For 

example, the Louisiana tax credit agency will increase the 

points in the state’s 2017 QAP for projects that agree to 

set-aside 25 percent of units for PRA and give preference 

to the development of one-bedroom units. 

Of the 12 grantees, 9 committed to set aside housing 

choice vouchers, project-based vouchers, and public 

housing units to extremely low-income households with 

disabilities to supplement the 811 PRA units. Through 

June 2016, 5 grantees reported that 432 vouchers were 

issued as part of this commitment, representing 30 

percent of the total leverage commitment. 

Outreach and Referral to PRA 

Target Populations

Grantees report many advantages of centralizing the 

acceptance and review of applications at state, regional, 

or county levels and maintaining a single program waiting 

list, especially when using software to automate and 

facilitate the process. PRA program staff also reported 

challenges when the centralized process relies on an 

individual staff person however.

All grantees developed some type of 811 PRA program 

waiting list that is maintained by the housing agency 

or their partners, but each PRA program uses waiting 

lists differently. Grantees and their partners maintain 

waiting lists at various levels, including by state, region, 

outreach or referral agency (contracted service provider), 

and property. Two grantee programs combined the 

PRA waiting list with waiting lists for other established 

programs.

Some grantees noted mismatches between locations of 

available vacancies, available and accessible services, 

and where eligible applicants want to live. 

PRA Applicants and Residents

Through June 2016, grantees reported a combined 3,270 

applicants for the 12 PRA programs. More than onethird of applicants were either homeless (26 percent) or 

at risk for homelessness (10 percent). More than onefourth of applicants were either residing in institutions (18 

percent) or were at risk for institutionalization (9 percent). 

People living in group homes, adult care homes, or other 

residential settings constitute 11 percent of applicants. 

Grantees vary in the distribution of applicants by place of 

prior residence, largely reflecting the states’ priorities and 

eligible populations. Most homeless applicants are from 

three states (Louisiana, Maryland, and Minnesota) that are 

specifically targeting people experiencing homelessness 

or at risk for homelessness.

Through June 2016, the 12 demonstration PRA programs 

assisted 133 households with rental assistance, and 124 

residents were living in PRA-funded units at the end of 

the month (8 households had exited the program since 

January 2015). The 124 households represent just 6 

percent of the estimated 2,193 units that grantees expect 

to fund with the 2012 PRA demonstration grant.

Approximately one-half of PRA residents came 

from institutions (35 percent) or were at risk for 

institutionalization (15 percent) as defined by each PRA 
HUD Section 811 PRA Program – Process Evaluation

x

Executive Summary

program. An additional one-fourth of residents had 

previously experienced homelessness or was at risk for 

homelessness.

PRA residents range in age from 19 to 60 but skew toward 

the higher age limit of the 811 PRA program. The average 

head of household is age 47, and the median age is 50. 

PRA residents have extremely low household incomes and 

report few assets. After taking deductions into account, 

average adjusted annual income of PRA residents was 

$8,886. On average, adjusted PRA household income 

was about 16 percent of the Area Median Income in 

the locations where PRA residents live. Most PRA 

households receive only Social Security (42 percent), 

only Supplemental Security Income (34 percent), or both 

Social Security and Supplemental Security Income (13 

percent).

The average rental assistance amount for PRA residents 

was $599, ranging from a low of $317 to a high of $1160. 

For data available on PRA residents as of June 2016, 

actual assistance payments were about $141 a month 

higher than estimated by grantees in the grant cooperative 

agreements. The average resident payment for residents 

moving into PRA units by June 2016 was $223 a month, 

ranging from $5 to $443. 

Provision and Coordination of 

Services and Supports

• Most grantees were still in the early stages of 

implementing 811 PRA programs during the data 

collection period, few PRA residents were housed, and 

grantees had little experience with service delivery for 

individuals living in PRA units.

• Different Medicaid waiver and state plan services 

serve different target populations, and the types and 

availability of healthcare and supportive services will 

vary. In a number of states, 811 PRA activities were 

closely coordinated with the states’ MFP programs. 

MFP staff and systems were critical resources in 

identifying potential applicants for the 811 PRA 

program, determining eligibility, and (for those found 

eligible for an available unit) assisting with transitions. 

• Although states may have appropriate waiver programs 

for the 811 PRA target populations, grantees noted 

that a key factor in identifying suitable properties for 

the program is confirming the proximity of appropriate 

services. Some grantees noted concerns about the 

availability of services in rural or suburban areas, 

although the program was still early in implementation.

As a new program, state housing agencies and their 

partners faced some challenges in the first 18 months 

of implementation in identifying eligible properties and 

securing units, matching individuals with disabilities to 

PRA-subsidized units, and navigating new reporting and 

data systems required to administer the rental subsidies. 

Although this report addresses those challenges, 

this report also identifies several ways state agencies 

successfully developed or expanded existing state-level 

partnerships to meet the goals of state PRA programs. 

More recent data from March 2017 show that the 2012 

grantees identified most (81 percent) of the estimated 

units to be funded by the PRA grant and had significantly 

increased resident leasing efforts since conducting 

research for this process evaluation. Housing agencies 

that received fiscal year 2012 grant funds have until 

September 2025 to disburse grant funds. All PRA units 

must be under lease by September 2020 in order for the 

grantee to fund all the PRA units for the full 5 years of 

available rental assistance.

Research conducted and lessons learned in this Section 

811 PRA process evaluation report are informing 

subsequent phases of the evaluation of the program. 

The Phase II evaluation is currently under way to address 

ongoing program implementation, begin to examine 

participant-level outcomes and access to services, and 

estimate PRA program costs.
HUD Section 811 PRA Program – Process Evaluation

1

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

Background of the 

Section 811 Project 

Rental Assistance 

Program and 

Report Overview

This chapter provides a brief history of the Section 811 

Project Rental Assistance Contract (PRAC) and Project 

Rental Assistance (PRA) programs. The chapter then 

describes the objectives and data sources for the process 

evaluation and provides an overview of this process 

evaluation report.

Section 811 and PRA Programs

HUD has administered the Section 811 Supportive 

Housing for Persons with Disabilities program since 1991. 

The Section 811 program goal is to expand the supply 

of supportive housing for very low-income nonelderly 

people with disabilities. The program traditionally awarded 

interest-free capital advances and contracts for projectbased rental assistance to nonprofit organizations to 

develop supportive housing (such as group homes and 

small rental housing developments) occupied by very lowincome households headed by nonelderly people with 

disabilities aged 18 to 61.2

The Section 811 supportive housing model provides 

residents affordable housing and access to appropriate, 

voluntary supportive services. Organizations that receive 

capital advances must develop a supportive services 

plan that meets tenant’s health, mental health, and other 

needs. Grantees must either provide services directly or 

partner and coordinate with community service providers 

to provide services. Grantees must also ensure that 

services are available for the duration of the 40-year 

capital advance period. Capital advances continue to be 

permitted for the development of group homes and other 

projects specifically for people with disabilities, but no 

funds were appropriated for new projects since fiscal year 

2012. 

2 Under the Section 811 statute, a person with disabilities is defined as an individual having a physical, mental, or emotional impairment that (1) is 

expected to be of long-continued and indefinite duration, (2) substantially impedes his or her ability to live independently, and (3) is of such a nature 

that the ability to live independently could be improved by more suitable housing conditions. In addition, under the Section 811 statute, persons with 

developmental disabilities as defined under the Developmental Disabilities Assistance and Bill of Rights Act (P.L. 106-402) qualify for Section 811 

housing.

The Frank Melville Supportive Housing Investment Act of 

2010 (Melville Act) introduced significant reforms to the 

Section 811 program, including creating the Section 811 

PRA (811 PRA) program. The 811 PRA program provides 

project-based rental assistance for integrated supportive 

housing in affordable housing developments. For the 811 

PRA program, integrated housing means that no more 

than 25 percent of units in a building are set aside for 

people with disabilities or supportive housing in general, 

and units must be scattered throughout the property.

The 811 PRA program provides rental assistance funding 

to state housing agencies that work in partnership with 

state health and human services and Medicaid agencies 

to create community-based supportive housing. This 

approach responds to several recent policy priorities 

related to housing and support for people with disabilities. 

First, it responds to renewed emphasis on achieving 

the goals of the U.S. Supreme Court’s 1999 decision in 

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

in the least restrictive settings possible that meet their 

needs and preferences. In their decision, the Supreme 

Court ruled that, under title II of the Americans with 

Disabilities Act, people with disabilities must be afforded 

opportunities to live in settings appropriate to their 

abilities, with freedom to choose daily life activities and 

to interact with people without disabilities. As states 

and communities worked to implement the decision 

(sometimes in response to litigation), the limited supply 

of affordable and appropriate housing and supports 

in community-based settings became a significant 

challenge.

Second, the Olmstead decision encouraged federal and 

state efforts to rebalance Medicaid systems to provide 

long-term services and supports away from institutional 

settings, such as nursing homes, and toward housing that 

is integrated within communities. Medicaid programs offer 

community-based services to beneficiaries through homeand community-based services waiver programs and 

optional state plan services. Community-based services 

provided by Medicaid and other programs help ensure 

that people with disabilities have the supports needed to 

live successfully in the community. 

In particular, the Money Follows the Person (MFP) 

demonstration, administered by the U.S. Department 

of Health and Human Services’ Centers for Medicare 

and Medicaid Services (CMS), is a major initiative that 

provides funding to many states to support transitions 
HUD Section 811 PRA Program – Process Evaluation

2

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

from institutions to community-based settings. However, 

the lack of affordable housing often constrained the 

demonstration’s ability to transition large numbers of 

Medicaid beneficiaries to community settings.

The Affordable Care Act also created or strengthened 

programs to expand community-based care, but again, 

the lack of available affordable housing is a barrier to 

these efforts. HUD designed and implemented the 811 

PRA program in collaboration with CMS to help address 

the lack of affordable housing resources for people with 

disabilities to live in the least restrictive setting possible.

Section 811 PRA Program 

Requirements

HUD designed the 811 PRA program to accomplish 

several objectives (HUD, 2013a).3 First, HUD envisioned 

the 811 PRA option would increase the supply of 

affordable housing linked with community-based 

supportive services that would serve as an alternative 

to more costly and restrictive institutional care. Second, 

the 811 PRA program would encourage state-level 

collaboration between health and human services and 

housing agencies, resulting in long-term, permanent 

supportive housing strategies. Finally, the program would 

increase production of affordable housing units for 

people with disabilities and leverage funds by integrating 

the 811 PRA units in multifamily properties where other 

federal and state programs fund the capital costs for 

construction. This section describes the 811 PRA program 

requirements aimed at achieving these objectives.

Interagency Partnership Agreements

To apply for 811 PRA funds, state housing agencies 

must partner with the state agency responsible for the 

administration of the state’s Medicaid program, as well as 

the state’s health and human services agency (if different). 

An interagency partnership agreement—a memorandum 

of agreement between the agencies that is required as 

part of the grant application—outlines the state Medicaid 

agency’s commitment to identifying and conducting 

outreach to the target population(s) the state’s 811 PRA 

program serves. The agreement also describes the 

funding streams that will provide access to appropriate 

services and supports. 

Property Selection and Contracting

State housing agencies select properties to award 

811 PRA subsidies. Eligible properties can be newly 

built or existing multifamily developments in which the 

development costs are subsidized by federal sources, 

3 Summarized in 2013 HUD budget summary https://portal.hud.gov/hudportal/documents/huddoc?id=housing-disabilities-2013.pdf.

such as low-income housing tax credits (LIHTCs), HOME 

Investment Partnerships Program funds, the Community 

Development Block Grant program, or other federal, state, 

or private sources. 

The 811 PRA program funds only rental assistance. It 

does not provide any funding for capital costs. Grantees 

establish Rental Assistance Contracts (RACs) with owners 

of eligible properties. The agreement sets forth the rights 

and duties of the parties with respect to the assisted 

unit(s) and identifies the number and sizes of units that 

the owner agrees to commit to the program, as well as 

the contract rent of these units. The 811 PRA units are 

floating; that is, the RAC does not identify specific units 

allocated to the program, simply the number and sizes of 

units. Owners may commit to RACs even if the property 

does not have vacant units available for immediate 

occupancy. This program feature means that 811 PRAeligible households may have to wait until current non-811 

PRA residents move to occupy units. 

As a precursor to a RAC, grantees and property owners 

can also enter into a signed Agreement to Enter into a 

RAC, or ARAC. ARACs are formal agreements between 

the grantee and the owner of an eligible multifamily 

property that is either existing or under construction. 

New developments are under construction, or substantial 

rehabilitation, at the time the ARACs are signed or that 

state housing agencies plan to develop through statecontrolled financing. Existing developments are already 

constructed and placed into service as affordable rental 

housing.

Property owners must agree to a 30-year use restriction 

for providing a specified number of units as supportive 

housing for people with disabilities and a contract with 

HUD for at least 20 years. The initial RAC provides funding 

for 5 years of rental assistance. The use restriction and 

renewal funding are contingent on continued Section 811 

appropriations. 

To ensure achievement of community integration goals 

under the 811 PRA program, the Section 811 statute 

specifies that no more than 25 percent of the units in the 

affordable housing development can be set aside for 

supportive housing or have an occupancy preference for 

people with disabilities. Moreover, the units need to be 

scattered throughout the building and not concentrated in 

one section or floor.

Section 811 PRA Contract Rents

Grantees determine the 811 PRA contract rents, the 

maximum rents that property owners can charge for 811 

PRA units, which may or may not reflect current rental 
HUD Section 811 PRA Program – Process Evaluation

3

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

market conditions. The Section 811 PRA Notice of Funding 

Availability (NOFA) required that the PRA rent not exceed 

the applicable Fair Market Rent (FMR) or Small Area FMR 

level for the property location, as determined annually 

by HUD (with some exceptions). The NOFA provided 

incentives for state housing agencies to target units that 

would produce the lowest possible per-unit rental subsidy 

costs by targeting properties that have existing rent 

restrictions, such as those funded with LIHTC or HOME 

funds. 

Resident Eligibility

Section 811 PRA funds may be provided only for housing 

units set aside for extremely low-income households, 

including at least one nonelderly person with disabilities 

who is 18 to 61 years old at the time of occupying the 

811 PRA unit. Participants in the 811 PRA program must 

also be eligible for community-based long-term care 

services provided under the state’s Medicaid program. 

Long-term care services may be provided under Medicaid 

1915(c) waivers, Medicaid state plan options, or other 

comparable long-term services programs. Services paid 

for under these Medicaid programs include services 

and supports that are not traditional medical services, 

but those that people need during long periods of time 

to maintain health and independence such as personal 

care assistance, adult day health or habilitation services, 

or home modifications. The community-based nature of 

the services means that services are provided in people’s 

homes or in other residential settings such as group 

homes. Hospitals and institutions are not considered 

community-based settings.

Grantees can choose to further specify the target 

population(s) to serve with their state 811 PRA programs 

and, in partnership with Medicaid agencies, have 

further specific target populations who are currently in 

institutions, homeless, or at risk of institutionalization or 

homelessness. Chapter 2 describes the target populations 

of the 2012 811 PRA grantees.

Funding Awards Under the 811 PRA Program 

Demonstration 

In fiscal years 2012, 2013, and 2014, congressional 

appropriations language for the Section 811 program 

required that any new Section 811 units be created under 

the 811 PRA option. An initial NOFA for 811 PRA grants 

was issued in 2012 with language that identified the 

funding round as a demonstration round. In February 

2013, HUD selected 13 states to receive 811 PRA 

4 HUD selected North Carolina in the fiscal year 2012 grant competition to fund an estimated 562 units, but North Carolina Housing Finance Agency 

decided not to sign the cooperative agreement and participate in the program.

5 HUD selected the District of Columbia Housing Authority in the fiscal year 2013 grant competition to fund an estimated 60 units, but the District 

of Columbia Department of Housing and Community Development did not to sign the cooperative agreement and is not participating in the program. 

demonstration grants totaling $98 million to provide 

subsidies for an estimated 3,530 units.4 HUD awarded a 

second round of funding in March 2015 under a combined 

NOFA for fiscal years 2013 and 2014. In the second round, 

HUD awarded 811 PRA funding to 25 state housing 

agencies for approximately $150 million to provide 

subsidies for some estimated 4,584 units.5 Between the 

two funding rounds, selected states proposed to fund an 

estimated 7,900 units of affordable housing set aside for 

nonelderly persons with disabilities.

Evaluation of the Section 811 PRA 

Program

The Melville Act, which created the 811 PRA option, 

mandates an evaluation of the program. In 2015, HUD’s 

Office of Policy Development and Research issued a 

contract to a research team to carry out the Phase I 

evaluation of the demonstration round of 811 PRA grants. 

This process evaluation report focuses only on the 2012 

grants. 

The Phase I evaluation’s overarching research questions 

are— 

• How are successful state and local partnerships 

structured to carry out the 811 PRA program?

• How are outreach and marketing efforts designed 

to support compliance, provide tenant choice, and 

ensure efficient occupancy policies for housing owners 

or managers?

• How is the 811 PRA integrated with and adapted to 

state housing and service delivery systems operating 

in varied political, fiscal, and housing market contexts?

• What are the preliminary outcomes of the initial funding 

round?

The Phase I evaluation produced two major reports. 

This process evaluation report is the second and final 

report. A separate case study report presents detailed 

descriptions of the early implementation experiences of 

six states funded in the initial funding round, with a focus 

on (1) the housing and services context in each state, (2) 

the partnerships developed to implement the 811 PRA 

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

within these contexts.

A second phase of the evaluation, under way between 

October 2016 and April 2019, will build and expand on 

work conducted under Phase I. This evaluation focuses 

on a subset of six states selected from grantees in the 
HUD Section 811 PRA Program – Process Evaluation

4

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

first and second rounds of funding: California, Delaware, 

Louisiana, Maryland, Minnesota, and Washington. The 

Phase II evaluation has four core components. 

1. An implementation analysis to continue documenting 

the implementation of the 811 PRA program from 

Phase I. 

2. A descriptive analysis of all 29 Section 811 grantees 

funded in fiscal years 2012 and 2013–2014. 

3. An impact analysis to examine the differences between 

the 811 PRA program, the PRAC program, and two 

additional matched comparison groups on number of 

outcomes.

4. An economic analysis to measure the costs of 

housing and supportive services provided to 811 PRA 

participants and to compare costs to benefits.

The goal of this Phase I process evaluation is to provide 

an overall picture of the demonstration implementation in 

the 12 states and analyze differences in 811 PRA program 

designs, target population, and housing and service 

strategies. This process evaluation report supports the 

overall Phase I evaluation by describing the process by 

which the 811 PRA partnership between the state housing 

and Medicaid agencies implements the 811 PRA grants 

and the extent to which grantees identify and occupy 

units for 811 PRA subsidies, as expected in the 12 states 

awarded grants.

The Phase I process evaluation addresses the following 

research questions. 

• What are the characteristics of the partnerships 

between state housing and health and human services 

or Medicaid agencies? 

• What are grantees procedures in selecting properties 

to be assisted with 811 PRA funding? 

• How many units did grantees propose to assist and 

occupy? What were the proposed characteristics of 

these units? How many units did grantees actually 

assist and occupy? What are the main characteristics 

of these units?

• What are 811 PRA program procedures to reach target 

populations, refer applicants to PRA units, and place 

them in 811 PRA units? Where do delays occur? 

• How many people did grantees propose to reach, refer, 

and place in housing by target population? How many 

people did grantees actually reach, refer, and place in 

housing by target population? 

• What services are offered to program participants? 

How are services managed and coordinated? Do the 

services meet the service target population’s needs? 

What are the accountability measures? 

• What are the program implementation’s challenges and 

successes? What approaches achieved the expected 

goals and outcomes of the Section 811 PRA program?

Process Evaluation Data Sources 

and Limitations

The research team used a combination of quantitative 

and qualitative data sources to address the process 

evaluation’s research questions. These data sources are—

• Grantee funding applications. Grantee responses 

to the 2012 Section 811 PRA Demonstration NOFA 

provide information on the proposed 811 PRA program 

models, including target population, rent and subsidy 

assumptions for PRA units, and types of eligible 

properties. 

• Cooperative agreements and budgets. The 

cooperative agreements executed between grantees 

and HUD specify total grant amounts, rental assistance 

amounts, original 811 PRA unit and rental subsidy 

assumptions, planned implementation schedule, and 

expected administrative costs.

• Quarterly reports. Grantees submit quarterly reports 

to HUD on the number and characteristics of PRA 

properties and units under contract, applicants and 

referrals to the 811 PRA program and to specific PRA 

units, households that have moved into PRA units, 

and households ineligible for the PRA program or for 

specific properties. 

• Administrative data. Administrative data for this 

study came from two HUD data systems. Data from 

HUD’s Tenant Rental Assistance Certification System 

(TRACS) include demographic characteristics of 

PRA households such as household composition, 

race, ethnicity, age of head of household, household 

income and income sources, unit size, and total tenant 

payment. TRACS data also include dates of admission 

into the 811 PRA program and, where applicable, exits 

from the 811 PRA program and reasons for exiting. We 

obtained additional limited data on the characteristics 

of 811 PRA-assisted properties and units from HUD’s 

Integrated Real Estate Management System (iREMS). 

These data includes the contract rent and utility 

allowances by bedroom size.

• Interviews with grantees and key partners. Twoperson research teams conducted field visits between 

October 2015 and June 2016 to each of the 12 states 

to interview grantee representatives and their partners. 

The teams spent an average of 4 days in each state. 

Teams conducted in-person interviews (with telephone 

followup as needed) using standardized, semi-
HUD Section 811 PRA Program – Process Evaluation

5

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

structured interview guides that were tailored to each 

state’s 811 PRA program design and partners. In states 

with occupied 811 PRA units, teams had informal 

conversations with PRA-assisted residents when 

convenient.

Data collected for the process evaluation report have 

some limitations. The process evaluation focuses on 

a 15- to 22-month implementation period between the 

signing of the first (August 15, 2014) and the most recent 

(March 15, 2015) cooperative agreements and June 2016, 

the date of the most recent data extract, acquisition of 

quarterly reports, and state interview updates. This data 

collection period was early in the implementation of the 

5-year grants. As of June 30, 2016, the 12 states had a 

combined 604 units under contract with owners for PRA 

subsidies, 124 residents currently living in PRA-funded 

units, and 9 households that had moved into PRA units 

but subsequently moved out.

During the initial 18 months after grant awards, grantees 

and their partners (with assistance from HUD) devoted 

much of their effort to startup activities and putting in 

place systems and procedures to support the new subsidy 

program. Key activities included solidifying agreements 

between housing and Medicaid partner agencies, 

conducting outreach to owners to identify candidate 

properties for PRA units, and establishing outreach and 

referral procedures to identify eligible individuals and 

connect them to PRA-subsidized units. 

During the field visits between October 2015 and May 

2016, few of the 811 PRA units had been occupied. As a 

result, grantees and their partners had little experience 

recruiting PRA-eligible households, transitioning them 

into units, and providing services. This report, therefore, 

provides information on plans for tenancy supports 

and service delivery but limited information on the 

implementation of these plans.

Also some inconsistencies exist across the administrative 

data sources because of lags in data entry and 

inaccuracies or grantees reporting incomplete data. As of 

June 2016, contract rent and rental assistance payments 

were only available in TRACS for 94 of the 133 current and 

former PRA participants at the time of data extraction. 

Owners have 120 days after a lease starts to submit data 

to HUD. 

PRA subsidies are not tied to properties or to specific 

units within a property. As such, information about some 

features of units under executed RACs, including bedroom 

size and accessibility, may not be known for units that 

are occupied by non-PRA residents until the units turn 

over. This information is unavailable for 24 percent of units 

under RAC.

Quarterly report data are available for all participants with 

some exceptions. For a small percentage of applicants, 

some information on PRA applicants is missing, either 

because this information was unknown or PRA program 

partners did not report it to grantees. Grantees reported 

3,270 applicants to the PRA program. Information on 

type of applicant referral source was unknown for 241 

applicants. Information on disability type was provided 

only for 2,780 applicants, because grantees are required 

only to report the type of disability on an annual basis. 

Grantees and referring partners may also not know the 

disabling condition(s) of applicants. Grantees also did not 

report the housing status at time of application for 217 

applicants.

Finally, data reported to HUD via grantee progress reports, 

TRACS, and iREMS are self-reported by grantees and 

their partners and may include inaccuracies.

Organization of This Report

This report contains nine chapters, organized as follows.

1. This chapter outlines the history of the Section 811 

program leading up to the PRA demonstration and 

summarizes the PRA evaluation efforts. 

2. Chapter 2 provides an overview of the 12 PRA 

demonstration programs, including target populations 

and implementation status. 

3. Chapter 3 describes the grantee partnership 

organization and structure, describes PRA program 

partners’ collaboration to administer the PRA program, 

and identifies challenges that program partners 

experienced in administering the program, as well as 

systems and procedures that appeared to work well. 

4. Chapter 4 examines methods states used to identify 

units for PRA subsidies and recruit owners into 

the program, challenges experienced by grantees, 

and strategies states employ to overcome those 

challenges. 

5. Chapter 5 describes the property contracting 

requirements, presents a profile of the properties 

and units identified for the PRA program, and the 

characteristics (number of bedrooms, accessibility, 

contract rent) of units.

6. Chapter 6 describes the outreach and referral 

processes, including the PRA program application and 

PRA-subsidized unit move-in procedures. The chapter 

also describes the challenges that Medicaid agencies 

and grantees identified as they implemented their PRA 

program outreach procedures and referred eligible 

households to available units. 
HUD Section 811 PRA Program – Process Evaluation

6

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

7. Chapter 7 presents profiles of applicants and residents 

of the PRA program as of June 2016. Applicants are 

described by referral source and the housing status 

that made them a target population. Demographic 

information on residents includes household 

composition, age, income, and income sources. 

8. Chapter 8 reviews the services available to PRA 

residents as they transition to PRA units and through 

ongoing tenancy. 

9. Chapter 9 offers conclusions of the report and 

implications for future research. 
HUD Section 811 PRA Program – Process Evaluation

7

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

Overview of Project 

Rental Assistance 

Demonstration 

Programs

This chapter provides an overview of the 12 Section 811 

Project Rental Assistance grant programs that comprise 

this report. This chapter provides a summary of the 

goals of each state’s PRA program, describes the target 

populations of the 12 programs, and gives an update of 

the implementation status of the grant programs as of 

June 2016.

Overview of Section 811 PRA 

Grants

The initial 12 demonstration round PRA grantees executed 

cooperative agreements with HUD to implement the 

program under its first funding round. The $88,300,377 

in grant funds provided subsidies for an estimated 2,625 

units for nonelderly people with disabilities and extremely 

low-income people during the 5-year grant term. The 

grants range in size from approximately $2 million for 

Montana to more than $12 million for California, Illinois, 

and Texas. The projected number of units to be assisted 

with 811 PRA funding ranges from 81 for Montana to 

732 for Illinois. The average proposed per-unit monthly 

811 PRA subsidy is $458 and ranges widely, from $226 

in Illinois to $1,055 in Maryland (table 2.1). The average 

expected tenant rent contribution is $242 a month.

Table 2.1: Overview of 2012 Section 811 PR A Grant Awards

Grantee Partner Agencies

Total Section 

811 PRA Funds 

Awarded ($)

Section 811 

PRA Units

Average 

Estimated 

per-Unit 

Monthly Rental 

Subsidy ($)

Average 

Estimated 

per-Unit 

Monthly Tenant 

Contribution ($)

California Housing 

Finance Agency

California Health and Human Services Agency, 

California Department of Health Care Services, 

Department of Housing and Community 

Development, California Tax Credit Allocation 

Committee, Department of Developmental 

Services

12,208,558 229 705 288 

Delaware State 

Housing Authority Department of Health and Social Services 5,246,276 148 502 217 

Georgia Housing 

Finance Authority 

Department of Behavioral Health and 

Developmental Disabilities, Georgia Department 

of Community Health,

Georgia Department of Community Affairs

4,279,650 134 441 209 

Illinois Housing 

Authority

Illinois Department of Healthcare and Family 

Services, Illinois Department of Human 

Services, Illinois Department on Aging, Office of 

the Governor

12,324,352 732 226 249 

Louisiana Housing 

Corporation Louisiana Department of Health and Hospitals 8,489,928 199 597 216 

Maryland Department 

of Housing and 

Community 

Development

Maryland Department of Health and Mental 

Hygiene, Maryland Department of Disabilities 11,229,308 150 1,055 180 

(cont)
HUD Section 811 PRA Program – Process Evaluation

8

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

Grantee Partner Agencies

Total Section 

811 PRA Funds 

Awarded ($)

Section 811 

PRA Units

Average 

Estimated 

per-Unit 

Monthly Rental 

Subsidy ($)

Average 

Estimated 

per-Unit 

Monthly Tenant 

Contribution ($)

Massachusetts 

Department of 

Housing and 

Community 

Development

Massachusetts Executive Office of Health and 

Human Services 5,427,208 90 781 255 

Minnesota Housing 

Finance Agency Minnesota Department of Human Services 3,085,500 85 503 240 

Montana Department 

of Commerce

Montana Health and Human Services 

Department 2,057,000 81 351 245 

Pennsylvania Housing 

Finance Agency Pennsylvania Department of Public Welfare 5,870,880 200 378 300 

Texas Department 

of Housing and 

Community Affairs

Texas Health and Human Services Commission 12,342,000 362 478 232 

Washington 

Department of 

Commerce

Washington State Department of Social and 

Health Services, Washington State Housing 

Financing Commission, Washington State 

Health Care Authority

5,739,717 215 354 235 

Total 88,300,377 2,625 458 242

PRA = Project Rental Assistance. 

Source: Fiscal year 2012 cooperative agreements as of March 2015

HUD selected 13 states for the 2012 funding round, 

but only 12 state housing agencies signed cooperative 

agreements with HUD to administer the Section 811 

PRA grant. The North Carolina Housing Finance Agency 

decided not to participate in the program or sign a 

cooperative agreement with HUD. In their 2012 grant 

applications, the 12 states proposed to support 2,968 PRA 

units with the awarded grant funds. The total estimated 

number of PRA units the 2012 grant could support was 

revised to 2,625 units in the cooperative agreements. 

Estimated units were revised in response to additional 

guidance from HUD about how to estimate rental subsidy 

amounts and new information about property locations 

and contract rent levels. Based on information that 

average rental subsidies were higher than expected for 

the first 18 months of the PRA grant, HUD can expect 

the program to fund fewer than the 2,625 estimated to 

be funded in grantee’s cooperative agreement budgets. 

Chapter 5 describes changes some grantees made to the 

estimated number of PRA units that states expect to fund 

with their 2012 grants.

Section 811 PRA Program 

Summaries

The following paragraphs provide overviews of the 12 PRA 

programs that comprise this report.

California. California’s PRA program is a partnership 

among five state agency partners—the California 

Housing Finance Agency, California Tax Credit Allocation 

Committee, the California Department of Housing and 

Community Development, the Department of Health 

Care Services, and the Department of Developmental 

Services. The state received a grant of $12,208,558 to fund 

an estimated 229 PRA units. The PRA program targets 

people in California Community Transitions, the state’s 

Money Follows the Person program since 2007, and others 

eligible for Medicaid services. Two service agencies that 

are under California’s 13-agency Medicaid agency are PRA 

partners—the Department of Developmental Disabilities 

and the Department of Health Care Services that 

administers the state’s Medicaid program and its MFP.

Delaware. The Delaware State Housing Authority, 

partnering with the Delaware Department of Health 

and Social Services, administers Delaware’s Section 

811 PRA program. The state received a fiscal year 2012 

grant of $5,246,276 to fund an estimated 148 PRA units. 

Table 2.1: Overview of 2012 Section 811 PR A Grant Awards (cont)
HUD Section 811 PRA Program – Process Evaluation

9

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

Delaware’s Section 811 PRA program was built off the 

success of its State Rental Assistance Program, which 

launched in 2011. The target populations for the PRA 

program are people with serious and persistent mental 

illness covered under a 2011 Department of Justice 

settlement agreement, people exiting institutions, and 

other individuals identified as at risk of being admitted to 

long-term care facilities. 

Georgia. Olmstead litigation mandates and a U.S. 

Department of Justice settlement agreement drive the 

Georgia 811 PRA program. Partners are the Georgia 

Housing Finance Agency and the Departments of 

Community Affairs, Behavioral Health, Disabilities, and 

Community Health. Target populations are those covered 

by settlement agreements and who have severe and 

persistent mental illness and those eligible for the state’s 

MFP program. The Georgia Housing Finance Agency 

received $4,279,650 in fiscal year 2012 grant funds for an 

estimated 134 units.

Illinois. Illinois designed its 811 PRA program to address 

three Olmstead consent decrees and serve the MFPeligible population. The PRA partners are the Illinois 

Housing Authority, the Departments of Healthcare and 

Family Services, Human Services, and Aging, and the 

Office of the Governor. The Illinois Housing Authority 

received $12,324,352 for 732 units. Target populations are 

people eligible for the MFP program and those covered by 

settlement agreements. For the PRA program, five Lead 

Referral Agents track and process referrals and manage 

their own regional waiting lists under the supervision of 

the statewide housing coordinator housed in the state’s 

Department of Human Services.

Louisiana. Louisiana’s PRA program builds on the 

state’s permanent supportive housing (PSH) program 

developed in response to the 2005 hurricanes in the Gulf 

Coast region. The state received a fiscal year 2012 grant 

of $8,489,928 for 200 units. The PSH program targets 

people with disabilities, who are either homeless or living 

in institutions, and have supportive service needs. PRA 

partners are the Louisiana Housing Corporation and 

the Department of Health and Hospitals. An executive 

management council, made up of representatives from a 

number of state agencies, oversees the program. With the 

PRA grant, Louisiana hoped to expand the PSH program 

from the Gulf region to other parts of state and to address 

priorities in its Ten-Year Plan to End Homelessness and 

the terms of a class action lawsuit settlement under 

Olmstead (Barthelemy v. Louisiana Department of Health 

and Hospitals). 

Maryland. In Maryland, the PRA program partners are the 

Departments of Housing and Community Development, 

Developmental Disabilities, and Department of Health 

and Mental Hygiene. The state received a fiscal year 2012 

grant of $11,229,308 to fund an estimated 150 PRA units. 

Maryland built its PRA program approach on two previous 

programs that provided rental- and project-based 

subsidies for people with disabilities and low-income. 

The Bridge Program that provided temporary tenantbased rental subsidies to assist people until they could 

obtain a housing choice voucher (HCV) and the Weinberg 

Apartments program that provided rental housing in tax 

credit properties. 

Massachusetts. The Massachusetts 811 PRA program 

partners are the Department of Housing and Community 

Development and the Executive Office of Health and 

Human Services. Target populations are MFP participants, 

people living in institutions who are not MFP participants 

but are waiver eligible, people living in institutions who are 

not in MFP and are not waiver eligible, and people living 

in the community and waiver eligible. The state received 

$5,427,208 in the fiscal year 2012 to fund an estimated 90 

PRA units. The Medicaid agency coordinates four offices, 

statewide housing coordinators, and five regional housing 

coordinators to conduct outreach and referral to PRA 

applicants. 

Minnesota. The Minnesota Housing Finance Agency and 

the Department of Human Services, the state Medicaid 

Agency, administers Minnesota’s PRA program. The state 

received a fiscal year 2012 grant of $3,085,500 to fund an 

estimated 85 units. The PRA program built on the state’s 

MFP and Bridges Rental Assistance subsidy programs 

and other supportive housing initiatives for people 

experiencing homelessness and serious mental illness. In 

addition, the state views the PRA program as an important 

source of community-integrated housing to support goals 

an Olmstead class action lawsuit settlement. 

Montana. Partners for Montana’s 811 PRA program are 

the Montana Department of Commerce and the Health 

and Human Services Department. The grantee also 

works closely with the Missoula Housing Authority, which 

oversees a large portfolio of tax credit properties in the 

Missoula area and was an early partner with the state 

housing agency to apply for the PRA grant. The state 

received $2,000,057 in fiscal year 2012 grant funds for 

an estimated 81 units. Montana’s target populations are 

people with physical disabilities or severe mental illness 

who are served by Medicaid waivers or on waiting lists for 

Medicaid waiver services. 

Pennsylvania. The Pennsylvania State Housing Finance 

Agency received $5,870,880 to fund an estimated 200 

PRA units statewide using a decentralized, county-based 

approach. Pennsylvania’s PRA program builds on the 
HUD Section 811 PRA Program – Process Evaluation

10

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

state’s Rental Subsidy Fund, an existing state program 

that provides incentives to developers to build housing for 

extremely low-income people with disabilities. PRA target 

populations are people living in institutions or at risk for 

institutionalization and those in congregate settings who 

want to live in the community. The state began the 811 

PRA program as a pilot in a single county and plans to 

expand. 

Texas. Texas designed its Section 811 PRA program to 

build on the success of its Project Access program that 

uses Section 8 HCVs to assist low-income people with 

disabilities transition from institutions into the community 

by providing access to affordable housing. The state PRA 

Program partners are the Texas Department of Housing 

and Community Affairs and the Health and Human 

Services Commission. Target populations are people with 

disabilities living in institutions who wish to transition to 

the community, people with serious mental illness who are 

engaged in services but facing challenges due to housing 

instability, and youth exiting foster care. The state received 

$12,342,000 in fiscal year 2012 to fund an estimated 362 

PRA units. 

Washington. In Washington, the Department of 

Commerce and Department of Social and Health Services 

are the key PRA program partners. The Department of 

Commerce received a fiscal year 2012 grant of $5,739,717 

for 215 units. The PRA program has regional housing 

program managers who market to owners and coordinate 

housing referrals in three regions. The Bremerton Housing 

Authority administers the PRA rental assistance. The 

Washington Housing Finance Agency and the State Health 

Care Authority (the state Medicaid agency) coordinate 

with the key partners but do not play active roles in 

PRA program management. The 811 PRA fills gaps in 

Washington’s existing housing programs for people with 

disabilities.

Target Populations of the 2012 PRA 

Grants

The target population for the 811 PRA program is 

extremely low-income (household income is less than 

30 percent of a local area’s median income), nonelderly 

persons with disabilities who are at least 18 but less than 

62 years of age at time of admission. Applicants must 

meet HUD’s definition of disability for the 811 program 

(HUD, 2013b).6 PRA residents must also be eligible for 

6 In the Section 811 PRA program, a person with disabilities includes (1) any adult having a physical, mental, or emotional impairment that is 

expected to be of a continued and indefinite duration, substantially impedes his or her ability to live independently, and is of a nature that such 

ability could be improved by more suitable housing conditions; (2) a person with a developmental disability, as defined in Section 102(7) of the 

Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6001(8)); (3) a person with a chronic mental illness; and (4) a person infected 

with the human acquired immunodeficiency virus (HIV) who are disabled as a result of HIV infection. For more information, see the definition of 

disability in Figure 3-6 of HUD’s Occupancy Handbook 4350.3 Rev-1. https://portal.hud.gov/hudportal/documents/huddoc?id=43503c3HSGH.pdf.

a Medicaid home and community-based services or a 

similar plan for community-based long-term services 

and supports. Beyond these basic criteria, grantees may 

establish more specific target populations as long as they 

are in accordance with grantee-approved tenant selection 

policies and federal nondiscrimination laws PRA may be 

used for people who are living in institutions, homeless, 

at risk of institutionalization, or at risk of homelessness. 

Grantees may determine whether and how to prioritize 

outreach and recruitment within these groups.

Grantees took varied approaches to targeting 811 PRA 

resources. Grantees identified PRA target populations 

based on the unmet needs for supportive housing 

of people with disabilities in their states and on the 

opportunities provided by existing state-administered 

supportive housing programs serving people with 

disabilities. Most of the 12 grantees targeted multiple 

disability groups—that is, a combination of people with 

physical, developmental, or mental health disabilities. 

Some grantees prioritized populations covered by courtordered settlement agreements or in required or voluntary 

Olmstead plans. 

All 12 states participate in the Centers for Medicare 

and Medicaid Services’ MFP program. Several states—

California, Delaware, Massachusetts, Minnesota, and 

Washington—prioritize the availability of PRA assistance 

to individuals participating in MFP more than others. 

Most see PRA subsidies as a housing resource for MFP 

participants moving out of institutional care, including 

those covered by legal settlements. 

The target population has implications for the way in 

which state housing and Medicaid agencies administer 

the PRA program in their state. Grantees may have 

different outreach procedures and referral procedures 

for different target populations. For example, identifying 

individuals eligible for the PRA program is vastly different 

if a person lives in an institutional setting versus someone 

experiencing homelessness. Different target populations 

are served under different Medicaid waiver and state 

plan services, and the types and availability of healthcare 

and supportive services vary. Outreach procedures and 

transition services may also vary depending on whether 

PRA applicants are participants in the state’s MFP 

program. 

Table 2.2 presents an overview of the target populations 

for the 12 demonstration programs and priority levels for 
HUD Section 811 PRA Program – Process Evaluation

11

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

those states with priorities. All 12 states target people 

who are institutionalized, and this population is a priority 

in 6 states (California, Delaware, Illinois, Louisiana, 

Massachusetts, and Pennsylvania). All but two grantees 

(Illinois and Texas) target people who are at risk of 

7 California targets people experiencing homelessness with the 2013 811 PRA grant.

institutionalization. All but three grantees (California, 

Illinois, and Texas) target people who are homeless or at 

risk of homelessness.7 The PRA program in Texas also 

targets people exiting foster care. 

Table 2.2: Target Populations of 2012 PRA Demonstration Programs

Grantee Target Population in Order of Priority (if Applicable)

California

1. Individuals residing in inpatient facilities for at least 90 consecutive days, for which Medi-Cal has paid for at least 1 of those days, and 

who are enrolled in the California Community Transitions Money Follows the Person program.

2. Individuals receiving Medi-Cal long-term home- and community-based services waiver or state plan services who are at risk for 

placement in inpatient facilities.

Delaware

1. Individuals exiting the Delaware Psychiatric Center, with serious and persistent mental illness, or both. 

2. Individuals exiting institutions, with emphasis on Money Follows the Person participants.

3. Identified as at risk of being admitted to long-term care facilities.

Georgia • Eligible under the settlement agreement and who have serious and persistent mental illness.

• Eligible under the State of Georgia’s Money Follows the Person program.

Illinois

• Williams class action lawsuit members.

• Colbert class action lawsuit members.

• Ligas class action lawsuit members. 

• Money Follows the Person participants.

• Persons moving from state-operated developmental centers to the community.

Louisiana

1. Persons who are inappropriately institutionalized.

2. Homeless persons. 

3. Persons who are at risk of homelessness (including those living in transitional housing for persons who are homeless) and persons at risk 

of institutionalization.

Maryland

1. Institutionalized Medicaid recipients.

2. Households at risk of institutionalization due to current housing situation.

3. Developmental Disabilities Administration Community Pathways Waiver participants moving from group home and alternative living 

units to independent renting and Mental Hygiene Administration Residential Rehabilitation Programs participants moving to independent 

renting.

4. Homeless persons who are Medicaid recipients, prioritized in HEARTH Act of 2009 definition order. 

Massachusetts

• Money Follows the Person participants.

• Persons in institutions, not Money Follows the Person, waiver eligible.

• Persons in institutions, not Money Follows the Person, not waiver eligible.

• Persons in the community, waiver eligible.

Minnesota

• Individuals experiencing long-term homelessness who have a serious mental illness. 

• Individuals with physical or mental disabilities exiting institutional settings after long-term stays (90 days or more) and are assisted by 

Minnesota’s Money Follows the Person program.

Montana • People with physical disabilities served by Medicaid waivers or on waiting list for Medicaid waivers. 

• People with severe mental illnesses served by Medicaid waivers or on waiting list for Medicaid waivers.

Pennsylvania

• Persons institutionalized but able to live in the community with permanent supportive housing.

• Persons at risk of institutionalization without permanent supportive housing.

• Persons living in congregate settings, who desire to move to the community.

Texas

• People with disabilities living in institutions who wish to transition to the community. 

• People with serious mental illnesses who are engaged in services but facing challenges due to housing instability. 

• Youth exiting foster care. 

Washington

• Individuals served through the Roads to Community Living (Money Follows the Person) Project.

• Individuals with developmental disabilities served through the Developmental Disabilities Division.

• Individuals with functional disabilities served through the Home and Community Services Division.

• Individuals with mental illnesses served through the Division of Behavioral Health and Recovery.

HEARTH = Homeless Emergency Assistance and Rapid Transition to Housing. PRA = Project Rental Assistance.
HUD Section 811 PRA Program – Process Evaluation

12

Chapter 2. Overview of Project Rental Assistance Demonstration Programs

The following examples illustrate the manner in which 

grantees identified targeting priorities to address 

programmatic or policy priorities in their states.

Expanding existing supportive housing initiatives. 

Louisiana planned to expand its PSH program, which 

had originally been established to respond to the critical 

housing needs of vulnerable people that arose after 

Hurricane Katrina devastated the Gulf Coast region in 

2005. The PSH program serves populations similar to 

those targeted in the 811 PRA program. Louisiana saw the 

811 PRA grant as a way to expand the PSH program to the 

central and northern parts of the state. 

In Texas, the grantee wanted to build on the success of its 

Project Access program and provide more housing choice 

for persons with disabilities. The Project Access program 

uses Section 8 HCVs administered by the state housing 

agency to assist low-income persons with disabilities 

transition from institutions to the community by providing 

access to affordable housing. At the time of the evaluation 

site visit, Project Access had 175 persons on its waiting 

list. The 811 PRA grant will help the state address this 

unmet housing need.

Addressing homelessness. In Minnesota, the grantee 

integrated PRA resources with programs for people 

experiencing homelessness, including the state’s MFP 

program and their Projects for Assistance in Transition 

From Homelessness (PATH) grants to counties. PATH 

and MFP staff coordinate with the 811 PRA program’s 

housing coordinator to engage people experiencing 

long-term homelessness. The housing coordinator serves 

as an intermediary between homeless clients, MFP or 

PATH caseworkers, and properties with 811 PRA units to 

facilitate housing placements.

Meeting the housing needs of members of groups 

covered by legal settlements. Several states (Delaware, 

Georgia, Illinois, and Maryland) target PRA resources 

to members of groups covered by legal settlements 

under Olmstead or other laws. For example, in Georgia, 

the target population includes people with serious and 

persistent mental illness who are currently being served 

in state hospitals, who are frequently seen in emergency 

rooms, who are chronically homeless, who are being 

released from jails or prisons, or who are experiencing 

some combination of these factors. Illinois has three 

Olmstead consent decrees, creating a substantial need 

for community-based housing options for people living 

in institutions. The state committed to conduct outreach, 

evaluate, and offer community placement to approximately 

33,000 persons currently residing in institutions.

In Delaware, a settlement agreement created a need for 

more housing units in the community for people with 

severe mental illness. This target population became the 

first priority for Delaware’s PRA program. In Maryland, the 

city of Baltimore is under a consent decree as a result of a 

settlement agreement in the 2004 housing discrimination 

lawsuit. The agreement requires the city of Baltimore to 

provide housing vouchers and other accommodations to 

persons with disabilities. To address this need, Maryland 

directs part of 811 PRA program resources to Baltimore.
HUD Section 811 PRA Program – Process Evaluation

13

Chapter 3. Project Rental Assistance Partnerships

Project Rental 

Assistance 

Partnerships

The goal of the Section 811 Project Rental Assistance 

program is to create effective, successful, and sustaining 

partnerships between state housing or other appropriate 

housing agencies and state health and human service 

or Medicaid agencies. In some of the 12 states involved 

in this evaluation, housing and Medicaid agencies had 

some history of working together, but in others, the 

partnership was newly created for the 811 PRA program 

or another recent initiative. In either case, the 811 PRA 

program required partners to work together to establish 

and implement a new and complex approach to delivering 

affordable rental housing to nonelderly persons with 

disabilities. 

This chapter describes the partnerships established 

for the program and early lessons from the partners’ 

implementation efforts. The key research questions on 

partnership are—

• What were the planned roles and responsibilities 

across partner agencies as described in grantees’ 

applications? 

• Did the roles change during implementation? If so, 

what changes occurred and why? 

• How are partner agencies held accountable? 

This chapter describes the partnership structures across 

the 12 811 PRA grants, reviews the partners’ previous 

experiences working together, examines partnership 

practices that support collaboration, and reviews grantee 

experiences with the level of effort required to implement 

the 811 PRA program.

Overview of PRA Partnership 

Organization and Structure

The 811 PRA program requires a partnership between a 

state housing agency and the state Medicaid agency. The 

distribution of program responsibilities across the two 

agencies was generally similar among the 12 states and is 

summarized in table 3.1.

Table 3.1: Standard Division of PR A Program Responsibilities 

Between State Housing and Medicaid Agencies

State Housing Agency State Medicaid Agency

• Identify or finance eligible units for Section 811 PRA program.

• Execute Rental Agreement Contracts with property owners.

• Perform outreach to developers and property owners.

• Monitor Section 811 PRA program unit occupancy and compliance with 

eligibility requirements.

• Make rental payments to property owners.

• Collect and report required occupancy and financial information. 

• Conduct ongoing communication with state health and human services or 

Medicaid agency and housing providers.

• Recruit and collaborate with direct service providers responsible for 

implementing the program.

• Oversee referral process in collaboration with direct service providers.

• Provide outreach, training, and technical assistance to direct service providers.

• Monitor processes on prioritizing individuals for housing placement.

• Monitor processes for ensuring residents have necessary access to housing and 

support services.

• Collect and report data on service delivery, costs, and outcomes. 

• Conduct ongoing communication with state housing agency, direct service 

providers, and housing providers.

PRA = Project Rental Assistance.

Sources: Interagency Partnership Agreements; field interviews with staff from grantees and state Medicaid agencies

Table 3.2 shows the partner agencies in each state, and 

where pertinent, examples of their previous experience 

working together on similar initiatives. In most states, 

one state housing agency partnered with the state’s lead 

Medicaid agency. In a few states, multiple partners existed 

for one or both areas, as shown in the middle column. For 

example, in California, housing functions are distributed 

across several agencies. The California Housing Finance 

Agency is the 811 PRA grantee, but the California 

Tax Credit Allocation Committee and the California 

Department of Housing and Community Development 

both play roles as well. As discussed in more detail in 

chapter 4, the grantee as the tax credit allocation agency 

can play an important role in a state’s ability to secure 

units for the 811 PRA program.
HUD Section 811 PRA Program – Process Evaluation

14

Chapter 3. Project Rental Assistance Partnerships

Table 3.2: Grantee and Partnering Agencies and Their Previous Experience

Grantee Partner Agencies

Previous Experience With Housing or Services 

for People With Disabilities

California Housing Finance 

Agency

California Health and Human Services Agency, California 

Department of Health Care Services, Department of Housing 

and Community Development, California Tax Credit Allocation 

Committee, Department of Developmental Services

No previous experience working together. Each had previous 

experience with housing and providing services.

Delaware State Housing 

Authority Department of Health and Social Services Previous experience administering the State Rental Assistance Program, a program for low-income people with disabilities. 

Georgia Housing Finance 

Authority 

Department of Behavioral Health and Developmental Disabilities, 

Georgia Department of Community Health, Georgia Department of 

Community Affairs

General experience with community-based supports.

Illinois Housing Authority

Illinois Department of Healthcare and Family Services, Illinois 

Department of Human Services, Illinois Department on Aging, 

Office of the Governor

Previous experience with Money Follows the Person and Olmstead 

Consent Decrees. 

Louisiana Housing 

Corporation Louisiana Department of Health and Hospitals Previous experience administering the state’s Permanent Supportive Housing program developed in 2007. 

Maryland Department of 

Housing and Community 

Development

Maryland Department of Health and Mental Hygiene, Maryland 

Department of Disabilities 

Previous experience with two programs that provide rental 

subsidies to low-income people with disabilities. 

Massachusetts Department 

of Housing and Community 

Development

Massachusetts Executive Office of Health and Human Services Previous experience transitioning people with disabilities from 

institutional settings into the community. 

Minnesota Housing Finance 

Agency Minnesota Department of Human Services

Previous experience with Bridges rental subsidy program, as well 

as Olmstead plan, Money Follows the Person, and Plan to End 

Homelessness, and targeting people who are homeless with severe 

mental illness. 

Montana Department of 

Commerce Montana Health and Human Services Department Agencies previously partnered with each other on Shelter Plus Care program developed in 2007.

Pennsylvania Housing 

Finance Agency Pennsylvania Department of Public Welfare

Previous experience through a program that used developers’ 

fees to produce affordable housing for low-income people with 

disabilities. 

Texas Department of 

Housing and Community 

Affairs

Texas Health and Human Services Commission

Previous experience on the Project Access Program, which 

partners the State’s Money Follows the Person program and 

housing choice vouchers for people with disabilities. 

Washington Department of 

Commerce

Washington State Department of Social and Health Services, 

Washington State Housing Financing Commission, Washington 

State Health Care Authority

Previous experience working with housing authorities on Non 

Elderly Disabled vouchers. Additional experience with outreach or 

referral mechanisms for institution-to-community transitions. 

Sources: Grantee applications; field interviews with grantees and Medicaid agencies

On the Medicaid side, each state has a lead Medicaid 

agency, known as the single-state agency, but other 

agencies may administer Medicaid-funded activities, 

often based on beneficiary type (for example, elderly, 

people with developmental disabilities, people with mental 

health issues). In California, the Department of Health 

Care Services is the official Medicaid partner, although 

the Department of Developmental Services is also a key 

partner, because one of the 811 PRA program’s target 

populations is people with developmental disabilities. 

The primary housing and Medicaid partners in Georgia, 

Illinois, Maryland, and Washington similarly worked with 

other services agencies on the health side, as shown in 

the table. 

As the final column of table 3.2 shows, partner agencies 

often have some experience working on similar initiatives 

serving similar populations. In some cases, key staff 

had previously collaborated on other supportive housing 

initiatives and programs for people with disabilities, 

including developing and administering supportive 

housing rental subsidy programs or housing development 

programs for people with disabilities or other vulnerable 

populations. Previous collaboration often meant the 

partners had mechanisms to identify eligible applicants 

that could be adapted to the 811 PRA program, as well 

as knowledge of where people live, where the need for 

housing is, and the extent of need by type of disability 

among the state’s 811 PRA target populations. 
HUD Section 811 PRA Program – Process Evaluation

15

Chapter 3. Project Rental Assistance Partnerships

Many state Medicaid agencies had already developed 

outreach and referral mechanisms for transitioning people 

out of institutional care as part of their participation in the 

Money Follows the Person program. Grantees in Illinois, 

Minnesota, and Washington developed their PRA program 

based on procedures that were already in place for the 

MFP program and often relied on MFP-funded staff to play 

key roles in outreach, referrals, and transition services. 

Some grantees identify MFP participants as their priority 

or only target population for the 811 PRA program. 

Delaware and Washington had established previous 

outreach and referral systems for other state programs 

targeted specifically to people with disabilities or people 

experiencing homelessness. In addition, the Washington 

state Medicaid agency had experience working with 

local public housing agencies to issue HUD’s nonelderly 

disabled vouchers, a program serving a target population 

very similar to those served in the PRA program. The 

Montana Department of Commerce’s Housing Assistance 

Bureau and the Mental Health Services Bureau within 

the Medicaid agency had previously worked together 

on HUD’s Shelter Plus Care program, providing housing 

subsidies for people with disabilities who were chronically 

homeless. 

Previous experience with supportive housing programs 

was the most applicable to the new 811 PRA program. 

Some states were already administering programs very 

similar to the 811 PRA. For example— 

• Minnesota’s Section 811 PRA partnership is built on 

several existing programs targeting people who are 

homeless and have severe mental illness. Beginning 

in the 1990s, Minnesota’s housing finance and 

Medicaid agencies collaborated on the Bridges Rental 

Assistance Program, a state-funded program that 

provides interim supportive housing subsidies for 

people with severe mental illness who are waiting for 

other long-term rental subsides. Louisiana modeled its 

Section 811 PRA program on its permanent supportive 

housing program, which was implemented through a 

partnership between the state’s housing finance and 

Medicaid agencies. The state agencies established 

the PSH program in 2007 to provide stable housing for 

people with disabilities and supportive service needs in 

response to the devastation of Hurricanes Katrina and 

Rita in the Gulf Coast region. The Louisiana partners 

saw the Section 811 PRA program as a way to serve 

similar households in the northern and central regions 

of the state. 

• In Pennsylvania, the state housing finance and 

Medicaid agencies developed partnerships around 

supportive housing programs for both elderly and 

nonelderly people with disabilities, most notably 

through the Rental Subsidy Fund initiated in 2005. 

Pennsylvania’s Section 811 PRA program is modeled 

after this program, through which the housing finance 

agency uses developer fees to create units affordable 

to households with incomes at or less than 20 percent 

of Area Median Income (AMI).

How 811 PRA Partners Collaborate 

Given the complexity of the 811 PRA program and its 

novel structure compared with most affordable rental 

housing programs, partner agencies had to make a lot 

of decisions, solve problems as they arose, and adapt 

the program over time. The grantees tried to accomplish 

these goals by establishing clear roles and responsibilities, 

setting up mechanisms for communication, cross-training 

staff, and undertaking tasks collaboratively. 

Structures To Support Collaboration

Each state developed structures and procedures for 

collaboration (or adapted existing ones) that worked 

for them. It was too early in the implementation period 

to determine which practices were most successful in 

accomplishing the 811 PRA’s ultimate goals of securing 

units and housing eligible residents, but here, we offer 

some examples of practices that these early grantees 

found promising. 

Pennsylvania envisions a statewide 811 PRA program but 

began with a pilot program in one county. The housing 

finance and Medicaid agencies worked together on the 

application approach and program design and structure, 

and they collaborated on decisions related to Section 

811 PRA program implementation. In addition, both 

agencies conducted outreach and marketing to encourage 

participation in the Section 811 PRA program. As a result, 

both agencies feel a shared responsibility for the role 

of grantee, meeting weekly to review issues and track 

progress on the Section 811 PRA program. 

In Washington, the housing and Medicaid agencies work 

together as a team, making most major decisions together 

on both the health and housing issues. In addition, 

Washington conducts cross training between departments 

to bring together housing and health staff in dialogue 

around key issues and necessary training. 

In several states, housing and Medicaid agencies 

undertake 811 PRA program tasks together. Staff from 

state housing and Medicaid agencies jointly conduct 

outreach to property owners to encourage interest in the 

PRA program and to educate owners about the program’s 

target populations. Other tasks shared by cross-agency 

teams are reviewing owner applications for 811 PRA 

assistance, training service providers, and monitoring and 

reporting. 
HUD Section 811 PRA Program – Process Evaluation

16

Chapter 3. Project Rental Assistance Partnerships

Communication

Grantees reported that effective communication between 

partner agencies is critical to share information and 

resolve problems. The states used a variety of means to 

coordinate activities, resolve issues, and communicate 

progress among the partners. Nine grantees report using 

in-person meetings, 10 use email, and 7 use systems for 

document sharing. 

In most states, partners meet monthly or every 2 weeks, 

in person or by telephone. In California, partner agencies 

initiated regular meetings after the grant was awarded but 

before the cooperative agreement had been signed and 

continued them thereafter. California partner staff report 

that this preplanning contributed to California moving 

the country’s first residents into 811 PRA funded units. 

Pennsylvania meets weekly to address problems and 

monitor progress, and Illinois partners meet every 2 weeks 

to review progress and discuss program adjustments.

In addition to meetings, staff reported that documentsharing platforms such as SharePoint are an effective 

communication tool, along with other software programs 

that facilitate sharing documents and data. For example, 

California noted the state has a system that enables 

multiple agencies to concurrently review property owner 

applications for 811 PRA assistance. Some grantees 

developed data sharing systems to share applicant and 

participant data between partners. In Delaware, both 

housing and health agencies use the same systems 

(SocialServe and PAIR) to determine eligibility for 811 PRA 

assistance. 

Cross-Agency Entities for Program 

Coordination

Some of the grantees have cross-agency committees 

that provide oversight and coordination. For example, 

Louisiana developed an executive management council 

that meets monthly to make program and property 

selection decisions, resolve disputes, and monitor the 

program. In Illinois, an interagency panel chaired by the 

statewide housing coordinator (housed in the governor’s 

office) convenes several housing and Medicaid-related 

agencies to make sure the referral process and service 

delivery systems are working effectively. 

Financial and Staffing Resources

Section 811 PRA program responsibilities were distributed 

across staff in the housing and health agencies, as well 

as staff from other program partners. The 2012 notice of 

funding availability allowed for up to 5 percent of the grant 

to be used for administrative costs. HUD increased the 

allowable administrative fee to 8 percent in cooperative 

agreements with grantees.

Grantees commonly reported that the program required 

more time and resources than expected. In NOFA 

responses, grantees estimated the expected level of effort 

for the program in full-time equivalents. The estimates 

ranged from 1.1 full-time equivalent in Delaware to 7.65 

full-time equivalents in Illinois. During field visits, the 

evaluation team asked partner staff to estimate the level 

of effort actually required in the first year of the program. 

Most reported the level of effort was higher than expected 

but were unable to quantify the difference. Four grantees 

did provide an estimate, and the estimates were much 

higher than the estimates in the NOFA responses. 

Maryland originally estimated staff investment at 4.25 fulltime equivalents but reported an estimate of 6.75 full-time 

equivalents after implementation, noting that the Section 

811 PRA program will cost the agencies a combined $2 

million to operate (versus the approximate $900,000 in 

administrative funds available through the 2012 grant). 

Grantees were asked if, after more than a year of program 

implementation, they still felt the Section 811 PRA program 

required a higher level of effort than originally expected. 

This question was to determine if the increased effort 

was only for startup or continued throughout program 

implementation. Of the 12 states, 7 states reported that 

staff investment still exceeded their expectations, 3 states 

reported they were unsure, 1 state reported that the level 

of effort was no longer higher than expected, and 1 state 

did not report.

This study did not collect detailed data on program costs, 

but it is clear that 811 PRA grantees must identify other 

resources beyond the PRA grant to cover some costs of 

the program. In at least five states, Medicaid agencies 

are not receiving any of the Section 811 administration 

fee. The MFP grant may pay for staff time working on 

the Section 811 program. In many states, MFP grants 

funded housing coordinator positions to help facilitate the 

transition of individuals from institutions to communitybased settings. In some states, MFP-funded housing 

coordinators play an essential role in the PRA program by 

helping to market the program to owners, to identify where 

housing is needed, and in matching eligible applicants 

to available PRA units (chapter 6 describes the role of 

housing coordinators in the PRA program.). MFP funding 

is time-limited, however, and states have only until 2020 

to expend MFP grant funds. Some states are particularly 

concerned about ways to fund housing coordinator 

positions after MFP ends. One option is for states to 

incorporate housing-related activities and services into 

state Medicaid waivers to support community integration 

for individuals needing long-term services and supports 

(CMS, 2015).
HUD Section 811 PRA Program – Process Evaluation

17

Chapter 3. Project Rental Assistance Partnerships

Conclusion

In general, the 12 states funded in the inaugural round of 

811 PRA grants established or strengthened partnerships 

between housing and Medicaid agencies and developed 

policies and procedures to launch the program. Other 

chapters in this report address in more detail the ways in 

which the 811 PRA partners in each state carry out their 

roles. The complexity and novelty of the program proved 

challenging, requiring substantially more staff and financial 

resources than the grantees expected, especially in the 

first year. Lessons from the early implementation include—

• The 811 PRA program necessitates ongoing 

communication and collaboration between partners. 

In addition to meetings, staff reported that documentsharing platforms such as SharePoint are an effective 

communication tool, along with other software 

programs that facilitate sharing documents and data. 

• In several states, housing and Medicaid agencies 

undertake 811 PRA program tasks together, 

necessitating learning a common language and 

training the other agency on their areas of expertise. 

Jointly conducted PRA program activities by staff from 

state housing and Medicaid agencies are outreach 

to property owners to encourage interest in the PRA 

program, reviewing owner applications for 811 PRA 

assistance, training service providers, and monitoring 

and reporting for grant compliance.

• Housing and Medicaid partners with previous 

experience working together had an advantage in 

launching the program more quickly. State agencies 

that had previously worked together to administer 

supportive housing programs typically had established 

mechanisms for communication between agencies, 

had a greater understanding of their target populations, 

and had existing outreach procedures, systems, 

applicant pools, and waiting lists that could be adapted 

for the PRA program.

• Grantees commonly reported that the program 

required more time and resources than expected, and 

most (7 out of 12) reported that administrative tasks 

continued to take longer than expected a year after 

PRA programs started. 

• Sustaining program staffing is a concern in Medicaid 

agencies given the expiration of MFP grants that 

fund staff and services in many states to help 

individuals who are transitioning out of institutions into 

community-based housing. To keep funding these 

activities, states may need to consider changes to their 

Medicaid waiver programs to incorporate housingrelated activities and services and supports as eligible 

Medicaid waiver expenses.

The Phase II evaluation will continue to follow the progress 

of a subset of these grantees and will assess more 

indepth the nature of the partnerships and the outcomes 

of the partners’ efforts. Partnerships will be evaluated 

under a core set of categories—leadership, financial and 

nonfinancial resources, collaboration, decisionmaking, 

and sustainability. The second phase will also include a 

more detailed cost analysis to explore 811 PRA program 

costs compared with other programs that serve similar 

populations.
HUD Section 811 PRA Program – Process Evaluation

18
HUD Section 811 PRA Program – Process Evaluation

19

Chapter 4. Property Selection

Property Selection

The goal of the Section 811 Project Rental Assistance 

program is to provide appropriate, affordable housing for 

persons with disabilities that is integrated in multifamily 

developments serving people with and without disabilities. 

This chapter examines how state housing agencies 

identify units for 811 PRA and enter into long-term rental 

agreements with property owners. 

The chapter describes grantee strategies to secure 

units in both new and existing housing and in specific 

geographic areas. The chapter describes strategies that 

grantees perceive as most effective for identifying units 

for PRA subsidies, as well as challenges in identifying 

eligible owners and properties and in obtaining owner 

participation. This chapter reviews the financing incentives 

and marketing tools grantees used to attract owners, the 

challenges encountered, and the strategies and tools used 

to address the challenges.

Property Targeting Approaches: 

New Versus Existing Properties

Grantees were required to recruit owners of existing 

or new (to be constructed), affordable multifamily 

developments who were willing to allocate units to 

the 811 PRA population. According to the 811 PRA 

grantees’ notice of funding availability responses, most 

expected to contract with owners of a mix of new and 

existing properties. Each strategy has both benefits and 

disadvantages. The rationale for recruiting owners of new 

properties is that the units are newly coming on line, and 

thus, many could be available for occupancy at one time. 

The downside is that the properties need to be built first, 

a process that takes time (sometimes years). Existing 

properties do not present the problem of construction 

delays, but units are likely occupied and not available to 

811 PRA residents until resident turnover.

In their 811 PRA NOFA responses, grantees described the 

ways in which they expected to recruit property owners 

for the program. Some revised their strategies over time 

to address the challenges in recruiting interested owners 

with suitable properties. Table 4.1 shows grantees’ original 

plans as presented in their NOFA responses and their 

strategies as of June 2016, when researchers completed 

data collection for this study. All but three grantees 

(Delaware, Minnesota, and Montana) initially planned 

to recruit owners of both new and existing properties. 

Delaware added new properties through the state’s tax 

credit awards because of concerns of limited turnover 

in existing properties that would slow the ability to place 

eligible 811 PRA applicants in housing. Over time, Georgia 

and Maryland chose not to recruit existing properties for 

the same reason. 

Table 4.1: Targeted Versus Actual Property Recruitment Strategies

Targeted (Grant Application) Actual (June 2016)

State New Existing New Existing Comments

California X X X X Unchanged

Delaware X X X Added new

Georgia X X Xa Removed existing

Illinois X X X X Unchanged

Louisiana X X X X Unchanged

Maryland X X Xa Removed existing

Massachusetts X X X X Unchanged

Minnesota X X Unchanged

Montana X X Unchanged

Pennsylvania X X X X Unchanged

Texas X X X X Unchanged

Washington X X X X Unchanged

a

 Includes rehabilitated.

Sources: 2012 Section 811 Project Rental Assistance Notice of Funding Availability responses; field interviews with grantee staff
HUD Section 811 PRA Program – Process Evaluation

20

Chapter 4. Property Selection

In the remainder of this chapter, we review the specific 

strategies grantees used to recruit owners, the challenges 

encountered, and the ways grantees adapted their 

strategies to secure units for the program. 

Strategies To Recruit Owners of 

New Properties

Grantees recruited owners of new properties primarily 

through incentives in the state’s affordable housing 

financing programs. Approaches include creating 

incentives in awards for low-income housing tax credits 

and other housing financing programs for owners to 

allocate PRA subsidies to a portion of units in their 

properties and making subsidies available through a 

NOFA, either as a one-time competitive allocation or on a 

rolling basis. 

Incentives for Tax Credits and Other Housing 

Funding Awards

The LIHTC is the nation’s largest financing source for the 

development of affordable housing, funding approximately 

2.8 million housing units since 1997. Many states already 

include incentives to property developers to build 

affordable supportive housing or housing for persons with 

disabilities through the state’s Qualified Allocations Plans 

(QAPs), which outline the state’s selection criteria for 

distributing tax credits. 

As discussed in chapter 5, all properties with units under 

Rental Assistance Contract as of June 2016, were funded 

at least in part by tax credits. Some states could target 

their QAP special population priorities to PRA subsidies or 

otherwise provide incentives for developers to set aside a 

percentage of the units in a property specifically for PRA. 

Creating incentives in state QAPs for PRA units was a 

primary tool for grantees to secure units under contract for 

PRA. 

Table 4.2 summarizes the extent to which each state’s 

QAP includes any incentives for the Section 811 PRA 

program specifically or incentives for housing to assist 

special needs populations in general. One-half of the 

2012 grantees had QAPs that gave preference, points, 

priority, or required an applicant for tax credit funds to 

participate in the 2012 811 PRA program. Five states gave 

a preference, priority, or required a tax credit applicant to 

participate or serve persons with disabilities in programs 

in general. 

Table 4.2 : Q A P Preferences and S trategies To Improve Unit Production 

QAP Incentives (Points, Priorities, or Preferences)

State For Section 811 PRA For Housing for Persons With Disabilities in General

California No

A 4-percent set-aside for projects where at least 50 percent of 

the units serve special needs populations, including persons with 

disabilities. A 10-percent set-aside for projects serving homeless 

persons.

Delaware Points for projects that set aside at least five units for the Section 811 

PRA program. No

Georgia Not at the time of the field visit but will going forward. Points for projects offering units for persons with disabilities.

Illinois Not specifically for PRA but PRA is eligible for general QAP priorities. 

Developers can earn up to 10 points for allocating units to underserved 

populations for six underserved populations, including low-income 

persons with disabilities.

Louisiana

PRA is eligible for PSH priority points. In 2017, points for participating 

in PSH were increased for projects that agree to a 25-percent setaside.

Points to developers who set aside 5 to 10 percent of the project units 

for the state’s PSH program.

Maryland Yes—compatible with PRA.

Requires that developers temporarily restrict 5 percent of units for 

persons with disabilities. Additional points for restricting 25 percent of 

the units for persons with disabilities.

Massachusetts None specified. Points for offering units for people who are homeless and persons with 

disabilities.

Minnesota None specified. Extra points for agreeing to incorporate PSH units into the development 

and for projects that provide units for people with certain disabilities.

Montana No 10 points awarded for each 5 percent of the units targeted for person 

with disabilities.

(cont)
HUD Section 811 PRA Program – Process Evaluation

21

Chapter 4. Property Selection

QAP Incentives (Points, Priorities, or Preferences)

State For Section 811 PRA For Housing for Persons With Disabilities in General

Pennsylvania

All else being equal, a developer who expresses interest in the Section 

811 PRA program is given preference in receiving low-income housing 

tax credits, or LIHTCs.

Yes

Texas Requires developers to allocate 10 units per project for PRA or no more 

than 18 percent of the total units in property. No

Washington No

Points for a project that sets aside 20 percent of the units for persons 

with disabilities. Developments can earn maximum points by setting 

aside 75 percent of the units for supportive housing for people 

experiencing homelessness. 

LIHTC = low-income housing tax credit. PRA = Project Rental Assistance. PSH = permanent supportive housing. QAP = Qualified Allocation Plan.

Sources: 2015–2016 grantee interviews; states’ Qualified Allocation Plans

Adding New QAP Incentives for PRA

Three states were able to specifically add incentives for 

participating in the 811 PRA program. In all these states, 

the grantee is also the tax-credit allocating agency and 

has the authority to develop priorities in the state QAP.

Delaware State Housing Authority (DSHA) had intended 

to locate PRA units in existing developments, but did not 

receive many eligible responses from their open owner 

application process. Before 2014, all properties had to 

allocate 5 percent of their units for special populations, 

which were broadly defined and could include veterans, 

people experiencing homelessness, and people with 

disabilities. Due to the low response to the intent-toparticipate form, DSHA established points in the 2014, 

2015, and 2016 QAPs for Section 811 units in new and 

rehabilitated properties. Applicants received up to 3 points 

for accepting an allocation of PRA subsidies. As a result, 

as of June 2016, DSHA had identified 97 of its 148 PRA 

units in 17 properties. Maryland’s housing finance agency 

modified its QAP to encourage property developers to 

participate in the 811 PRA program. Property developers 

may earn bonus points in their applications if they agree 

to restrict up to 25 percent of the units in the property for 

persons with disabilities who have incomes at or less than 

50 percent of Area Median Income. 

Originally, Pennsylvania’s 811 PRA program application 

stated that it intended to obtain units for its 811 PRA 

program from units newly developed using LIHTC 

allocations from the 2011 through 2013 allocation rounds. 

The housing agency discovered that far fewer developers 

were interested in participating in the program than 

expected and, as a result, implemented preferences in 

its subsequent QAP for tax credit awards. Although the 

housing agency is not technically awarding points, if 

two developers submit applications that score exactly 

the same and one expressed an interest in the 811 PRA 

program, that developer would be given preference in 

receiving tax credits and would be required to provide 

units for 811 PRA program residents.

Using Existing QAP and Other Incentives To 

Encourage PRA Units

Several grantees’ QAPs already had incentives that 

encouraged new developments for special needs 

populations and were able to use these incentives to 

identify units for the PRA program. In two states, grantees 

were able to identify PRA units through existing incentives 

in the state QAP. In Louisiana, PRA is part of the state’s 

permanent supportive housing program focusing on the 

northern part of the state. Louisiana’s QAP, beginning in 

2007, provides points to LIHTC applications when those 

responsible for operating the tax-accredited projects 

agree to participate in the PSH program by allocating 

5 to 10 percent of the project’s units to PSH-eligible 

applicants. In 2017, the Louisiana tax credit agency will 

increase the points for projects that agree to a 25 percent 

set-aside and give preference to the development of 

one-bedroom units, a particular need in Louisiana’s PRA 

program.

In Illinois, a statewide comprehensive housing initiative, 

created under the Illinois Comprehensive Housing 

Planning Act, sets aside approximately 16 percent of tax 

credit funds to encourage development of housing for six 

underserved populations, including low-income persons 

with disabilities and persons who are homeless or at-risk 

of homelessness. Developers can earn up to 10 points 

for allocating units to the Statewide Referral Network, a 

housing resource set up to link vulnerable populations 

who are already connected to services to affordable and 

available housing. 

Even if state QAP plans do not include a preference 

specifically for the PRA program, all state QAPs include 

some general preference for people with disabilities or 

Table 4.2: QAP Preferences and Strategies To Improve Unit Production (cont)
HUD Section 811 PRA Program – Process Evaluation

22

Chapter 4. Property Selection

include people with disabilities as an eligible population 

under more general special population incentives. State 

QAPs in Massachusetts, Minnesota, and Montana all 

include general priorities for property development for 

people with disabilities but do not include any incentives 

directly for owners to accept PRA subsidies. 

In addition to the LIHTC program, some states have 

additional funding mechanisms for affordable housing 

and for supportive housing or housing for people with 

disabilities specifically. Although California was unable 

to allocate tax credit points for the 811 PRA program, 

California was able to incorporate points into a state 

bond-funded Multifamily Housing Program (MHP), which 

provides financing for the construction, rehabilitation, or 

preservation of rental housing for low-income households. 

In 2015, the California Department of Housing and 

Community Development made available $47.5 million in 

MHP funds and included priority points for properties that 

include at least five PRA units in the funding application. 

As a result, six applications for the MHP requested 

funding for 811 PRA units, and MHP funds were awarded 

to three properties for 15 PRA units. 

Challenges to Recruiting Owners 

Through QAP Incentives 

Grantees encountered a number of challenges 

to recruiting owners of new properties, including 

disincentives to participating inherent in the program’s 

statutory regulations or grant requirements and the 

availability of affordable housing not always matching 

locations where needs exist or where services and 

supports are available and accessible. In some states, the 

grantee is not the same agency that allocates tax credits 

and does not have the authority to establish priorities 

for the PRA program in tax credit competitions. In some 

states, the grantee does not have authority for statefunded housing programs.

QAP incentives misaligned with the PRA program. In 

some states, the state’s general housing priorities were 

not aligned with the integration goals for the Section 

811 PRA program. For example, PSH developed under 

the LIHTC program is often specifically for people who 

experience homelessness. This group may include people 

with disabilities, but the units are not specifically set aside 

for that population. In addition, supportive housing priority 

points are often awarded only when owners set aside a 

minimum percentage of units in a property for supportive 

housing. The threshold typically exceeds the 811 PRA 

program regulation that limits the number of supportive 

housing units for people with disabilities to 25 percent for 

one property. 

In Washington, the QAP includes points for projects 

that set aside at least 20 percent of units for people with 

disabilities, but developers can earn maximum points 

by setting aside 75 percent of the units for supportive 

housing for people who experience homelessness. The 

California state QAP includes a 10 percent set-aside 

for projects exclusively serving people who experience 

homelessness and a 4 percent set-aside for projects 

that allocate at least 50 percent of units to special needs 

populations, including people with disabilities. Because 

both set-asides for maximum points exceed the 811 PRA 

program’s 25-percent maximum of units for people with 

disabilities or supportive housing, generally only those 

projects that do not apply for tax credits under the special 

needs or homeless set-asides can qualify for the 811 PRA 

program. 

Tax credit properties do not align with location of PRA 

need. Even in states where QAP incentives align with the 

goals of the PRA program, locations of tax credit-funded 

properties may not always match the locations where 

the programs’ target populations want to live or where 

necessary services and housing supports are available 

and accessible. 

In Georgia, the state’s QAP includes points for projects 

that would accept very low-income disabled persons 

but not for 811 PRA program specifically. The QAP’s 

integration requirement matches well to the PRA program 

however. To receive points for serving people with 

disabilities, the property must have between 15 and 

20 percent of its units set aside for this population, the 

upper limit due to one of the state’s Olmstead settlement 

agreements as described in chapter 2. Even with these 

preference points, Georgia’s housing agency reports 

challenges with identifying units for the PRA program. 

Georgia’s QAP gives preferences to properties in rural 

areas. Conversely, housing agency staff report that 

most of the individuals who would benefit from 811 PRA 

subsidies reside in and around the urban Atlanta area. 

Although the grantee has been able to fill some of its rural 

units, an overall mismatch exists in the state between 

eligible PRA properties and the areas with access to the 

services and supports that PRA residents need to be able 

to live independently.

Texas’s QAP also provides incentives for developers to 

develop tax credit properties outside of urban areas, 

which is not the location of most of the demand for 

supportive housing nor where residents are more likely 

to have access to services and supports. Although the 

Texas PRA program had no units under contract as of 

June 2016, the state’s 2015 and 2016 QAP included 

incentives for PRA participation, and the 2017 QAP 
HUD Section 811 PRA Program – Process Evaluation

23

Chapter 4. Property Selection

requires participation in the 811 PRA program. The 2017 

QAP requires applicants to allocate 10 units for the PRA 

program or the maximum set-aside allowed for under the 

QAP for people with disabilities, which is 18 percent of 

the units in each property and less than the PRA program 

maximum of 25 percent. The Texas QAP also gives 

owners a choice about whether they will place the PRA 

units in new tax credit-financed development or in another 

existing development. To receive approval for an existing 

development, a property’s vacancy rate must be less 

than 15 percent, and the property must be in an area with 

transportation and access to services. 

Grantees that are not tax credit allocating agencies.

Some grantees are not the state agency that awards 

tax credits and therefore do not have the authority to 

create priorities for the 811 PRA program in state QAPs. 

In California, the California Housing Finance Agency is 

the grantee, although the California Tax Credit Allocation 

Committee is responsible for issuing tax credits and 

develops the priorities for the state’s QAP. Other states 

where the grantee is not the tax credit-allocating agency 

are Louisiana and Washington. 

Outreach and Marketing Strategies 

for Existing Properties

For states that do not have specific priorities for the 

811 PRA program in their QAP, grantees point to the 

importance of extensive outreach and marketing to 

property owners and developers to educate them on and 

gain interest in the 811 PRA program. Grantees conducted 

targeted outreach to owners by identifying funded 

properties that met PRA requirements and broad outreach 

through presenting at owner or developer conferences or 

events or through email or mass mailings. 

The Minnesota PRA program initially targeted PRA 

units only to existing affordable housing properties. 

Both the housing and Medicaid agencies conducted 

extensive research to identify eligible properties and 

educate property owners about the PRA program. The 

Medicaid agency determined residential locations of its 

institutionalized participants, using data on residents of 

nursing home and other institutional settings. The housing 

agency identified specific properties within its portfolio 

that may contain housing units eligible for 811 PRA 

program. For the 2016 811 PRA Request for Proposals, 

Minnesota’s housing agency modified its Request for 

Proposals process to encourage developers seeking 

financing for new construction projects to participate in 

the 811 PRA program. 

In Washington, both the housing and Medicaid agency 

staff extensively marketed the availability of 811 PRA units 

to developers and owners of state-funded units. Staff 

analyzed properties funded through the state’s housing 

trust fund and owners that would be good candidates 

for the 811 PRA program, including properties with 40 or 

more units or high numbers of accessible units. The 811 

PRA program staff attended local housing conferences 

and met with regional support network providers and 

homeless assistance providers. Through November 

2015, housing agency staff estimated they had spoken to 

approximately 50 owners. 

To gain interest in the 811 PRA program, key staff from 

California’s housing and Medicaid agencies extensively 

marketed the 811 PRA program to owners of state-funded 

multifamily properties. Staff from the two agencies 

held webinars, conducted in-person local meetings 

throughout the state, and responded to questions from 

developers. Contact information for housing and Medicaid 

staff was also provided in all marketing and application 

materials and on the 811 PRA program website. Program 

staff conducted limited targeted outreach to owners 

of particular existing projects in their housing agency 

portfolios, because agency data systems do not enable 

staff to easily determine which properties may be eligible 

for 811 PRA subsidies. 

In Pennsylvania, staff at the state housing finance 

agency conducted both targeted and broad outreach 

to potential property owners. Before engaging property 

developers directly, staff researched their inventory of 

affordable housing projects and screened out all ineligible 

properties, such as buildings for people aged 62 and 

older and properties constructed before 2011 because of 

the environmental requirements of the grant. The housing 

agency held two regional meetings to explain and market 

the program to property owners and landlords. In addition, 

the agency issued press releases on the program and sent 

mass emails to eligible property owners to inform them of 

the available subsidies.

Staff at the Illinois housing agency conducted extensive 

research on both existing properties and planned 

new construction to identify eligible properties. Illinois 

awards two rounds of tax credits each year, and staff 

are constantly reviewing property information to look for 

properties coming available for lease. 

Although the Montana housing agency maintains an open 

application process for PRA subsidies, the agency was 

able to secure most of its planned units under contract 

by June 2016 through its relationship with the Missoula 

Housing Authority. Most units under RAC (40 of 48) in 

Montana are in Missoula and under contract with the 
HUD Section 811 PRA Program – Process Evaluation

24

Chapter 4. Property Selection

housing authority, which oversees a large portfolio of tax 

credit properties in the Missoula area and partners with 

the state housing agency to apply for the PRA grant.

Procedures for Applying for 811 

PRA

Six 2012 grantees issue PRA units to owners through 

an open or closed NOFA or other formal application 

procedures. Grantees in four states (California, Minnesota, 

Montana, and Washington) use an application process 

exclusively, in addition to outreach to eligible property 

owners and developers as described in the previous 

section. PRA programs in Delaware and Maryland use a 

separate 811 PRA application process in addition to the 

tax credit allocation of PRA units. All but Maryland accept 

applications on an ongoing basis. 

In Washington, housing and Medicaid agency staff 

developed a streamlined application process. Owners 

can download the funding application on the housing 

agency’s website and submit the application by email. 

The application is designed to help owners determine if 

their properties are eligible for the 811 PRA program and 

the number of 811 PRA units a property could support. 

Staff from both agencies review applications for eligibility 

based on the number of units a property contains, the 

811 PRA units requested, and the types of subsidies 

already attached to units at the property. Both agencies 

also review the owner for organizational capacity and 

the property’s proximity to transportation and services. 

The agencies review applications as they are received 

and keep the application process open until the housing 

agency achieves its goal for units under contract. Housing 

agency staff provide technical assistance to owners 

throughout the application process. Applications are 

usually submitted after several conversations between 

owners and housing agency staff. 

In California, staff from the housing finance’s partnering 

agency, the Department of Housing and Community 

Development, developed the 811 PRA NOFA for property 

owners and the funding application review process. As 

the housing agency provides funding for the development 

and rehabilitation of affordable housing through 

multiple state and federal funding programs (including 

HOME Investment Partnerships Program, Community 

Development Block Grant, and Emergency Solutions 

Grants program), agency staff lent their expertise to 

develop the funding application for the PRA subsidies. The 

811 PRA application period began August 1, 2014 and is 

open until all 811 PRA funds are awarded. Housing staff 

streamlined the application process to make it as easy 

as possible for owners interested in the program to apply 

for funding. They created an application form and sample 

tools, such as memorandums of agreement between 

owners and referral organizations, tenant selection plans, 

board resolutions, and affirmative marketing plans. 

Housing and Medicaid agency staff also provide technical 

assistance to owners throughout the application process. 

The five partnering agencies review and approve 811 

PRA funding applications according to their respective 

expertise. Partner staff described the process as timeconsuming but necessary, and ultimately, successful. 

Although most of Delaware’s units have been identified 

through the QAP process, the state’s housing agency 

initially established a formal application process for 

existing properties. The agency developed an incentive 

to participate form based on a similar form Washington 

developed for their 811 PRA program. The Delaware 

housing agency emailed the form to large developers 

and management companies in Delaware to ask about 

interest in participating and property information. 

Although the agency received about 25 responses from 

interested owners, most properties were not eligible for 

PRA subsidies, because the proportion of units set aside 

for residents with special needs already exceeded the 25 

percent cap or because the owner was unable or unwilling 

to meet environmental review or other 811 PRA program 

requirements. 

Challenges in Identifying 

Properties for the PRA Program

Across the 12 states, owner interest in the 811 PRA 

program was less than expected. Through June 2016, 

2012 grantees had 23 percent of the estimated PRA 

rental subsidies under contract with property owners. 

Grantees experienced difficulty attracting sufficient new 

and existing properties or units to meet their goals for 

several reasons. Although the most commonly cited 

reason (mentioned by 7 of the 12 grantees) was that the 

recruitment process simply took more time and effort than 

anticipated, several of the remaining grantee responses 

provide deeper insight into the reasons for the difficulty, as 

discussed in the following paragraphs. 

Properties exceed the 25-percent cap on housing for 

special needs populations. In six states, the grantees 

reported that they found owners who were interested 

in the 811 PRA program, but the owners proposed 

properties already exceeded the 25-percent limit on 

supportive housing units. California and Washington 

encountered this issue, because existing affordable 

housing programs for people with disabilities gave 

incentives for higher concentrations of special needs units 

(as high as 75 percent). 
HUD Section 811 PRA Program – Process Evaluation

25

Chapter 4. Property Selection

The 811 PRA program is a new and unfamiliar 

program. The fact that the 811 PRA program was new 

and operated differently from other affordable housing 

programs meant that grantees and their partners had to 

educate owners about the new approach. In some states, 

available alternative programs were more familiar to 

owners and, in some cases, potentially more profitable. In 

five states, the grantee said owners were more interested 

in other affordable housing programs that had the 

potential for higher rental income. Grantees in California, 

Maryland, Minnesota, Pennsylvania, and Washington 

reported that robust rental markets, high development 

costs, and modest 811 PRA program rents raised owners 

concerns about the financial feasibility of the program. 

Grantees in Massachusetts, Minnesota, and Washington 

reported that owners also expressed concern over the 

30-year use restriction and 20-year RAC with only a 5-year 

PRA funding commitment, and three grantees said that 

the environmental review requirements deterred owners. 

Maryland, for example, reported that these requirements 

eliminated potential properties. To address this challenge, 

Minnesota set aside $50,000 from its operating budget to 

help fund environmental reviews.

Four grantees mentioned that owners were unfamiliar 

with HUD systems and requirements for the 811 PRA 

program, which operates differently from other tax credit 

or multifamily programs. According to grantees, owners in 

Louisiana, Minnesota, Pennsylvania, and Washington all 

expressed unease about program requirements. Payment 

systems are different for the 811 PRA program as well, 

with payments routed from HUD to the state grantee, and 

then, to the property owner, instead of going directly from 

HUD to the owner.

Owners were also unfamiliar with entering tenant data 

into the Tenant Rental Assistance Certification System 

and using HUD’s Model Lease forms, which may include 

additional provisions that owners do not have to meet 

under existing leases. For example, Washington reported 

that one large property management group came close 

to signing a contract for PRA-subsidized units but backed 

out, because they did not want to have to use TRACS. The 

group said they could find renters on the open market and 

avoid the PRA administrative requirements. 

Grantees encountered challenges matching 

appropriate housing supply, eligible and interested 

applicants, and locations with access to services. 

Grantees also mentioned various mismatches in the 

locations of interested owners with suitable properties 

relative to the desired locations of eligible applicants 

and the availability of accessible services. Grantees in 

Louisiana, Pennsylvania, and Texas all mentioned difficulty 

finding appropriate properties with one-bedroom units, 

and three grantees mentioned challenges finding units 

with good access to services. As noted previously in this 

chapter, Georgia has suitable properties in rural areas, but 

most of the eligible and interested households are in urban 

areas in or near Atlanta. As expected, of the 76 persons on 

Georgia’s waiting list, 36 are in the Atlanta area, where the 

grantee has no 811 PRA units under RAC. 

In the next chapter, we review the characteristics of the 

properties and units thus far secured for the 811 PRA 

program.
HUD Section 811 PRA Program – Process Evaluation

26
HUD Section 811 PRA Program – Process Evaluation

27

Chapter 5. Project Rental Assistance Properties and Units

Project Rental 

Assistance Properties 

and Units

This chapter provides a snapshot of properties and units 

under contract for Section 811 Project Rental Assistance 

subsidies. The chapter addresses the number of units 

grantees proposed to assist and occupy compared with 

how many units had been committed and occupied as 

of June 2016. In their funding applications, grantees 

established annual and targets for the total number of 

811 PRA units to be assisted during the initial PRA 5-year 

grant period based on assumptions about locations of 

PRA units and the amount of rent residents would pay 

based on expected incomes. The chapter also presents 

characteristics of units that are under agreement for PRA 

subsidies as of June 30, 2016, such as bedroom size, unit 

accessibility, unit rent, and subsidy levels. For unit rent 

and subsidy levels, this chapter also compares the actual 

rent and subsidy amounts to date with the assumptions 

that grantees used to develop estimated PRA grant and 

unit amounts.

Rental Assistance Contract 

Requirements

Property owners must agree to a 30-year use restriction to 

provide a specified number of units as supportive housing 

for people with disabilities and must execute a RAC with 

the state housing agency for at least 20 years. The initial 

RAC provides funding for 5 years. The use restriction and 

renewal funding are contingent on continued Section 811 

appropriations made by Congress. 

RACs are formal agreements between the grantee 

and the owner of the eligible multifamily property. The 

agreements set forth the rights and duties of the parties 

with respect to assisted units and identifies the number 

and size of units that owners agree to commit to the 

program. The units covered by a RAC might be vacant and 

available immediately, but, in many cases, other residents 

occupied some or even all the units at the time of the 

RAC execution. In these cases, owners committed the 

availability of occupied units to eligible 811 PRA residents 

on tenant turnover. 

Prior to executing a RAC, grantees and property owners 

can also enter into signed Agreement to Enter into a 

Rental Assistance Contract or other formal agreements 

that indicate a commitment to eventually enter into a 

RAC for an assisted unit. HUD requests that grantees 

execute only RACs for properties that are expected to be 

leased within 6 months. Grantees can execute ARACs 

with owners if properties are expected to be leased 

beyond this timeframe. ARACs can be effective tools for 

securing units that are still under construction. Grantees 

may secure other formal agreements to eventually enter 

into a RAC, such as a memorandum of understanding 

signed by the state and an owner, a letter of agreement 

signed by an owner, or a funding award (for example, lowincome housing tax credits, HOME, state funds) letter that 

includes the commitment of PRA units.

The RAC lays out the agreed-on maximum rent, the 

estimated amount of monthly PRA funding that owners 

receive (based on an estimated resident contribution of 

$0), and the number of units set aside for PRA subsidies 

at a property. To ensure that community integration goals 

are achieved under the 811 PRA program, the Section 811 

statute specifies that no more than 25 percent of the units 

in the affordable housing development can be set aside 

for supportive housing or have an occupancy preference 

for people with disabilities. The PRA program statute 

requires that PRA subsidies be added to multifamily 

properties with at least five units. The units under contract 

are floating, which means that the PRA subsidy is not tied 

to any specific unit and can move from unit to unit within 

a building based on vacancies. To maintain integrated 

housing, PRA residential units cannot be grouped in 

proximity to one another.

Progress in Achieving PRA Unit 

Goals

Table 5.1 shows the PRA program implementation for 

the 2012 grantees as of June 30, 2106, based on grantee 

quarterly reports. The table shows the grantees’ 5-year 

unit goal, the number of units under RAC, the number of 

units under ARACs and other formal agreements, and the 

number of 811 PRA units leased. 
HUD Section 811 PRA Program – Process Evaluation

28

Chapter 5. Project Rental Assistance Properties and Units

Table 5.1: Status of Section 811 PR A Program Implementation, June 2016

State

PRA Units 

Total 5-Year 

Goala

PRA Units 

Under RAC

Percent of 

5-Year Goal 

Under RAC

Units Under 

ARAC 

or Other 

Agreements

Percent of 

5-Year Unit 

Goal Under 

RAC or 

Identified

PRA Units 

Under Lease

Percent of 

5-Year Unit 

Goal Under 

Lease

California 233 88 38 20 46 38 16

Delaware 148 97 66 26 83 9 6

Georgia 143 67 47 156 156 0 0

Illinois 369 4 1 34 10 4 1

Louisiana 199 103 52 28 66 19 10

Maryland 150 21 14 0 14 13 9

Massachusetts 90 6 7 0 7 0 0

Minnesota 85 72 85 0 85 15 18

Montana 81 48 59 0 59 5 6

Pennsylvania 200 52 26 10 31 2 1

Texas 362 10 3 32 12 0 0

Washington 133 36 27 28 48 19 14

Total 2,193 604 28 334 43 124 6

ARAC = Agreement to Enter into a Rental Assistance Contract. PRA = Project Rental Assistance. RAC = Rental Assistance Contract.

a

 As of March 2017.

Sources: 2012 cooperative agreements; 2014, 2015, and 2016 811 PRA quarterly reports 

The PRA unit goals in table 5.1 reflect some changes 

grantees made to their PRA unit goals, because they 

signed cooperative agreements with HUD. The number of 

units that grantees expect to fund decreased from 2,625 

to 2,193, between March 2015 and March 2017. Four 2012 

grantees modified the number of PRA units they expect to 

fund based on updated information on actual contract rent 

levels and tenant rent contributions. The largest change 

in unit goals was in Illinois. The Illinois Housing Authority 

determined its PRA unit goal based on rents that were 

affordable to households with incomes 30 percent of Area 

Median Income and committed to funding an estimated 

732 units with an average monthly rental subsidy of $226, 

the lowest of any of the 2012 grantees. The state had 

difficulty attracting owners at these rent levels and was 

authorized a waiver by HUD to increase allowable contract 

rent up to the Fair Market Rent. 

Two states, California and Georgia, increased the number 

of PRA units they expect to fund. California increased its 

5-year unit goal from 229 to 233, and Georgia increased 

the number of PRA units the state expects to fund from 

134 to 143. 

As of June 2016, all 2012 grantees had units under 

contract with property owners for PRA subsidies. 

Combined, the grantees had 604 PRA units under RAC, 

more than one-fourth (28 percent) of the total number of 

estimated PRA units funded in this demonstration round. 

When adding the number of units identified under ARACs 

or other formal agreements, grantees identified 43 percent 

of the total estimated PRA units expected to be funded 

through the 2012 awards. 

The number of PRA units under contract varies by state. 

Reasons for variations include the promptness in which 

the grantee began implementing the program or started 

recruiting property owners, which may be related to state 

schedules for awarding tax credits or other affordable 

housing program awards, as well as challenges with 

obtaining owner interest in PRA subsidies. The housing 

agencies with the most units under RAC relative to 

their goals as of June 2016 are Minnesota (85 percent 

of planned units under RAC), Delaware (66 percent), 

Montana (59 percent), and Louisiana (52 percent). 

Financing Sources of Properties

A key goal of the PRA program is to offer a more costeffective method of providing supportive housing to 

extremely low-income people with disabilities and to 

leverage additional resources. Eligible properties can 

be new or existing multifamily developments in which 

the development costs are subsidized by other public 
HUD Section 811 PRA Program – Process Evaluation

29

Chapter 5. Project Rental Assistance Properties and Units

or private sources, such as the LIHTC, HOME funds, the 

Community Development Block Grant program, or other 

federal, state, or private sources. The 811 PRA program 

funds only project-based rental assistance. It does not 

provide any funding for capital costs to the properties 

where PRA subsidies will be used. 

The state housing agency grantees select the properties to 

receive the PRA subsidies and define the eligible sources 

of funding for properties that will receive PRA subsidies. 

Table 5.2 shows the primary financing mechanism for 

72 of the 78 properties under RAC through June 2016. 

Grantees report only the primary source of funding for 

8 Most of the vacant units were in Delaware and, based on a vacancy reporting system, may overstate the actual number vacant units as of June 

2016. 

properties with PRA units under RAC in quarterly reports. 

Most properties have more than one funding source and 

may have multiple sources of funding. Through June 

2016, LIHTC was the primary financing mechanism for 79 

percent of all properties with units under RAC. In addition 

to LIHTC and state funds, California, Delaware, Louisiana, 

and Washington entered RACs for properties financed 

with HOME funds. Delaware and Pennsylvania executed 

RACs for properties financed with U.S. Department of 

Agriculture Rural Development funds, and Minnesota used 

other HUD assistance to develop a property targeted for 

PRA assistance. 

Table 5.2: RACs by Property’s Primary Financing Mechanism, as of June 2016

Primary Financing Mechanism Number of RACs Percent of RACs

Low-income housing tax credits 57 79

HOME Investment Partnerships Program funds 4 6

Community Development Block Grant 0 0

Rural development 2 3

State capital funds 5 7

Other HUD assisted 1 1

National Housing Trust Fund 0 0

Other 3 4

Total 72 100

HUD = U.S. Department of Housing and Urban Development. RAC = Rental Assistance Contract. 

Sources: 2014, 2015, and 2016 Section 811 Project Rental Assistance quarterly reports

Characteristics of Units Under RAC

This section presents characteristics of the 604 units 

under RAC as of June 30, 2016. The data on bedroom 

size, unit accessibility, unit rent and subsidy levels, 

contract rent, and rental assistance payment were 

available only in HUD’s TRACS for 94 of the 133 PRA units 

currently or formerly leased as of June 2016. Owners have 

120 days from the time of a new admission until they must 

report tenant data to HUD. Although grantees report unit 

size and accessibility of properties under RAC in quarterly 

reports to HUD, they are not required to report this 

information for leased units. 

Vacancy Status 

Through June 2016, 604 units were under RAC, and 124 

residents were living in PRA-funded units (see table 5.3). 

Of the remaining 480 units under contract, 57 units were 

vacant and 423 were not available, because other tenants 

occupied them.8 These units will be available for PRA 

residents on tenant turnover. In some cases, the number 

of units reported as unavailable are in properties that are 

newly constructed or renovated, and the units are not yet 

available for leasing. 
HUD Section 811 PRA Program – Process Evaluation

30

Chapter 5. Project Rental Assistance Properties and Units

Table 5.3: Occupancy and Vacancy Status of Section 811 PRA Units by Grantee, June 2016

State

Number of Occupied 

Units Number of Vacant Units

Number of Unavailable 

Units

Total Number of Units 

Under RAC

California 38 1 49 88

Delaware 9 46 42 97

Georgia 0 7 60 67

Illinois 4 0 0 4

Louisiana 19 0 84 103

Maryland 13 0 8 21

Massachusetts 0 0 6 6

Minnesota 15 0 57 72

Montana 5 0 43 48

Pennsylvania 2 3 47 52

Texas 0 0 10 10

Washington 19 0 17 36

Total 124 57 423 604

Percent of Units Under RAC 21 9 70 100

RAC = Rental Assistance Contract.

Note: Ten units in Texas have unknown occupancy status. 

Sources: 2014, 2015, and 2016 Section 811 Project Rental Assistance quarterly reports

Number of Units per RAC

The number of units under RAC may reflect owners’ 

willingness to commit to PRA subsidies, incentives or 

limits in awarding PRA units or tax credits, the size of 

the properties, or a combination of the three. Properties 

must be multifamily properties with at least five units, and 

no more than 25 percent of the units can be set aside 

for PRA. The overall average number of units under RAC 

is 8.6 units per property. The number of units for each 

RAC varies widely from 21 units per property in Louisiana 

and 18 in California (where PRA units are in larger 

developments) to an average of 3 PRA-subsidized units 

in properties in Massachusetts and 4 in Pennsylvania and 

Illinois. In Delaware, the grantee required property owners 

applying for LIHTCs to agree to accept PRA subsidies for 

at least 5 percent of the property’s units. As a result, the 

agency reports 97 units under RAC in 17 properties, for an 

average of about 5.7 units per property. The Pennsylvania 

Housing Finance Agency has RACs in place for 14 

properties to fund an expected 52 units, an average of 3.7 

per property.

Unit Bedroom Size

Most grantees (10 out of 12) report that they based their 

PRA rental subsidy estimates on the expectation that 

most PRA residents will be one-person households, 

based on previous experience serving similar populations. 

Although grantees expect that one-person households 

will make up most of PRA residents, residents may have 

a range of household arrangements, including married 

couples and families with children or other dependents. 

Some residents may need an additional bedroom for 

visiting staff or medical equipment. HUD has also issued 

guidance to PRA grantees that provides greater flexibility 

for PRA residents to have roommates. Chapter 7 presents 

early information on household composition of the first 

PRA residents.

Table 5.4 provides details on units under agreement and 

leased by bedroom size. The percentage of units leased 

is generally proportional to the breakdown of units under 

RAC. Approximately 20 percent of units under RAC are 

two-bedroom units, and 4 percent of units under RAC are 

three-bedroom units compared with 23 percent of units 

under lease that are two-bedroom units and less than 2 

percent that are three-bedroom units. A larger percentage 

of units are available for single-person households under 

RAC (69 percent of units under RAC are efficiencies or 

one-bedroom units) than under lease by PRA residents (51 

percent combined). 
HUD Section 811 PRA Program – Process Evaluation

31

Chapter 5. Project Rental Assistance Properties and Units

Table 5.4: Section 811 PRA Units Under RAC and Under Lease by Bedroom Size, June 2016

Number of PRA Units

Under RAC

Percent of PRA Units

Under RAC

Number of PRA

Units Leased

Percent of PRA

Units Leased

SROs or efficiencies 121 20 20 16

One-bedroom units 296 49 44 35

Two-bedroom units 123 20 28 23

Three-bedroom units 24 4 2 < 2

Unit size unknown 40 7 30 24

Total 604 100 124 100

PRA = Project Rental Assistance. RAC = Rental Assistance Contract. SRO = single room occupancy

Sources: 2014, 2015, and 2016 Section 811 PRA quarterly reports; Tenant Rental Assistance Certification System data

Although these data suggest that a significant mismatch 

does not exist between bedroom size, needs, and 

availability, at least three grantees (Louisiana, Montana, 

and Pennsylvania) report that the lack of one-bedroom 

units in the state’s affordable housing portfolio was a 

challenge in identifying units for the program. 

Unit Accessibility

PRA subsidies are floating, not tied to specific units in the 

property, and are assigned based on unit availability. As 

such, grantees do not yet know the accessibility status 

of nearly one-third of the program’s units under RAC 

(33 percent). These units are under RAC but currently 

occupied by other residents. Accessibility features 

will become known at the time of tenant turnover. As 

current tenants vacate units and units become occupied 

by PRA residents, additional units may be modified 

to meet residents’ needs in response to reasonable 

accommodation requests. Most affordable housing 

properties typically have only a small number of units that 

are accessible for people with mobility, hearing, or vision 

impairments, depending on federal and state regulations. 

As table 5.5 shows, through June 2016, 58 units under 

RAC (10 percent) were designated as accessible for 

people with mobility impairments (52 units), hearing 

impairments (5 units), and vision impairments (1 unit). 

Because units are floating and accessibility will not be 

known until future turnover, the reported percentage of 

accessible units under RAC may be underestimated. 

Of the 124 PRA units occupied as of June 2016, 11 

(9 percent) are accessible for people with mobility 

impairments, and none are accessible for people with 

vision or hearing impairments. The actual accessibility of 

the remaining units cannot be determination until current 

residents vacate PRA-designated units. 

Table 5.5: Accessibility of Section 811 PRA Units Under RAC, as of June 2016

Type of Accessibility

Number of PRA Units 

Under RAC

Percent of PRA Units 

Under RAC

Number of PRA Units 

Leased

Percent of PRA Units 

Leased

Hearing impaired 5 < 1 0 0

Visually impaired 1 < 1 0 0

Mobility impaired 52 9 11 9

Units that are not accessible 136 23 83 67

Accessibility unknown 410 68 30 24

Total 604 100 124 100

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

Sources: 2014, 2015, and 2016 Section 811 PRA quarterly reports; Tenant Rental Assistance Certification System data
HUD Section 811 PRA Program – Process Evaluation

32

Chapter 5. Project Rental Assistance Properties and Units

Unit Rent and Subsidy Levels

Grantees determine the maximum rent amounts that 

property owners can charge for PRA units, which may 

or may not reflect current rental-market conditions. The 

Section 811 PRA Notice of Funding Availability required 

that the PRA rent not exceed the applicable FMR or Small 

Area FMR level for the property location, as determined 

annually by HUD. Grantees can set target rent levels 

higher than FMR if substantiated by market studies that 

meet HUD’s guidelines or approval. 

The NOFA provided incentives for state housing agencies 

to target units that produce the lowest possible per-unit 

rental subsidy costs by targeting properties that have 

existing rent restrictions, such as those funded with 

LIHTC or HOME funds. The 2012 NOFA awarded points 

to grantees that proposed to attract units with lower rents 

relative to their market area. Rents under contract for the 

811 PRA program are set to be affordable to persons with 

up to 50 percent of Area Median Income.

Targeted Rent Levels

Within the grant parameters, state housing agencies 

determined the maximum rent levels that owners can 

charge for units leased under the PRA program. Although 

the 811 PRA program enables grantees to set their rents 

up to FMR, several grantees chose to limit PRA units to 

those with rents less than FMR to receive additional points 

in the grant competition. Most states established contract 

rents that are affordable to households with incomes up 

to 50 percent of AMI. Exceptions to this rent level are 

California and Montana, two states that set contract rents 

to be affordable to households with incomes at 40 percent 

of AMI, and three states (Illinois, Massachusetts, and 

Texas) that proposed a combination of different contract 

rent levels. In California, the estimated monthly contract 

rent was an average of $993. In Montana, the estimated 

monthly rent was $596. Massachusetts set the maximum 

contract at FMR for 80 percent of its estimated PRA units, 

with the remaining units set to be affordable to households 

with incomes between 20 and 50 percent of AMI. 

Grantees in four states (California, Georgia, Illinois, 

and Washington) that had committed to lower subsidy 

amounts in their 811 PRA applications experienced 

difficulty securing units from property owners at these rent 

levels. These grantees subsequently received a waiver 

from HUD to increase the rents they can charge, up to 

the maximum allowable local FMR, to make it easier for 

these grantees to compete with other housing assistance 

programs and attract property owners and lease units. 

Rent increases were allowable for the four aforementioned 

2012 grantees, because their cohort was considered a 

demonstration round of funding. As of the time of this 

report, HUD was also considering issuing waivers to 2013 

grantees on a case-by-case basis.

Contract Rent and Rental Assistance 

Payments by Bedroom Size

Table 5.6 shows rents owners charged for units, plus cost 

estimates of any utilities paid by tenants (contract rent), 

and rental assistance payments by bedroom size for 94 

of the 124 PRA households that lived in PRA units as of 

June 2016. The average contract rent across all bedroom 

sizes was $821 per month, ranging from $565 to $1,118. 

Rents generally increase by bedroom size and vary widely 

based on local housing markets. The rental assistance 

payment is the difference between the approved contract 

rent and tenants’ contributions to rent, which is based on 

household income. The average rental assistance amount 

for these 94 PRA residents was $599, ranging from a low 

of $317 to a high of $1,160. 

Table 5.6: Contract Rent and Rental Assistance Payment by Bedroom Size, June 2016

Contract Rent ($) 

Studio or no 

Bedroom One Bedroom Two Bedrooms Three Bedrooms All Bedrooms

Minimum contract rent 669 565 827 1,049 565

Average contract rent 778 707 1,011 1,119 821

Maximum contract rent 838 892 1,185 1,188 1,188

Rental Assistance Payment ($)

Studio or no 

Bedroom One Bedroom Two Bedrooms Three Bedrooms All Bedrooms

Minimum rental assistance payment 407 317 426 899 317

Average rental assistance payment 528 497 784 964 599

Maximum rental assistance payment 833 887 1,160 1,029 1,160
HUD Section 811 PRA Program – Process Evaluation

33

Chapter 5. Project Rental Assistance Properties and Units

Note: Contract rents and rental assistance payments were available in Tenant Rental Assistance Certification System (TRACS) for 

only 94 of 133 Project Rental Assistance participants. 

Source: TRACS data

9 Welfare rent is the portion of a welfare benefit explicitly designated for rent payments.

Differences in Estimated and Actual Rental 

Assistance Payments

Grantees determined requests for 811 PRA funds by 

calculating an expected average per-unit PRA rental 

assistance payment based on either the incomes of 

households living in PRA units or local FMRs for expected 

PRA unit locations. Grantees based estimates of tenant 

rents and rental assistance payments on experiences 

from administering other similar programs or in response 

to NOFA incentives for the 2012 grant that provided 

points for targeting lower rent units. Similar to other HUD 

rental subsidy programs, PRA residents pay rent based 

on income. Total resident payment (rent and utilities) 

is calculated as the greatest of 30 percent of adjusted 

monthly income, 10 percent of monthly gross income, 

welfare rent (for some localities), or a $25 minimum rent.9

In executing RACs with owners, HUD instructs grantees 

to estimate the number based on a presumed household 

income of $0 so that the RAC reflects the maximum 

annual amount of HUD’s commitment for rental assistance 

payments under the contract. 

Grantees’ estimates of tenant rent and rental assistance 

payments did not always align with actual rents and 

payments for PRA residents as of June 2016. Table 5.7 

shows the difference between average estimated 811 

PRA rental assistance payments and actual average 

payments. For data available on PRA residents as of June 

2016, actual assistance payments were about $141 a 

month higher than the grantees’ estimates in their grant 

cooperative agreements. Three grantees overestimated 

average rental assistance payments (differences ranging 

from $9 in Louisiana to $181 in California), and five 

grantees underestimated average rental assistance 

payments (average rental assistance payments ranged 

from $59 to $266 higher than the grantees’ estimated 

monthly payments in their cooperative agreements.) 

Table 5.7: Dif ference Bet ween Average Section 811 PR A Rental A ssistance 

From Cooperative Agreements and Actual Rental Assistance, as of June 2016

California 705 524 181

Delaware 502 647 – 145

Georgia 441 NA NA

Illinois 226 NA NA

Louisiana 597 589 9

Maryland 1,055 927 128

Massachusetts 781 NA NA

Minnesota 503 708 – 205

Montana 351 617 – 266

Pennsylvania 378 437 – 59

Texas 478 NA NA

Washington 354 517 – 163

Average 458 599 – 141

NA = Not applicable, because grantees do not have leased units. PRA = Project Rental Assistance. 

Note: Contract rents and rental assistance payments were available in Tenant Rental Assistance Certification System (TRACS) for only 94 of 124 PRA 

residents.

Sources: 811 PRA Cooperative Agreements, Exhibit 6; TRACS data

Differences in estimated and actual assistance amounts 

can be attributed to several factors, including needing 

a larger or smaller number of bedrooms than assumed, 

higher or lower actual household incomes of PRA 

residents, or locations of PRA units in higher or lower 

cost areas than planned. As the data represent a small 

percentage of expected units to be assisted under the 

2012 grant program, it is too soon to determine whether 
HUD Section 811 PRA Program – Process Evaluation

34

Chapter 5. Project Rental Assistance Properties and Units

initial trends in rents and tenant payments will continue. 

Initial data suggest that the PRA program will have 

higher contract rents than grantees initially estimate in 

cooperative agreements. 

Leveraging Set-Asides of Housing 

Choice Vouchers

Of the 12 grantees, 9 committed to set aside HCVs, 

project-based vouchers, and public housing units to 

extremely low-income households with disabilities to 

supplement—or leverage as per NOFA language—the 811 

PRA units. Through June 2016, five grantees reported that 

432 vouchers were issued as part of this commitment, 

representing 30 percent of the total leverage commitment 

(table 5.8). 

Table 5.8: Level of Commitment to Leveraging HCVs by State, as of June 2016

State HCVs Committed to Leveraging HCVs Issued 

Percent of Committed

HCVs Issued

California 0 0 NA

Delaware 74 0 0

Georgia 175 117 67

Illinois 695 171 25

Louisiana 125 0 0

Maryland 97 34 35

Massachusetts 50 26 52

Minnesota 60 84 140

Montana 0 0 NA

Pennsylvania 152 0 0

Texas 0 0 NA

Washington 9 0 0

Total 1,437 432 30

HCV = housing choice voucher. NA = Not applicable.

Sources: 2014, 2015, and 2016 Section 811 Project Rental Assistance quarterly reports

In several states, grantees are also public housing 

agencies tasked with administering the HCV program 

in all or part of their states. These agencies were able 

to commit to setting aside additional housing resources 

for the PRA program from their own inventories. For 

example, the Delaware State Housing Authority is the 

public housing agency for two out of four counties in 

Delaware and committed to issuing 74 HCVs to the 

PRA target population. In Georgia, the Department of 

Community Affairs is the state public housing agency 

for the HCV program in 149 out of Georgia’s 159 

counties and committed to leveraging 175 HCVs for the 

Section 811 PRA grant. Through June 2016, the agency 

had leased 117 HCVs to people with disabilities in the 

state. The Massachusetts Department of Housing and 

Community Development also committed to leveraging 

its own housing resources for the 811 PRA grant. The 

agency committed to issuing 50 vouchers to extremely 

low-income households; 25 were from the agency’s HCV 

allocation, and 25 were new tenant-based vouchers that 

will be issued through the state’s Alternative Housing 

Voucher Program that serves individuals up to age 60 with 

long-term or chronic disabilities. 

Aside from points in the Section 811 PRA NOFA, no direct 

relationship exists between the Section 811 PRA program 

and the use of vouchers PHAs set aside, or leveraged, by 

the Section 811 program. The commitment of leveraged 

units does not expand the total number of affordable 

units to low-income households, but it does increase the 

number of units available specifically for low-income, 

nonelderly households with a person with disabilities. 

Conclusion 

This chapter provided a snapshot of properties and units 

under contract for 811 PRA subsidies and compared 

grantee goals for the number of units grants will fund 

with the number of units committed and occupied as 
HUD Section 811 PRA Program – Process Evaluation

35

Chapter 5. Project Rental Assistance Properties and Units

of June 2016. Through June 2016, 124 residents were 

living in PRA-funded units. Of the remaining 480 units 

under contract, 70 percent were not available because 

of occupancy by other, non-PRA, tenants and, therefore, 

unavailable until tenant turnover. 

The number of PRA units under contract varies by state. 

Reasons for variations include the promptness in which 

grantees began implementing the program or started 

recruiting property owners, which may be related to state 

schedules for awarding tax credits or other affordable 

housing program awards. Eligible properties can be 

new or existing multifamily developments in which 

development costs are subsidized by other public or 

private sources. Although most properties will have 

more than one funding source, through June 2016, the 

LIHTC program was the primary financing mechanism 

for 79 percent of all properties with units under RAC. The 

overall average number of units under RAC is 8.6 units 

per property. The number of units for each RAC varies 

widely from 2 to 21 units per property, based on property 

size and state-developed incentives for property owners 

to administer PRA subsidies. Some states developed a 

minimum number or percentage of PRA units that owners 

must agree to lease to program recipients in order to 

receive funding or priority through housing assistance 

programs. 

This chapter presented the characteristics—such as 

bedroom size, unit accessibility, unit rent, and subsidy 

level—of units under agreement, as of June 30, 2016. 

Most grantees (10 out of 12) report that they based PRA 

rental subsidy estimates on expectations that most 

PRA residents will be one-person households and, as 

presented in the next chapter, these households make 

up most of the existing PRA applicants. Although the 

percentage of units leased is generally proportional to the 

breakdown of units under RAC, at least three grantees 

report that the lack of one-bedroom units in the state’s 

affordable housing portfolio was a challenge in identifying 

units suitable for the program. As PRA subsidies are 

floating and not tied to specific units in the property, 

grantees do not yet know the accessibility status of nearly 

one-third of the program’s units under RAC. For leased 

units, 11 percent are accessible. 

This chapter also compared actual rent and subsidy 

amounts to date with the assumptions grantees used 

to develop estimated PRA grant amounts and number 

of units. For data available on PRA residents as of June 

2016, actual assistance payments were about $141 higher 

per month than grantees had estimated in their grant 

cooperative agreements.

As of June 2016, grantees that committed to leveraging 

additional HCVs for the program’s target populations 

issued 432 HCVs, or 30 percent of their leverage 

commitment. Although no direct relationship exists 

between the Section 811 PRA program and vouchers 

set aside by PHAs for the Section 811 program, the 

commitment increased the number of housing subsidies 

set aside specifically for nonelderly people with disabilities 

in the study states.
HUD Section 811 PRA Program – Process Evaluation

36
HUD Section 811 PRA Program – Process Evaluation

37

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

Identifying Project 

Rental Assistance 

Residents and 

Matching Them 

to PRA Units

This chapter describes the processes by which people 

with disabilities learn about and apply to live in Project 

Rental Assistance units, as well as determining eligible 

applicants for the PRA program and the specific 

properties where they would like to live. Although each 

PRA partnership established its own procedure to refer 

a potential applicant to the PRA program, at a minimum 

grantees and their partners must:

• Conduct outreach to PRA program’s target 

populations.

• Determine a method for selecting residents, including 

developing program application requirements and 

waiting lists.

• Determine applicant eligibility for the PRA program. 

• Determine applicant eligibility for specific properties.

• Match program-eligible applicants with available PRA 

units.

This chapter describes how grantees and their partners 

conducted outreach to target populations and referred 

target populations to available units. This chapter identifies 

early challenges partners reported in reaching, referring, 

and placing participants, as well as some promising 

outreach and referral practices that PRA programs use 

to successfully reach target populations and match 

interested and eligible applicants with available PRAsubsidized units. This chapter also describes the number 

and characteristics of applicants ineligible to live in PRAfunded units due to 811 PRA program requirements or 

property occupancy criteria. 

Outreach to PRA’s Program Target 

Population 

Medicaid agency staff (or their contractors) are typically 

responsible for identifying eligible applicants and referring 

them to available PRA units. Most grantees developed 

centralized or regional application and referral methods 

(usually using a combination of software systems and 

staff) to identify PRA applicants and match them to 

units, but others developed decentralized or targeted 

approaches that matched service provider organizations 

with specific properties. Several states adapted outreach 

and referral methods already in place for Money Follows 

the Person programs or other programs that target people 

with disabilities.

Potentially eligible individuals typically learn about 

available PRA subsidies through providers of services 

they are in contact with or serve their area. In contrast to 

other affordable housing programs like public housing 

or housing choice vouchers, the process of applying to 

PRA-subsidized units or being placed on waiting lists 

is generally not open to the public. An exception to this 

practice is in Louisiana, where the PRA application is 

available to the public on the state housing agency’s 

website. Individuals eligible to live in PRA units must also 

be eligible for Medicaid services. Individuals served by 

Medicaid waivers or other state plan services generally 

learn about the PRA program and application procedures 

through case managers as part of the overall receipt of 

services and supports. Individuals not currently served 

by Medicaid waivers, such as some people experiencing 

homelessness, may learn about the PRA program when 

seeking services from shelters or service providers. 

Overview of PRA Program Outreach and 

Referral Methods

PRA grantees and their partners developed procedures 

to recruit applicants, determine PRA program eligibility, 

and identify and refer applicants to available PRA units. 

Table 6.1 provides an overview of the outreach and referral 

procedures for the 12 demonstration grantees. 
HUD Section 811 PRA Program – Process Evaluation

38

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

Table 6.1: Outreach and Referral Model by State

Grantee

Outreach and Referral 

Waiting List Outreach and Referral Procedures

California Decentralized by referral 

organization and property

Contracted regional referral organizations (one for Money Follows the Person; one for developmental 

disabilities population) administer waiting lists. Property owners partner with referral organizations for 

referrals.

Delaware Centralized by area or region

Contracted case managers from four Medicaid divisions use SocialServe to determine eligibility and refer 

applicants. Housing agency manages the waiting list on SocialServe and works with the housing agency’s 

housing coordinator to match applicants to available units.

Georgia Centralized by area or region

Housing agency’s housing coordinator works with contracted service providers under the Medicaid agencies 

who conduct outreach and eligibility screenings. Housing agency manages the waiting list, which is 

organized by region, and notifies applicants in the region of available units.

Illinois Decentralized by lead referral 

agents

Five lead referral agents track and process referrals and manage their own regional waiting lists under the 

supervision of the statewide housing coordinator housed in the Illinois Department of Human Services.

Louisiana Centralized by parish

Medicaid agency coordinates a permanent supportive housing outreach implementation team, including 

staff from four offices, Medicaid, Money Follows the Person Program coordinator, homeless services, 

and healthcare providers. Waiting lists by parish; referrals to Section 811 Project Rental Assistance units 

tracked by parish. 

Maryland Centralized

Case managers screen applicants and enter information into a central Project Rental Assistance system that 

also tracks available units. Medicaid agency manages waiting list, which includes applicants for Weinberg 

and Bridge programs.

Massachusetts Centralized by outreach or referral 

agency

Medicaid agency coordinates four offices, statewide housing coordinators, and five regional housing 

coordinators to conduct outreach and referral and place applicants on consolidated statewide waiting list. A 

housing locator system is used to match applicants with appropriate units.

Minnesota Centralized by area or region

Medicaid agency housing coordinator works with Projects for Assistance in Transition From Homelessness, 

or PATH, and Money Follows the Person staff to perform outreach. Coordinator manages waiting list, 

matches referrals to available units, and ensures service coordination.

Montana Decentralized by outreach or 

referral agency

Medicaid agency coordinates case managers of three divisions to conduct outreach, determine eligibility, 

make referrals, and manage individual waiting lists. Housing coordinator notifies case managers of unit 

availability.

Pennsylvania Centralized by county Three Medicaid offices oversee 34 local lead agencies as single point of contact for service providers, 

landlords, and applicant intake. 

Texas Centralized by area or region

Medicaid agency oversees 50 or more qualified referral agencies (trained by Texas Department of Housing 

and Community Affairs) that conduct outreach, including prescreening checklists and applications, 

matching referrals, and identifying appropriate service coordinators.

Washington Centralized by area or region

Medicaid agency oversees contracted service providers who conduct outreach and screen applicants using 

online assessment tools for eligibility and service needs. Money Follows the Person program managers keep 

waiting lists and make referrals of eligible applicants to available units within the three regions of the state.

Oversight and Coordination of Outreach and 

Referrals

In all 811 PRA programs, state Medicaid agency 

partners have the primary responsibility for conducting 

and overseeing outreach to eligible target populations. 

Housing and Medicaid agencies developed outreach 

policies and procedures as part of their PRA grant funding 

applications. As discussed in chapter 3, interagency 

partnership agreements lay out the specific tasks that 

each agency will perform. According to interviews 

conducted with staff from grantees and Medicaid 

agencies, no major changes were made to the processes 

by which states conduct outreach since agencies began 

implementing the program. 

Most grantees have some version of a housing 

coordinator who is ultimately responsible for matching 

PRA-eligible applicants with available PRA units. This 

position is usually housed at the state Medicaid or health 

and human services agency, but in some states (Delaware 

and Georgia), the housing agency has taken on this role. 

In Illinois, the statewide housing coordinator in the Illinois 

Department of Human Services works with five statewide 

lead referral agents to track and process referrals. The 

housing coordinator is responsible for tracking PRA 

referrals and reporting information to the housing agency. 

The housing coordinator may coordinate housing and 

services for other programs besides the PRA program, 

particularly when PRA outreach activities are coordinated 
HUD Section 811 PRA Program – Process Evaluation

39

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

with or integrated with outreach activities for other 

programs. In states that administer an MFP program, 

the PRA housing coordinator is also often the MFP 

coordinator, a position that is partially or wholly funded by 

the MFP demonstration program. In some states, housing 

coordinators make some determination of applicant 

eligibility for the PRA program before placing applicants 

on waiting lists or referring applicants to property owners 

to complete applications.

Outreach and Referral Agencies 

Housing coordinators interact with and provide some 

oversight to referral agencies. These referral agencies 

are service providers and other organizations that are 

responsible for directly engaging potential PRA residents 

and offering support as they apply for PRA-funded 

housing and transition to their new homes. Referral 

agencies educate individuals about the availability of PRA 

subsidies as part of the services already provided to target 

populations. Referral agencies are state or local agencies 

serving people with disabilities or contracted direct 

service providers. The agency type is generally a function 

of the ways in which long-term Medicaid and state plans 

provide and coordinate services in the state and depend 

on whether state agencies provide these services directly 

or contract with outside organizations to provide services. 

Organizations that provide transition services to people 

moving from institutional settings or experiencing 

homelessness may be aware of existing affordable 

housing resources in the state, but the 811 PRA program 

is a new program resource. Grantees reported that service 

providers may not be aware of the 811 PRA program or 

its eligibility and application requirements. In many states, 

Medicaid agency and grantee staff gave extensive PRA 

program training and its application procedures to service 

providers and other agencies that regularly engage 

target populations. For example, in Texas, one primary 

agency is responsible for oversight of all referral agencies. 

The housing agency trained all 50 referral agencies to 

participate in and to make referrals to the PRA program. 

Outreach Models Adapted From Existing 

Housing Programs for People With 

Disabilities

State approaches to outreach are highly dependent on the 

target population and the state’s institutional framework. 

In some states, outreach methods build on procedures 

developed for existing supportive housing resources 

and initiatives. In Georgia and Illinois, state agencies 

were responding to Olmstead settlement agreements 

and already had established an application process for 

people with some categories of disabilities to search and 

apply for affordable housing. Maryland administers the 

application process for the Section 811 PRA program 

and two related programs, the Bridge Program and the 

Weinberg Apartments Program, through a single portal. 

Maryland leveraged the existing referral networks of 

these permanent supportive housing programs to identify 

an applicant pool. As a result, most applicants on the 

Maryland waiting list came from Bridge and Weinberg 

Apartment Program waiting lists.

Outreach Approaches Based on Target 

Population

Within state PRA programs, states may have different 

outreach procedures for different target populations. 

Outreach strategies may be disability-specific (that is, 

state or contracted service providers are responsible for 

targeting specific disability populations) or cross-disability

(state or contracted service providers are responsible 

for targeting multiple disability populations as part of 

the MFP or Projects for Assistance in Transition From 

Homelessness programs or other outreach efforts) 

strategies. MFP programs that assist people who are 

institutionalized transition into community-based housing 

and PATH programs that conduct outreach to people 

experiencing or at risk for homelessness are both 

examples of cross-disability outreach organizations. 

Although most states use a combination of disabilityspecific and cross-disability outreach organizations, 

a few demonstration programs use only one or the 

other. Louisiana uses five referring sources, depending 

on population and type of disabilities, and relies on 

population-specific state-level agencies. Pennsylvania 

uses a cross-disability approach for outreach and referral 

that relies on an existing network of county-based local 

lead agencies with housing and service experts.

Outreach strategies to reach people who are homeless 

or at risk for homelessness differ greatly from outreach 

strategies to reach people living in institutions or other 

target populations. For example, about one-third of 

Minnesota’s applicants (29 percent), as of June 2016, 

are people experiencing homelessness or at risk for 

homelessness. Minnesota’s strategy to target homeless 

people includes outreach by PATH workers in streets, 

shelters, hospitals, and jails. The state’s strategy to target 

people residing in institutions includes outreach in nursing 

homes, intermediate care facilities, and behavioral health 

hospitals. 
HUD Section 811 PRA Program – Process Evaluation

40

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

PRA Resident Application 

Approaches 

Of the 12 Section 811 PRA grantees funded in 2012, 6 

use centralized outreach and referral models, and 6 use 

regional or targeted models (see table 6.1).

Centralized and Targeted Outreach and 

Application Models

In centralized models, one central point of contact exists 

for PRA applicants, regardless of in which part of state the 

applicant lives or which agency or service provider refers 

the applicant. PRA applications are all routed through a 

central system, person (typically the housing coordinator), 

or both. Applicants may be placed on waiting lists for units 

if no units are available that meet their needs. Applicants 

are then matched to available PRA units as units become 

available for lease, often based on their place on waiting 

lists (described in detail in the following section, desired 

location, and unit size. Referrals and waiting lists can be 

ordered based on the state’s target population priorities 

or, in states with no ordered priorities, by application date.

Delaware has a centralized outreach model. All applicants 

work with case managers from the Medicaid agency to 

take program applications and refer eligible applicants 

to property owners. Similarly, Minnesota routes all 

applications to the housing coordinator at the state 

Medicaid agency. 

In a decentralized application model, no centralized 

person or system exists that accepts applications and 

refers applicants to available units. California requires 

property owners to partner with one or more regional or 

local tenant referral organizations who refer applicants to 

their properties. Some tenant referral organizations also 

conduct preliminary criminal background checks and 

credit checks to ensure that applicants are eligible before 

making the referral. 

In Pennsylvania, county-based local lead agencies handle 

outreach to potential applicants and referrals. The local 

lead agencies are community organizations that assist 

people with disabilities find affordable housing, manage 

outreach and referrals in their areas, and serve as a single 

point of contact for service providers and owners. Local 

lead agencies enter into agreements with direct service 

providers who reach out to people already served through 

existing programs and that may be eligible for PRA 

assistance. 

Washington’s PRA program has a regional outreach 

model that matches coordination services within the state. 

Each of Washington’s three geographic regions employs 

a regional housing coordinator who works with all the 

case managers in a region. As units become available in 

a region, the regional housing coordinator notifies case 

managers with clients in the region about upcoming 

housing availability. Case managers help individuals 

submit applications to property owners. Each regional 

case manager maintains a waiting list of people interested 

in PRA units in their areas. 

In Georgia, the outreach and referral system for the PRA 

program also uses a regional approach. Case managers 

from supportive service agencies contact clients that 

would benefit from the 811 PRA program to determine 

interest and likely eligibility. Case managers then provide 

completed applications to the housing agency.

Use of Waiting Lists for the PRA Program

All grantees developed some type of 811 PRA program 

waiting list that housing agencies or their partners 

maintain, but each PRA program uses waiting lists 

differently. Grantees and their partners maintain waiting 

lists at various levels, including state, region, outreach 

or referral agency (contracted service provider), and 

property. The grantees with a centralized application 

process also maintain statewide PRA program waiting 

lists. Two grantee programs combine the PRA waiting list 

with one for another established program. The Maryland 

Department of Disabilities maintains a statewide, 

centralized, waiting list that includes PRA applicants 

and applicants for two related programs serving people 

with disabilities. The Maryland Department of Disabilities 

selects individuals from the waiting list based on three 

established priorities for the PRA program and instructs 

property owners to review applications according to the 

predetermined order. 

Grantees and Medicaid agencies maintain waiting lists 

using a variety of tools, including automated software 

tools, spreadsheets, or (particularly for staff who work 

in the field) paper. Of the 12 grantees, 8 report using 

automated software tools or resident management 

software (such as SocialServe and Yardi) to maintain 

centralized waiting lists. In Washington, where three 

regional housing program managers in the state Medicaid 

agency oversee applicant outreach in their respective 

regions, the managers each maintain their own, separate 

waiting list for their region. 
HUD Section 811 PRA Program – Process Evaluation

41

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

Most grantees determine some level of PRA program 

eligibility prior to placing residents on waiting lists, 

although exceptions exist. In Maryland, where the PRA 

waiting list is combined with two other waiting lists, no 

PRA program eligibility determinations are made before 

residents are placed on the waiting list. In Louisiana, 

once an applicant is on the waiting list, their application is 

reviewed for eligibility for services, income, and age. If the 

applicant is determined eligible for a PRA unit, a letter is 

sent requesting additional information on unit preferences, 

including bedroom size. The waiting list is organized by 

parish and sorted by preference according to the state’s 

PRA target population priorities.

Implications of Different Application 

Practices 

Grantees report many advantages of centralizing the 

acceptance and review of applications and maintaining a 

single program waiting list, especially when using software 

tools to facilitate the process. Grantees report several 

benefits of using case management, spreadsheet, or 

database software to maintain PRA applicant lists. These 

benefits include the ability to automate some functions, 

such as making unit referrals to those on waiting lists, and 

the ability to sort applicants by target population priority, 

desired locations, and unit size and accessibility needs. 

Grantees can use software for program reporting to HUD 

and for sharing data internally and with partners. Waitinglist information can also help determine whether PRA units 

under contract match the needs and desires of applicants. 

This information may help grantees determine where to 

focus additional property outreach efforts. 

Grantees also report the challenges they experienced 

with centralized application approaches. Centralized 

application models that rely on a single staff person can 

bottleneck or suffer from diminished quality of service if 

the staff person has difficulty keeping up with demand, 

is out of the office, or leaves the position. Another 

disadvantage of relying on an individual staff person 

manually matching applicants to housing is that such a 

labor-intensive process can be difficult to administer when 

large numbers of applications or referrals to units exist at 

one time. 

Interviews with grantees also identified some advantages 

of regional or targeted outreach models. Regional or 

targeted, decentralized outreach models have the ability 

to scale to larger programs, because the administrative 

work can be more widely distributed across a larger 

number of organizations and staff. Regional or local 

housing coordinators may have more familiarity with the 

target population, available services and supports, and 

may have more knowledge of the local affordable housing 

community and resources. These advantages help the 

referral process operate more efficiently. However, service 

providers and specific case managers will vary in their 

program knowledge and the speed with which they inform 

their clients of available units. As a result, some eligible 

applicants may have access to PRA units sooner than 

others may. 

One of the benefits of formal waiting lists is the 

prioritization of applicants to ensure that individuals are 

matched to units in the order or priority established for 

the PRA program. Waiting lists can also be organized by 

desired bedroom size, location, and accessibility needs. 

A disadvantage of waiting lists is that the lists can very 

quickly become outdated when considering the changing 

preferences, interests, eligibility profiles of applicants, 

and the potential time difference between application 

submittal and unit availability. Massachusetts addresses 

this problem by calling its waitlisted PRA applicants every 

6 months to determine continued eligibility and interest. 

In large states, statewide waiting lists or lists that cover 

large geographic areas may be less effective tools 

to match applicants with available units. Georgia has 

a regional outreach model with a centralized waiting 

list organized by the six outreach regions in the state. 

Because the regions in Georgia are so large, an applicant 

may not be near a particular property when a unit 

becomes available, or no applicants may be available for 

a specific property, even though several applicants may 

be in the region. This challenge led Georgia’s housing 

coordinator to combine the broad, regional waiting lists 

with more focused, property-based waiting lists. 

PRA Program Eligibility 

Determination

All PRA residents must be determined eligible for the 811 

PRA program and for the specific property where they 

would like to live. This section addresses an applicant’s 

eligibility for the PRA program. The following sections of 

this chapter will address eligibility at the property level. 

The program statute requires that all Section 811 PRA 

program-assisted households have extremely lowincomes and a person between the ages of 18 and 61 at 

the time of move-in who has a disability and is enrolled 

in or eligible for state Medicaid services or similar statefunded program. Applicants must meet HUD’s definition 

of disability (see chapter 2). Grantees and their partners 

must also determine whether applicants meet their 

specific target population definitions.
HUD Section 811 PRA Program – Process Evaluation

42

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

Eligibility Based on Age and Eligibility for 

Medicaid Services

State Medicaid agencies and their contracted service 

providers generally conduct the program eligibility 

determinations for age, disability status, and eligibility 

for Medicaid services on behalf of an applicant. If a 

contracted service provider determines eligibility, state 

agencies still typically confirm this information and 

compare it with available state records. 

Eligibility Based on Income

State Medicaid agencies may confirm whether household 

incomes meet the requirements for PRA units, but 

property owners also confirm tenant income as part 

of the resident certification process. Property owners 

typically conduct income eligibility determinations, as they 

are responsible for certifying resident income to HUD. 

However, referral agencies may do some prescreening to 

determine if an applicant’s income is in the general range 

for eligibility. 

Oversight of Eligibility Determination

When service providers or referral agencies conduct 

program eligibility, a state’s Medicaid agency typically 

oversees this process and confirms eligibility. For 

example, in Pennsylvania, the local lead agencies decide 

together whether an applicant is eligible for the 811 PRA 

program, but the Department of Human Services retains 

oversight by confirming eligibility. Similarly, in Texas, the 

referring agency conducts an initial 811 PRA program 

eligibility screening, but then the housing agency does 

further evaluation of program eligibility. In some states, 

the Medicaid agency may have access to state systems to 

help confirm age and eligibility for services. 

When To Conduct PRA Program Eligibility

Grantees vary in the manner and the timing of determining 

eligibility for the 811 PRA program. Every grantee except 

California and Massachusetts performs some form 

of eligibility determination or prescreening, such as 

age, income, and criminal background, before placing 

applicants on waiting lists. Illinois conducts a complete 

eligibility determination prior to units becoming available. 

Maryland conducts prescreenings followed by eligibility 

verification prior to units becoming available. 

Tradeoffs exist in the timing of eligibility determination. 

Grantees report that confirming applicant eligibility before 

placing applicants on waiting lists or referring applicants 

to available PRA units can save staff time later, but it takes 

extra time and effort for applicants and staff. 

Applicants Determined Ineligible 

for the PRA Program

Of the 3,270 PRA applicants grantees reported through 

the second quarter of 2016, 403, or roughly 14 percent, 

were determined ineligible for the 811 PRA program 

based on age, income, or eligibility for Medicaid services 

(table 6.2). The most common reason for ineligibility 

was applicants being ineligible for Medicaid services (61 

percent). Of the 246 applicants, not eligible for Medicaid 

services, 155 were in Louisiana, where applications are 

accepted online before determining eligibility. Other 

reasons applicants were ineligible for the 811 PRA 

program include exceeding the maximum age of 62 (10 

percent) and household income above 811 PRA program’s 

income limit (8 percent). 

Table 6.2: Applicants Determined Ineligible for the Section 811 PRA Program by Reason, as of June 2016

Categories of Applicants

Number of Ineligible 

PRA Applicants

Percent of Ineligible 

PRA Applicants

Not disabled 13 3

Over income 32 8

Not eligible for Medicaid services 246 61

Criminal history 5 1

Older than age 62 42 10

Unknown 9 2

Other 56 14

Total 403 100

PRA = Project Rental Assistance.

Sources: 2014, 2015, and 2016 Section 811 PRA quarterly reports
HUD Section 811 PRA Program – Process Evaluation

43

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

Table 6.3 shows the number of ineligible applicants for 

the PRA program grouped by housing status at the time 

they applied. Applicants at risk of homelessness had 

the highest rate of program ineligibility at 43 percent. 

An additional 12 percent of ineligible applicants were 

homeless at the time of applying, 12 percent were 

living in institutions, and 10 percent were at risk for 

institutionalization. Of ineligible applicants, 2 percent 

were leaving group homes, adult care homes, or other 

residential settings. 

Table 6.3 : A pplicants Determined Ineligible for the Section 811 PR A Program 

by Housing Status, as of June 2016

Number of Ineligible 

PRA Applicants

Percent of Ineligible 

PRA Applicants

Institutionalized 45 12

At risk of institutionalization 36 10

Homeless 43 12

At risk of homelessness 160 43

Leaving group homes, adult care homes, or other residential settings 7 2

Exiting foster care 0 0

Other 77 21

Total 368 100

PRA = Project Rental Assistance.

Sources: 2014, 2015, and 2016 Section 811 PRA quarterly reports

Matching Applicants to Available 

Units

Grantees and partner agencies refer PRA-eligible 

households directly to specific properties with units under 

contract to complete an application in order to occupy a 

residence in that property. In general, this referral process 

does not occur until appropriate units are vacant or soon 

coming available. Some grantees, particularly those who 

are targeting people experiencing homelessness, do not 

match PRA applicants to units until units are actually 

available for occupancy. Once units are available, state 

Medicaid agency staff or contracted service providers 

reach out to eligible members in their caseloads and 

identify those interested in living in the available PRA units 

that match unit size and accessibility needs. However, 

owners can also accept applications for PRA units that 

are not vacant and place PRA-eligible households on 

property-based waiting lists until an appropriate unit 

becomes available. 

For most grantees, the state Medicaid agency also 

coordinates matching applicants to available units. 

Exceptions to this practice are Delaware, where the 

Delaware State Housing Authority maintains the PRA 

waiting and referral lists (with service providers submitting 

applications), and Georgia, where the housing agency 

plays this role. In Maryland, the Department of Disabilities, 

a statewide cross-disability organization, maintains and 

prioritizes the waiting list and coordinates applicant 

referrals with available units. 

For PRA programs with prioritized waiting lists, housing 

coordinators provide property owners the order in which 

to consider eligible applicants for PRA units. If the state 

does not have a prioritized list, applicant selection is left to 

the discretion of property managers and is usually based 

on the date of application. Housing coordinators typically 

refer between two and four applicants to each available 

PRA unit, assuming that some applicants will not be 

interested in the property or will not meet the property’s 

leasing requirements. 

Applicants Referred to PRA Units

As of June 2016, grantees and their partners referred 542 

PRA-eligible households to specific properties, referring 

most applicants during the second half of 2015 and the 

first two quarters of 2016. As programs matured, the pace 

of new applications in the 12 states trended upward. 

On average, 1 household moved into a PRA unit for every 

4 referrals to a PRA unit. Of the 542 households referred 

to properties after meeting PRA eligibility requirements, 

14 percent (78 households) were ineligible at the property 

level, and 24 percent (133 households) moved into PRA 

units. The remaining 61 percent of applicants referred 

to specific PRA unit openings either dropped out of the 

application process and self-selected to be removed from 

consideration, did not complete or follow up with required 

documentation, or were not selected due to higher priority 

status of other applicants. 
HUD Section 811 PRA Program – Process Evaluation

44

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

The time of submitting an application to a property owner 

may be the first opportunity for an applicant to see a 

property, unit, or neighborhood and may decide that the 

offer does not meet their needs. Grantees require owners 

to report when they deny applicants housing and the 

reasons why, but grantees do not report on (or may not be 

able to track) applicants who decide not to move forward 

with applications or the reasons.

Some lags exist in the data on lease ups. Households 

referred to PRA units during a given quarter may not move 

in until the following quarter. In addition, PRA-eligible 

households that fail to move into a particular property may 

receive a subsequent referral to a different property with 

PRA units or to other affordable housing programs. 

Applicants Who Did Not Meet Property 

Leasing Requirements

To move into PRA units, applicants must meet application 

requirements for the property where they would like to 

live. Property owners can establish their own admission 

criteria and generally require that PRA applicants meet the 

same application criteria as other non-811 PRA residents 

of the same multifamily rental property, such as previous 

rental history, criminal history, or minimum credit score. 

An applicant’s bedroom size and accessibility needs 

must also match an available unit. Property owners may 

maintain their own waiting lists of interested applicants 

for their properties’ PRA units, but grantees and partner 

agencies still need to determine whether applicants are 

eligible for the 811 PRA program. 

The program requires owners to establish tenant selection 

procedures for leasing to PRA applicants. Each property’s 

written tenant selection plan, developed as part of an 

owner’s initial agreement with the grantee, establishes 

the procedures for selecting residents to live in specific 

properties. Tenant selection plans outline the procedures 

for resident selection, eligibility, and support for continued 

occupancy. Several grantees developed plan templates 

that owners could modify. 

Approximately 14 percent of households did not to 

meet property eligibility requirements, or 78 out of the 

542 individuals that grantees referred to complete lease 

applications with property owners. Table 6.4 shows the 

target populations of the 72 PRA-eligible households 

that did not pass landlord screening. Applicants who 

were denied by property owners were most likely to 

be homeless (45 percent), followed by those residing 

in institutions (28 percent), individuals at risk for 

institutionalization (11 percent), or persons leaving group 

homes or adult care homes or other residential homes (11 

percent). Given the small number of households, these 

patterns may not reflect the overall pool of PRA applicants 

or eligible households. 

Table 6.4: Households That Owners Screened Out by Housing Status, as of June 2016

Institutionalized 20 28

At risk of institutionalization 8 11

Homeless 32 45

At risk of homelessness 2 3

Leaving group homes, adult care homes, or other residential settings 8 11

Exiting foster care 0 0

Other 2 3

Total 72 100

Note: Total adds greater to 100 percent, because one grantee reported two target populations for one applicant.

Sources: 2014, 2015, and 2016 Section 811 Project Rental Assistance quarterly reports

Reasons Applicants Were Ineligible

The most common reasons property owners gave for 

applicant ineligibility were criminal history (61 percent), 

poor credit (13 percent), and poor rental history (10 

percent). Nearly one-third of applicants who were 

screened out were in Minnesota, and the reason was 

criminal history. Of the 24 applicants screened ineligible 

in Minnesota, 23 were homeless. During field interviews, 

outreach staff reported that PRA applicants were typically 

denied housing because they had a history of nuisance 

crimes stemming from homelessness. As a result, 

Minnesota state agency staff report that they have taken 

steps to reduce the number of denials of PRA applicants 

at the property level. These steps include educating 

property owners about the availability of tenancy support 

services to PRA residents and instituting prescreening 
HUD Section 811 PRA Program – Process Evaluation

45

Chapter 6. Identifying Project Rental Assistance Residents and Matching Them to PRA Units

forms for applicants to disclose potential barriers to 

residency in order to preemptively discuss them with the 

property manager. 

Conclusion 

This chapter addressed what is arguably the most 

challenging aspect of the 811 PRA program—matching the 

right applicant to the right unit at the right time. Lessons 

from the first round of PRA grantees include: 

• Grantees developed a variety of tools and procedures 

to identify and track eligible applicants and match 

them to appropriate PRA units. For both applicant and 

property tracking, the processes may be statewide or 

regional, centralized or decentralized, and organized 

by target population or geography. 

• Housing coordinators, often funded by MFP grants, 

play a critical role in a number of states in coordinating 

this complex process. The expiration of the MFP 

funds is a concern as states consider how to pay for 

this function after 2020. States may want to consider 

changes to their Medicaid waivers to fund housingrelated activities with Medicaid funds after the MFP 

demonstration ends. States could also consider 

incorporating some PRA housing coordinator functions 

into the state housing agencies, as the Delaware and 

Georgia PRA programs have done. 

• Multiple layers to eligibility exist. An applicant must be 

eligible for Medicaid long-term services and supports, 

for the 811 PRA program (based on age, income, and 

disability), and for the property where the applicant 

would like to live (based on the property’s tenant 

selection plan). In addition, a property must meet an 

applicant’s needs and preferences. Many steps exist 

in which the approval process can slow down or derail 

entirely. 

• In the early implementation period covered by this 

research, a substantial share of applicants were 

ineligible for the 811 PRA program, because they did 

not qualify for Medicaid, but this outcome was largely 

because of the public application process Louisiana 

uses. 

• Also, some early evidence exists that people with 

histories of homelessness experienced higher rates 

of ineligibility, an issue for careful monitoring going 

forward.

The matching process in some states is largely manual. 

This manual process can result in successful matching, 

because it is so individualized, but the efficiency and 

success depend on staff making matches and distributing 

information effectively and equitably. A few grantees 

reported that some staff may be more effective than 

others at this function, raising some concerns about 

equity. Further, such staff-intensive approaches may be 

difficult to scale up as volume increases.
HUD Section 811 PRA Program – Process Evaluation

46
HUD Section 811 PRA Program – Process Evaluation

47

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Characteristics 

of Project Rental 

Assistance Applicants 

and Residents

This chapter provides a profile of Project Rental 

Assistance applicants and residents through June 

2016. It summarizes information on applicants of the 

811 PRA program by previous housing status (that is, 

institutions, group homes, homeless) or risk factor (at risk 

of homelessness or institutionalization without access to 

affordable housing), and source of applicant referral or 

type of agency that referred the individual residents. 

PRA Applicants

Grantees report aggregate information on applicants 

to the PRA program to HUD on a quarterly basis 

throughout the 5-year grant term. Through June 2016, 

grantees reported a combined 3,270 applicants for the 

12 PRA programs. Grantees report the percentage of 

applicants by type of reported disabling condition, place 

of prior residence prior to PRA, and type of disability. 

As discussed in chapter 2, grantees can target their 811 

PRA subsides to nonelderly people with specific disability 

types such as physical, mental health, or intellectual 

or developmental disabilities. Some states focus on 

people with disabilities who live in institutions, at risk 

for institutionalization, who are homeless, or at risk for 

homelessness in support of state efforts to assist these 

populations. 

Applicants by Referral Source

As discussed in chapter 6, referral agencies typically are 

agencies that provide services or supports to address 

mental health, intellectual, or developmental disabilities, 

or independent living needs. Referral agencies may be 

disability specific or may serve individuals with a number 

of different types of disabling conditions. As table 7.1 

shows, across all states as of the second quarter of 2016, 

service providers accounted for 64 percent of all PRA 

applications, followed by state or local health agencies or 

authorities (27 percent) and other (10 percent). 

Table 7.1: PR A Applicants by Referral Source, as of June 2016

Applicant Source

Number of PRA 

Applicants

Percent of PRA 

Applicants

State or local mental health agency or authority 277 9

State or local intellectual or development disability agency or authority 94 3

State or local aging or adult services agency or authority 212 7

State or local child or family agency or authority 48 2

Other state or local human services agency or authority 174 6

Total State Agencies or Authorities 805 27

Service provider—mental health 810 27

Service provider—intellectual or development disabilities 336 11

Service provider—center for independent living 257 8

Service provider—other 505 17

Total Service Providers 1,908 63

Other 316 10

Total 3,029 100

PRA = Project Rental Assistance. 

Note: Grantees did not report applicant source for 241 applicants. 

Sources: 2014, 2015, 2016 Section 811 PRA quarterly reports
HUD Section 811 PRA Program – Process Evaluation

48

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Among service providers, about a one-fourth of applicants 

came from providers of mental health services (27 

percent), followed by providers of services to people with 

intellectual or developmental disabilities (11 percent), and 

centers for independent living (8 percent). Within state 

agencies or authorities, state mental health agencies 

referred 277 of the 805 applicants, with the remaining 

applicants referred by agencies that serve people with 

intellectual or developmental disabilities, local aging or 

adult services agencies, local child or family agencies. 

The remaining 10 percent of applicants fall into the other

category, which includes numerous other organizations 

focused on aging and elder services, veterans services, 

healthcare providers, emergency homeless services and 

shelters, housing authorities, health insurance providers, 

nursing facilities, community action agencies, school 

districts, faith-based organizations, and other nonprofit 

organizations.

Applicants by Housing Status 

Grantees report applicant characteristics based on the 

housing circumstances of the individual at the time of 

application to the PRA program. Table 7.2 shows the 

percentage of PRA applicants by place of prior residence 

through June 2016. More than a one-fourth of applicants 

were either residing in an institution (18 percent) or were 

at risk for institutionalization (9 percent). PRA programs 

can determine the definition of at risk. More than a third of 

applicants are either homeless (26 percent) or at risk for 

homelessness (10 percent). People living in group homes, 

adult care homes, or other residential settings constitute 

11 percent of applicants. 

Table 7.2: PRA Applicants by Housing Status, as of June 2016

All Grantees

Target Population Number of PRA Applicants Percent of PRA Applicants

Institutionalized 549 18

At risk of institutionalization 279 9

Homeless 785 26

At risk of homelessness 315 10

Leaving group homes, adult care homes or other residential settings 322 11

Exiting foster care 1 0

Other 802 26

Total 3053 100.0

PRA = Project Rental Assistance. 

Note: Grantees did not report the housing status for 217 applicants.

Sources: 2014, 2015 and 2016 Section 811 PRA quarterly reports

Grantees vary in the distribution of applicants by place 

of prior residence, largely reflecting the states’ priorities 

and eligible populations. Most homeless applicants are 

from three states that specifically target people who are 

homeless or at risk for homelessness. The three states 

are Minnesota (200 applicants), which targets individuals 

through its Projects for Assistance in Transition From 

Homelessness program, Louisiana (292 applicants), 

which uses PRA as a resource as part of its permanent 

supportive housing program, and Maryland (548 

applicants), which has a combined application process 

and waiting list for PRA and two other housing programs. 

All states target people who are institutionalized, and five 

states give priority for PRA units to applicants who reside 

in institutions at the time of application. In California, 

applicants who are institutionalized receive first priority 

for PRA units, and 100 percent of applicants in the state 

were either living in institutions (67 percent) or at risk for 

institutionalization (33 percent). In Illinois, 74 percent of 

PRA applicants were institutionalized, and 22 percent 

were at risk for institutionalization. These high percentages 

reflect the state’s target populations as discussed in 

chapter 2. Two-thirds of Pennsylvania’s applicants 

are either institutionalized (38 percent) or at risk for 

institutionalization without affordable housing (30 percent). 

Most of applicants from group homes, adult care homes, 

or other residential settings are from Maryland (267 of 

322 applicants, or 83 percent), reflecting the state’s PRA 

program’s third priority for people wishing to move out of 

these residential homes. 
HUD Section 811 PRA Program – Process Evaluation

49

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Applicants by Disability Type

Through June 2016, grantees reported that 41 percent of 

applicants have mental health disabilities, 33 percent of 

applicants have physical disabilities, and 16 percent have 

an intellectual or developmental disability. Distributions 

of applicants by disability type vary greatly across state 

grantees. 

Caution should be taken when interpreting these 

percentages. Data were available for only 2,780 of 3,270 

applicants. Based on information in the grantee quarterly 

reports and the fact that applicants and residents can 

report more than one disability type, it was not possible to 

determine the exact proportion of applicants who report 

a specific type of disability or the percentage of residents 

with co-occurring disabilities. 

Profile of PRA Residents

This section presents the characteristics and tenancy of 

the first 133 households assisted by 811 PRA between 

January 2015 and June 2016. The chapter provides a 

breakout of residents by place of prior residency and 

length of stay. For the few residents who exited the 

program to date, the section provides information on the 

reasons those individuals exited the PRA program. This 

profile of PRA residents also provides some demographic 

information about the households that have been assisted 

by PRA including age, gender, and household income. 

Through June 2016, the 12 demonstration PRA programs 

assisted 133 households with rental assistance, and 124 

residents were living in PRA-funded units at the end of 

the month (8 households had exited the program since 

January 2015). 

Table 7.3 shows the number of PRA residents by state. 

As of June 30, 2016, the states with the most residents 

were California (38 residents, or 16 percent of their 2012 

grant goal), Washington (19 residents, or 9 percent of 

their grant goal), Minnesota (15 residents, or 18 percent 

of their goal), Louisiana (19 residents, 10 percent), and 

Maryland (13 residents, 10 percent). HUD authorized four 

states (California, Georgia, Illinois, and Washington) to 

increase their contract rents, which likely will reduce the 

total number of PRA units that the PRA grant will ultimately 

fund. PRA programs in three states had no residents, 

because they had not yet begun or had just begun the 

PRA leasing process (Georgia, Massachusetts, and 

Texas). The remaining three grantees all had less than 10 

residents each. 

Table 7.3: PRA Residents as of June 2016

State PRA Units Total 5-Year Goala

PRA Units Leased Through June 

2016

Percent of 5-Year Unit Goal Under 

Lease Through June 2016

California 233 38 16

Delaware 148 9 6

Georgia 143 0 0

Illinois 369 4 1

Louisiana 199 19 10

Maryland 150 13 9

Massachusetts 90 0 0

Minnesota 85 15 18

Montana 81 5 6

Pennsylvania 200 2 1

Texas 362 0 0

Washington 133 19 14

Total 2193 124 6

PRA = Project Rental Assistance. 

a

 As of March 2017.

Sources: 2014, 2015 and 2016 Section 811 PRA quarterly report
HUD Section 811 PRA Program – Process Evaluation

50

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Grantees report the prior housing status of residents. Table 

7.4 shows that approximately one-half of PRA residents 

came from institutions (35 percent) or were at risk for 

institutionalization as defined by each PRA program 

(15 percent). An additional one-fourth of residents were 

previously experiencing homelessness (30 residents, 

or 23 percent), 18 residents (14 percent) were at risk for 

homelessness, and 10 residents (8 percent) moved from 

group homes, adult care homes, or other residential 

settings. An additional 8 residents moved from other 

housing situations. 

Table 7.4: PRA Residents by Prior Housing Status, June 2016

All Grantees

Target Population Number of Residents Percent of Residents

Institutionalized 47 35

At risk of institutionalization 20 15

Homeless 30 23

At risk of homelessness 18 14

Leaving group homes, adult care homes or other residential settings 10 8

Exiting foster care 0 0

Other 8 6

Total 133 100

PRA = Project Rental Assistance. 

Sources: 2014, 2015 and 2016 Section 811 PRA quarterly reports

Characteristics of PRA Households

Information on income and rent is only available for 94 of 

the first 133 residents who moved into PRA units between 

January 2015 and June 30, 2016. The missing data for the 

remaining residents are due to lags in tenant reporting to 

HUD.

Household Composition

Most PRA households were single-person households (78 

percent). Two-person households represent 16 percent of 

total households, and households of three or more people 

(6 percent) made up a smaller proportion (table 7.5). 

Some 15 percent of households have dependents. Eleven 

PRA residents reported a family member with a mobility 

impairment, and none reported a family member with a 

hearing or vision impairment. 

Table 7.5: Household Composition of Section 811 PRA Residents, June 2016

Number of Households Percent of Households

Household size

One person 73 78

Two person 15 16

Three or more person 6 6

Households with dependents 14 15

Families with member who has

Hearing impairment 0 0

Vision impairment 0 0

Mobility impairment 11 12

Total households 94 100

PRA = Project Rental Assistance.

Note: Data are available on only 94 of the first 133 PRA participants. 

Source: Tenant Rental Assistance Certification System data
HUD Section 811 PRA Program – Process Evaluation

51

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Table 7.6 provides demographic characteristics of PRA 

resident heads of households. PRA residents range in 

age from 19 to 60 but skew toward the higher age limit of 

the 811 PRA program. The average head of household is 

47 years old, and the median age is 50. Nearly one-half 

of the PRA head of households (49 percent) were at least 

51 years of age in June 2016. Approximately one-half of 

PRA heads of household are female (52 percent), and 48 

percent are male. PRA residents self-reported race as: 

48 percent White, 35 percent Black or African American, 

3 percent Native American or Alaskan Native, 1 percent 

Asian or Pacific Islander, and 6 percent are classified 

as other. 

Table 7.6 : Characteristics of Section 811 PR A Heads of Household, June 2016

Number of Heads of Household Percent of Heads of Household

Age of head of household

18–24 4 5

25–30 5 6

31–50 39 42

51–61 45 48

62 or more 1 1

Sex of head of household

Male 45 48

Female 49 52

Race of head of household

White 45 48

Black or African-American 33 35

Native American or Alaskan Native 3 3

Asian or Pacific Islander 1 1

Other 6 7

Total households 94 100

PRA = Project Rental Assistance.

Notes: Data are available on only 94 of the first 133 PRA participants. Data on ethnicity of the heads of household were not available.

Source: Tenant Rental Assistance Certification System household data

Household Income and Assets

The reported household income represents the most 

recent income reported to HUD as of June 2016. HUD 

requires households to recertify their incomes at least 

annually as part of their lease agreements but may 

recertify it more often if they have increases or decreases 

in household income.

PRA participants must have extremely low-income, no 

more than 30 percent of Area Median Income, when 

they move into PRA units. Most households (91 out 

of 94) report extremely low household incomes as of 

June 2016. The average household income for 811 PRA 

households reported through June 2016 was $9,113, 

ranging between $0 and $18,128. After taking deductions 

into account, average adjusted income of PRA residents 

was $8,886. Based on this adjusted income, the average 

household, spending 30 percent of monthly income on 

rent, could afford a monthly rent of $236. Actual total 

monthly resident payments for this period range from $5 

to $443, with an average resident rent payment of $223. 

On average, adjusted PRA household income is about 16 

percent of AMI. 

Actual total resident payments were less than expected 

through June 2016. All PRA residents report at least 

one source of household income (table 7.7). Most PRA 

households (88 percent) receive Social Security benefits, 

either Social Security (42 percent), Supplemental Security 

Income (34 percent), or both (13 percent). Fewer residents 

had income from wages (6 percent), receive welfare 

assistance (6 percent), or have other income sources 

(7 percent). 
HUD Section 811 PRA Program – Process Evaluation

52

Chapter 7. Characteristics of Project Rental Assistance Applicants and Residents

Table 7.7: PRA Household Sources of Income, June 2016

Source of Income Number of Households Percent of Households

Wage 6 6

Pension 0 0

Social Security 39 42

Supplemental Security Insurance (SSI) 32 34

Both Social Security and SSI 12 13

Welfare 6 6

Other 7 7

Total households 94 100

PRA = Project Rental Assistance.

Note: Households may report more than one source of income. 

Source: Tenant Rental Assistance Certification System data

PRA residents report very low values of assets and 

savings. Two-thirds of PRA households (61 percent) 

reported cash assets on moving into PRA units, typically 

amounts in checking or savings accounts. For households 

with reported assets, the average value of these assets 

was $729, and the median was $170. Many PRA residents 

(42 percent) reported less than $100 of value in assets. 

Tenancy of PRA Residents

As the PRA program is new and the first residents did not 

move in to PRA-assisted units until January 2015, resident 

tenancy is largely a reflection of the demonstration 

programs’ implementation status at the time of the 

process evaluation. Of 121 households residing in PRAsubsidized units as of June 2016, 61 percent lived in the 

PRA unit for 6 or fewer months, and 29 percent lived in 

PRA units between 6 months and 1 year (table 7.8). Less 

than 10 percent of residents had lived in PRA-funded units 

for longer than 1 year as of June 2016.

Table 7.8: PRA Participants by Tenancy, June 2016

Of the Total Number of Households Living in PRA Units at the End of 

the Quarter, Number by Length of Tenure

Number of PRA 

Participants Percent of PRA Participants

6 months or fewer 74 61

7–12 months 35 29

13–24 months 12 10

25–48 months 0 0

Total 121 100

PRA = Project Rental Assistance.

Note: Does not include Maryland tenancy data.

Sources: 2014, 2015, and 2016 Section 811 PRA quarterly reports

Transfers With Program and Program Exits

As of June 30, 2016, grantees report only one resident 

transfer from one unit to another within the same property. 

Grantees reported that eight PRA households exited the 

Section 811 PRA program—three were reinstitutionalized, 

two died, one exit was owner-initiated for reasons other 

than nonpayment of rent, and two left for unknown 

reasons. The program requires property owners to report 

the reasons residents move out of units or no longer 

participate in the PRA program, but property owners may 

not always be aware of the reasons.
HUD Section 811 PRA Program – Process Evaluation

53

Chapter 8. Service Provision and Coordination

Service Provision 

and Coordination

The Section 811 Project Rental Assistance program 

targets extremely low-income households with disabilities 

who live in institutions, are homeless, or are at risk of 

institutionalization or homelessness without access to 

affordable housing. Participants in the 811 PRA program 

must also be eligible for community-based long-term care 

services provided under the state’s Medicaid or similar 

program, but services are voluntary and participation 

in services is not a requirement for receiving rental 

assistance. 

The research questions for the process evaluation 

included what resources are used to pay for services for 

811 PRA-assisted residents, what services are offered 

during the transition to housing and after residents have 

moved in, how are services coordinated across providers, 

whether available services adequately address the needs 

of the target population, and how services are monitored 

to ensure accountability. However, because most grantees 

were still in the early implementation stages of their 811 

PRA programs during the data collection period for this 

study, few PRA residents were housed, and grantees 

had little experience with service delivery for individuals 

living in PRA units. As a result, this chapter reviews the 

expected sources of services funding and the planned 

structures for service delivery and monitoring based 

on program documents and discussions with program 

staff during field visits, but the chapter has few findings 

to present on grantees’ actual experiences with service 

provision, coordination, adequacy, or monitoring. As 

described in chapter 9, a Phase II evaluation will collect 

data on the implementation of the first and second round 

811 PRA grants and will assess resident outcomes. The 

Phase II study will collect more indepth information on 

service delivery (including resident outcomes) as more 

residents move to housing with 811 PRA assistance. The 

second phase of the evaluation includes surveys with PRA 

residents in six states. 

This chapter begins with a brief overview of Medicaid, its 

coverage, and those eligible. It then summarizes the types 

of services the 811 PRA grantees planned to provide and 

the Medicaid and other resources they expected to draw 

on to pay for services for 811 PRA residents during their 

transitions to housing and after living in 811 PRA units. 

What Does Medicaid Cover and for 

Whom?

Medicaid is a health insurance program implemented 

through partnerships between states and Centers for 

Medicare and Medicaid Services. Although states develop 

Medicaid state plans within the basic parameters set by 

the CMS in accordance with federal law, each state’s 

Medicaid program is different. States must include a core 

set of benefits and may choose to offer additional benefits 

than the set required by CMS. Through waivers and state 

plan amendments, states may add benefits for specific 

purposes or populations, establish structures for care 

delivery such as managed care organizations, and follow 

other approaches to fit the program to state needs and 

budget constraints.

Before full implementation of the Affordable Care Act, 

most Medicaid beneficiaries were eligible, because (1) 

they were disabled as defined by eligibility criteria for 

Supplemental Security Income, (2) they were children, 

pregnant, or members of households that met Medicaid 

eligibility criteria, or (3) they were Medicare beneficiaries 

whose incomes were low enough to qualify them for 

Medicaid (these beneficiaries are known as dual-eligibles). 

As implemented, the Affordable Care Act enabled states 

to expand eligibility to people with incomes less than 

133 percent of the federal poverty level, starting in 2014. 

This change resulted in more adults without children 

becoming eligible for Medicaid in states that implemented 

the expansion. All but 2 of the 12 states in this evaluation 

(Georgia and Texas) had expanded Medicaid eligibility 

under the Affordable Care Act to people with annual 

incomes less than 133 percent of the federal poverty level, 

regardless of their age, family status, or health.

Medicaid cannot pay for housing outside of institutional 

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

services and supports that people with disabilities may 

need in order to maintain their health and, for 811 PRA 

participants, live stably in a community-based setting. 

Long-term care services may be provided under Medicaid 

waivers, Medicaid state plan options, or other comparable 

long-term services programs. In addition, in 2016, CMS 

issued guidance on the use of Medicaid to provide 

certain housing and tenancy supports to help Medicaid 

recipients obtain and retain housing, such as assessing 

housing and supporting needs, preparing housing 

support plans, helping prepare housing applications, and 

identifying resources for covering transition expenses. The 

guidance also covers the use of Medicaid for support to 

ensure successful tenancy, such as coaching residents 

on sustaining tenancy (for example, paying rent on 
HUD Section 811 PRA Program – Process Evaluation

54

Chapter 8. Service Provision and Coordination

time, getting along with neighbors and landlords) and 

monitoring and intervening if any behaviors jeopardize 

tenancy. Finally, the guidance encourages state-level 

collaboration across agencies to identify resources and 

opportunities for coordinating housing, health, and longterm services and supports to help Medicaid beneficiaries 

live successfully in community settings (CMS, 2015). 

Expected Services and Supports 

for PRA Residents

In responses to the 2012 Section 811 PRA Notice of 

Funding Availability, grantees proposed a variety of 

service types they planned to make available to 811 PRA 

residents, including transition services and supports to 

help eligible households search for appropriate units, 

complete housing applications, obtain household 

supplies, and move into units. Following the transition 

period, grantees identified resources for services and 

supports to ensure successful tenancy in the community. 

These services were to be tailored to individual resident 

needs and preferences but could include supports, 

such as inhome skilled nursing, home health aide, 

transportation to medical appointments, medication 

management, and specialized medical equipment. 

Services also include case management, homemaker 

and chore services, personal care, recreational services, 

supported employment, accompaniment to medical 

appointments, and respite care for informal caregivers. 

Medicaid is expected to be the primary source of services 

funding, but other federal and state sources may support 

811 PRA residents as well. This section briefly describes 

the resources states plan to use to provide services. First, 

we provide a brief description of the Medicaid authorities 

the 811 PRA grantees plan to use to pay for services. 

Table 8.1 summarizes sources by grantee. 

Table 8.1: Funding Sources for Services for PR A Residents

State

Medicaid Waiver Programs Expected to Serve Section 811 PRA 

Participants

Other Medicaid or State Programs for Section 811 PRA 

Participants

California

Nine 1915c waiver programs; two specifically for people with developmental 

disabilities.

1115 renewal proposed to have tenancy supports services.

MFP; Health Homes starting in 2017. 

Delaware 1115 waiver consolidates several previous HCBS waiver programs under one 

Medicaid managed care program for people with long-term care needs. MFP, PATH, HUD Continuum of Care.

Georgia 1915c waivers for physical or functional and developmental disabilities. MFP, PATH.

Illinois 1915c waivers for people with brain injuries, developmental disabilities, 

mental illness. MFP. State Plan Community Health Services.

Louisiana

1915c for housing stabilization and housing transition or crisis intervention; 

four 1915c waivers for adults (two for people with developmental disabilities, 

two for physical disabilities).

MFP, 1915i State Plan Amendment for behavioral health includes 

services or skill building to get or keep housing.

Maryland Waivers: Community Pathways (developmental disabilities); brain injury; 

medical daycare; HCBS options.

MFP. Under state plan: Community First Choice to consolidate three 

previous waivers for disabled adults; Balancing Incentive Program to 

supplement MFP and augment HCBS.

Massachusetts 1915c for adults with intellectual disabilities, adults with brain injury. MFP. Independent living supports for intermittent needs. State plan 

services that facilitate community living. 

Minnesota 1915c waivers for developmental disabilities, brain injury 1915(i) for mental 

health population; proposed tenancy supports.

MFP. Three state-funded services programs: two for mental health 

and one for homeless populations.

Montana 1915c waivers for people with physical disabilities, developmental disabilities, 

mental illness. MFP. 

Pennsylvania 1915c waivers for intellectual disabilities supports and services; Adult Autism 

Waiver; and HCBS waivers for physical disabilities.

MFP, 1915i (managed care), Nursing Home Transition, state block 

grants to counties.

Texas 1915c waivers for people with developmental or physical disabilities. MFP, 1115, state plan services for mental health.

Washington Two 1915(c) waivers for people with functional disabilities; five HCBS waivers 

for developmental disabilities.

MFP plus state-funded supplement to MFP program. Medicaid 

rebalancing funds allocated to create temporary rental subsidy 

program for people transitioning from institution to community. 

Under state plan—Community First Choice, private duty nursing.

HCBS = Home- and Community-Based Services. HUD = U.S. Department of Housing and Community Development. MFP = Money Follows the Person. 

PATH = Projects for Assistance in Transition From Homelessness. PRA = Project Rental Assistance.

Sources: Grantee Notice of Funding Availability responses; field interviews with Section 811 PRA program staff in each state
HUD Section 811 PRA Program – Process Evaluation

55

Chapter 8. Service Provision and Coordination

Although states may have appropriate waiver programs 

for 811 PRA target populations, grantees noted that 

confirming that appropriate services are available in the 

vicinity is a key factor in identifying suitable properties 

for the program. Early in program implementation, some 

grantees (Georgia, Pennsylvania, and Texas) noted 

concerns about the availability of services in rural areas. 

The Louisiana grantee mentioned having difficulty finding 

interested property owners with one-bedroom units 

(which are generally in short supply compared with larger 

units) in communities with good access to services. 

All 811 PRA residents are expected to be eligible for 

Medicaid, and many residents are expected to receive 

services through Medicaid waiver programs, as briefly 

described in the next paragraphs. The numbers refer to 

sections of the Social Security Act that authorize waivers. 

Under Section 1915(c) Home- and Community-Based 

Services waivers, states may offer services in community 

settings to people who have disabilities severe enough 

that they qualify for institutional care. With review and 

approval from CMS, states can provide a variety of 

services, such as homemaker services, home health and 

personal care assistance, and adult day health care to 

people living in the community. The waiver services must 

be cost neutral for the state; that is, the cost of waiver 

services cannot exceed the cost of providing the same 

services without the waiver. States may limit the number 

of people served, the scope and duration of services, and 

the geographic area the waiver covers.

Section 1915(i) State Plan Option waivers enable states to 

provide services similar to those provided under 1915c but 

to people with a lower level of care need. These waivers 

are for people who meet state-defined need criteria but do 

not meet the institutional level of care requirement. States 

may target these services to particular disability groups. 

No cost neutrality requirement exists, but states must 

offer the program statewide, and they may not limit the 

number of eligible people served or establish waiting lists.

Section 1115 research and demonstration waivers can 

be used to give states broad flexibility to design and test 

innovative ways to deliver and pay for Medicaid coverage. 

With CMS review and approval, states can implement 

projects that test policy innovations. States can use an 

1115 waiver to obtain approval to use Medicaid funding to 

pay for the costs of services that do not otherwise qualify 

for federal matching funds. 

The Affordable Care Act established Section 1915(k), 

the Community First Choice Option. This option enables 

states to provide home- and community-based attendant 

services to some Medicaid enrollees with disabilities who 

otherwise qualify for institutional care. Community First 

Choice provides an enhanced federal matching rate for 

expenditures related to this option. 

The Balancing Incentive Program is a new mechanism 

under the Affordable Care Act that offers enhanced 

federal matching funds to states for long-term services 

and supports that are provided in noninstitutional settings. 

States must meet some other requirements, including 

developing a statewide, single entry point system and a 

standardized assessment tool to determine service needs. 

Maryland and Washington have each used Medicaid 

rebalancing efforts in ways that support the 811 PRA. To 

reassure owners interested in the 811 PRA, Maryland’s 

Money Follows the Person program contributed $1 

million in rebalancing funds to be held in trust by the state 

housing agency. The funds will fund housing subsidy 

payments for 811 PRA participants for up to 6 months 

if HUD PRA funding is interrupted or discontinued. 

Washington allocated Medicaid rebalancing funds to 

create a temporary rental subsidy bridge program for 

people transitioning from institutions to the community. 

The Affordable Care Act also established Health Home 

State Plan Options. This program targets people who 

have, or are at risk for, multiple chronic health conditions. 

To address the complex needs of this population, states 

receive 2 years of enhanced federal matching funds 

to provide comprehensive care coordination, health 

promotion, transition assistance from inpatient to other 

community-based settings, and community, social and 

family supports.

In addition to waiver programs, the MFP Rebalancing 

Demonstration Grant is a key source of transition services 

funding for 811 PRA residents. This CMS grant program 

provides funds to states to help people living in institutions 

transition to community living with help from grant-funded 

transition coordinators and home- and community-based 

services-funded services. States received enhanced 

federal matching funds from CMS for this program. The 

grant period ended in 2016, and states have through 2020 

to spend grant funds. Transition services may include 

help locating community-based housing, purchasing 

household furnishings, moving expenses, transition 

support, and supported employment assistance. 

Transition assistance is available for 1 year after move-in. 

In a number of states, MFP funds state staff who help 

identify and refer eligible people for 811 PRA assistance 

and who provide transition services. 

Some 811 PRA grantees proposed other federal sources 

of services funding to assist 811 PRA residents who have 

experienced homelessness. For example, Georgia and 

Minnesota plan to use funding from the Department of 

Health and Human Services’ Projects for Assistance in 
HUD Section 811 PRA Program – Process Evaluation

56

Chapter 8. Service Provision and Coordination

Transition From Homelessness program. Administered 

through the Substance Abuse and Mental Health Services 

Administration with the Department of Health and Human 

Services, the PATH program provides formula-based 

grants to states to provide a variety of services not usually 

covered by mental health programs, such as outreach, 

screening and diagnostic services, community mental 

health, substance use treatment, and some housing 

transition services. HUD’s Continuum of Care Program 

may also be a source of service resources for grantees 

serving people who have experienced homelessness. 

Finally, most of the 811 PRA grantees will use state-funded 

services or services funded through Medicaid state plans 

to supplement these federal programs.

Early Lessons on Service Delivery 

for PRA Residents 

Given the small number of 811 PRA residents housed at 

the time of data collection for this evaluation, it is too early 

to produce findings on the appropriateness, sufficiency, 

or the quality of services provided to residents during 

housing transitions and after settling into 811 PRA units or 

to comment on quality of coordination of services across 

providers. It is apparent that states identified appropriate 

funding sources for target populations, including various 

Medicaid waiver programs and other federal initiatives. 

Phase II of the Section 811 PRA evaluation will explore 

the availability and appropriateness of transition and 

long-term services and supports through additional field 

interviews with staff from service provider organizations 

and state Medicaid agencies, surveys with PRA residents, 

and tenant-level administrative data on healthcare 

diagnoses, utilization, and costs. The second phase of 

the evaluation will explore the following early lessons on 

service delivery and funding for PRA residents, as more 

811 PRA residents are housed.

Availability of long-term supportive services and 

supports. Some grantees expressed concern about the 

availability of services in rural areas. Some also mentioned 

mismatches between locations of suitable properties and 

locations of appropriate services. 

Access to transition services. All 12 grantees reported 

assigning all people transitioning into PRA units a service 

coordinator or case management services coordinator 

to help the transition to PRA units. However, transition 

services may vary based on the waiver programs and 

specific services for which an individual is eligible. All 

grantees (no response from Maryland) responded that 

transition services and supports may differ based on the 

disabling condition of the individual and the Medicaid 

waiver or state plan program under which residents are 

eligible to receive services. 

Transition services and supports also vary depending 

on whether or not an applicant is a MFP participant. 

Individuals need to reside in an institution for at least 

90 days to be eligible services and supports through 

the MFP program. Services and supports available 

through the MFP program are available for up to a year 

after the person moves into a PRA unit, although some 

MFP programs make transition services and supports 

available for less time. For example, MFP participants in 

Pennsylvania receive only transition services through MFP 

for up to 180 days after moving into PRA units. 

Coordination with the MFP program. In a number 

of states, 811 PRA activities were closely coordinated 

with the states’ MFP programs. MFP staff and systems 

were critical resources for identifying potential 811 PRA 

program applicants, determining eligibility, and (for those 

eligible for available units) assisting with transitions. 

A number of grantees expressed concerns about the 

impending expiration of the MFP program in 2020 (sooner 

in some states), given its important role in outreach and 

transition services.
HUD Section 811 PRA Program – Process Evaluation

57

Chapter 9. Conclusions and Implications for Future Research

Conclusions and 

Implications for 

Future Research

Within the statutory requirements and goals of the 

Section 811 Project Rental Assistance program, HUD’s 

2012 notice of funding availability for the demonstration 

round gave housing agencies and partnering Medicaid 

agencies latitude to tailor the 811 PRA program to meet 

the state needs and to design policies and procedures 

to meet their goals. This process evaluation report is the 

final report produced by the Phase I evaluation of the 

PRA program and provides an aggregate summary of the 

implementation of the program and the partnerships in the 

12 initial states. 

The grantees and their partners spent much of the period 

this research covers by solidifying partner roles and 

responsibilities and developing systems and procedures 

needed to accommodate this new and complex approach 

to providing affordable housing for nonelderly people with 

disabilities. This chapter briefly summarizes key lessons 

learned from the experiences of this inaugural group 

of grantees and looks ahead to implications for future 

research and practice.

Grantee Partnerships and 

Organizational Structures

The 811 PRA program requires housing agencies that 

allocate the PRA subsidies to work together with state 

Medicaid or health and human services agencies that 

provide and coordinate services for residents. Beyond 

the state-level partnerships of housing and Medicaid 

agencies, the program also requires coordination among 

other partners and stakeholders, including divisions within 

the housing and Medicaid agencies, other state agencies, 

referral agencies, service providers, property owners, 

public housing authorities, and most importantly, the 

program’s intended residents. 

Many states built PRA program partnerships from 

existing partnerships that were created for supportive 

housing initiatives or other programs that support people 

with disabilities. Regardless of whether partnerships 

were new or preexisting, the program requires a broad 

range of program decisions and activities that may be 

new or different for grantees or Medicaid agencies to 

implement. These decisions and activities include ways to 

communicate and collaborate among partners facilitate 

with HUD contracting, payment, and tenant reporting 

systems; establish coordinated applicant outreach and 

referral networks; and procedures to match applicants to 

available PRA units. 

Many states were still resolving the details of these 

arrangements at the conclusion of data collection. 

Although the partnerships are a work in process in many 

states, partners reported strategies they found helpful in 

laying the groundwork for effective partnerships.

• Most states met every 2 weeks or monthly during the 

early implementation period. Document and datasharing platforms such as SharePoint proved useful 

for collaboration and communication among grant 

stakeholders.

• Sustaining program staff is a concern in Medicaid 

agencies because of the approaching expiration of 

Money Follows the Person grants that, in many states, 

fund staff and services helping individuals transition 

out of institutions into community-based housing. 

To keep funding these activities, states may need to 

consider changes to their Medicaid waiver programs to 

incorporate housing-related activities and services and 

supports as eligible Medicaid waiver expenses. 

• Partners reported the program took much more time 

and effort than expected, especially in the first year, 

considerably more than the 811 PRA’s 8-percent 

administrative fee covers. 

Target Populations 

Each PRA partnership developed target population 

criteria based on the type of disabling condition (physical 

health, mental health, and intellectual and developmental 

disabilities). Partners also identified target populations 

based on whether individuals reside in institutions or 

at risk for institutionalization or homeless or at risk for 

homelessness. 

• Five partnerships established priorities of target 

groups based on state affordable housing priorities for 

nonelderly people with disabilities or in response to 

settlement agreements or lawsuits that required states 

to develop affordable housing options for certain 

classes of people. 

• States had to identify eligible applicants based on 

their previously defined target populations, as well as 

applicant age, income, and individual interest in the 

811 PRA program. States with higher rates of program 
HUD Section 811 PRA Program – Process Evaluation

58

Chapter 9. Conclusions and Implications for Future Research

ineligibility had open application systems or combined 

application systems and waiting lists for the PRA 

program and other housing programs, which may or 

may not have the same eligibility requirements as PRA.

• State-selected target populations informs the way in 

which a program conducts outreach, refers eligible 

households to properties with PRA subsidized units, 

and supports residents through the transition and 

ongoing tenancy. Transitioning a person from an 

institution is a different process than transitioning 

a person who is homeless or moving from a family 

home. For example, partners may need more lead time 

to work with discharge staff to transition individuals 

coming from institutions. People who are homeless or 

at risk for homelessness have more immediate housing 

needs, and maintaining contact with the person may 

be difficult during the application process if they are in 

temporary or unstable housing situations. 

• Based on early data from quarterly reports and 

discussions with program staff, some evidence 

exists that people with mental health disabilities and 

people who are at risk for homelessness are ineligible 

for admission to PRA-assisted properties at higher 

rates than other groups. This finding is an issue for 

continued monitoring.

Outreach and Referral Processes

Grantees adopted varied approaches to referring, 

screening, and placing participants. Lessons on outreach 

and referral from the early 811 PRA grantees and their 

partners include—

• Initial research suggests a centralized application and 

referral model is an effective and scalable model for 

processing applications and referring applicants to 

available units. Most (8 of 12) grantees report using 

a centralized (at the state, regional, or county level) 

approach that, although not without some challenges, 

helps them process resident applications and refer 

applicants to units efficiently. 

• Several states used or adapted case management or 

waiting-list software programs developed for other 

housing programs, in some cases specifically modified 

for the PRA program, to manage applications and 

waiting lists. Others report using standard spreadsheet 

or database software.

• States that provided cross-training—that is, 

training housing staff on Medicaid terminology and 

procedure and vice versa—reported this strategy both 

strengthened the partnerships and improved program 

operations, particularly outreach and referral where 

coordination is particularly critical.

Housing Strategies 

The pace of attracting properties and units to the PRA 

program and leasing units identified for the program was 

slower than HUD and grantees expected. Grantees and 

their partners identified a variety of obstacles that had 

slowed the owner recruitment process.

• It was difficult to identify interested property owners 

whose properties met the program’s eligibility criteria 

and who were willing to enter into lengthy contracts 

with HUD for only a few units. Grantees reported 

that some property owners had concerns about the 

30-year use agreement, the 20-year contract period, 

and the lower PRA rents that grantees established in 

their grant applications, a particular concern in costlier 

urban areas. Some owners also had to learn to use 

HUD’s subsidy administration and reporting systems, 

with which they may not have prior experience. 

• Grantees reported that tax credits or other state 

resources fund many properties, already exceeding 

the 25-percent limit of units set aside for people with 

disabilities, often because other state affordable 

housing initiatives provide incentives to build 

properties with high concentrations of units for people 

with disabilities or other vulnerable populations. Some 

states adjusted their Qualified Allocation Plans for 

tax credit properties or funding priorities for other 

programs to better align incentives with the 811 PRA 

requirements.

• To reduce per-unit PRA costs and increase the number 

of units assisted, many states chose to limit PRA units 

to those affordable to lower income households. Low 

contract rents have posed a challenge for grantees to 

attract developers or owners. The PRA program may 

be competing with other housing assistance programs 

that allow for higher rent limits, such as the Housing 

Choice Voucher program or tax credit programs that 

enable rents up to Fair Market Rent or higher.

• Incentives in the Section 811 PRA NOFA encouraged 

grantees to propose cost effective uses of the PRA that 

may not be realistic. Since cooperative agreements 

were signed, four grantees received waivers from HUD 

to increase contract rents. Rent and subsidy levels 

should be closely monitored (and reevaluated) as the 

number of subsidized units grow in order to determine 

the extent to which grantees are accurately estimating 

rent and subsidy levels over time. 

• States that were not able to identify PRA units through 

the funding process conducted extensive outreach 

to potential property owners and developers to 

encourage interest in the program. Grantees also 

developed streamlined funding applications and 
HUD Section 811 PRA Program – Process Evaluation

59

Chapter 9. Conclusions and Implications for Future Research

procedures and provided technical assistance to 

property owners and developers to make the funding 

process less complicated and more inviting.

Grantees adopted various strategies to secure Rental 

Assistance Contracts for PRA units in newly built or 

rehabilitated housing, in existing affordable developments, 

or in a combination of the two. Newly built or renovated 

housing offers the advantage of having a number of units 

coming online at once, but construction can take a long 

time. Existing housing has the advantage that it is already 

built, but in many markets affordable developments 

have low vacancy rates. Units become available to PRA 

residents only on tenant turnover. Lessons from these 

choices include—

• Although the property strategies for nine grantees 

remain unchanged, grantees that made changes 

in their housing strategies either removed existing 

properties or added new properties to their strategies, 

mainly through incentives in state housing finance 

competitions. Grantees have until September 2020 

to lease their PRA units to allow for 5 years of rental 

subsidies as funded by the grant. As new construction 

projects can take 1 to 2 years or more to build, 

grantees have to identify new construction properties 

for PRA units by 2017 or 2018 in order for the units to 

be subsidized for the full 5 years.

• Few RAC units were leased as of June 2016, largely 

because non-811 PRA residents occupied 70 percent 

of the units under RAC. PRA residents cannot lease 

units until non-PRA residents vacate them. Turnover 

rates vary considerably and sometimes unpredictably 

by property. 

• Most PRA applications are for one-person households, 

and in most cases, applicants qualify for one-bedroom 

units. Three grantees reported that the demand for 

one-bedroom apartments is greater than the supply 

and spoke to the complexities associated with 

matching the supply with demand. Louisiana is an 

example of a grantee that uses tax credit competitions 

to increase the production of affordable one-bedroom 

units in the state. 

• Some grantees also noted mismatches between 

locations of available vacancies in proximity to 

available and accessible services and desired 

residential locations of eligible applicants. Grantees 

that are tax credit-allocating agencies may consider 

using tax credit competitions to encourage the 

production of affordable housing in neighborhoods 

with access to transportation and services and 

supports necessary for people with disabilities to live 

independently.

Overall, grantees secured fewer units under RAC (28 

percent) than their proposed target goal, although 

variation exists across grantees. Grantees established 

PRA unit goal targets based on assumptions of expected 

locations for PRA units, contract rent levels, and tenant 

rent contributions that may have been unrealistic or that 

changed since grantees signed cooperative agreements 

with HUD. Grantees also developed unit goals in response 

to incentives in the 2012 Notice of Funding Availability 

that encouraged them to make cost effective use of the 

PRA subsidies. As a result, the 2012 PRA grant could fund 

fewer than the grantee reported goal of 2,193 units. The 

actual number of units subsidized through the program 

will not be known until all the PRA units are under lease. 

Service Provision and Coordination 

Given the few number of people housed in 811 PRA units 

at the conclusion of data collection for this study, it is too 

early to assess the appropriateness or effectiveness of the 

offered services. Grantees and their Medicaid partners 

identified appropriate Medicaid waivers, state plan 

services, and other service sources to address the likely 

service needs of PRA residents in each state. 

During administrative interviews conducted for the study, 

some respondents raised concerns that the large number 

of service providers who work with their target populations 

and the high turnover in some positions (such as home 

health aides) make monitoring service delivery and quality 

difficult. Further, given the newness of the 811 PRA 

program, some service providers are more knowledgeable 

than others about the program’s procedures and 

requirements. States will need to provide ongoing training 

to familiarize service provider staff about the program.

HUD and grantees should assess access to services 

to determine possible links between services and longterm housing tenure. Adequate transition and long-term 

services and supports were often not equally available 

in all geographic areas, and some states have difficultly 

linking services to resident needs. A tool to map residents 

to available services would be beneficial.

Looking Ahead to Future Research 

and Practice 

As of spring 2017, the research team for Phase II of 

the Section 811 PRA evaluation completed the design 

phase and will begin collecting data soon. The Phase I 

evaluation informed all aspects of the design approach 

for Phase II. Data collection in Phase II will continue to 

assess implementation as the 811 PRA program matures. 

The study will further explore the partnerships, assess 
HUD Section 811 PRA Program – Process Evaluation

60

Chapter 9. Conclusions and Implications for Future Research

success, and provide a framework for interpreting the 

partnership’s effect on program outcomes. The study 

will also continue documenting states’ experiences 

with outreach and referral methods and will identify 

characteristics of successful and effective outreach and 

referral methods.

The Phase II research will also begin to look at participantlevel outcomes and access to services and to estimate 

PRA program costs compared with the outcomes and 

costs of comparison groups with similar characteristics 

and disabilities. A resident survey in the Phase II 

evaluation will provide residents’ points of view on their 

experiences with transitioning to PRA-subsidized housing, 

views on the quality of properties and neighborhoods in 

which they live, and ability to access the needed supports 

and services to successfully maintain tenancy. A final 

report on the Phase II evaluation is expected in the spring 

of 2019.
HUD Section 811 PRA Program – Process Evaluation

61

References

References 

Centers for Medicare and Medicaid Services (CMS). 2015. “CMCS Informational Bulletin: Coverage of Housing-Related 

Activities and Services for Individuals with Disabilities.” https://www.medicaid.gov/federal-policy-guidance/

downloads/CIB-06-26-2015.pdf.

U.S. Department of Housing and Urban Development (HUD). 2013a. “Housing: Housing for Persons With Disabilities (Section 

811).” https://portal.hud.gov/hudportal/documents/huddoc?id=housing-disabilities-2013.pdf.

. 2013b. “HUD Handbook 4350.3: Occupancy Requirements of Subsidized Multifamily Housing Programs.” 

https://www.hud.gov/sites/documents/43503HSGH.PDF.
U.S. Department of Housing and Urban Development

Office of Policy Development and Research

Washington, DC 20410-6000

January 2018