Under the United States Housing Act of 1937, as amended, Congress created the federal public housing program to provide decent and safe rental housing for eligible low-income families, the elderly, and persons with disabilities. HUD administers federal aid to local public housing agencies that manage housing for low-income residents at rents they can afford. More specifically, 3,150 public housing agencies manage approximately 1.2 million public housing units throughout the nation, of which approximately 1 million are occupied. Public housing comes in all sizes and types, from scattered single-family houses to high-rise apartments. Funding for public housing construction, renovation, or operation can come from a number of HUD programs, as well as other government and private sources. HUD’s Public Housing Capital Fund (Capital Fund) provides funds (distributed by formula) for activities such as redesign, reconstruction, improvement of accessibility, and replacement of obsolete utility systems. The fiscal year 2005 appropriation for the Capital Fund was about $2.4 billion. HUD’s Public Housing Operating Fund (Operating Fund) provides operating subsidies to housing agencies to help them meet operating and management expenses. The fiscal year 2005 appropriation for the Operating Fund was about $2.4 billion. In addition, between fiscal years 1993 and 2005, Congress appropriated $6.8 billion for the HOPE VI program, which HUD awarded to public housing agencies for planning, technical assistance, construction, rehabilitation, demolition, and housing choice voucher assistance. While most of the funds are intended for capital costs, a portion of the revitalization grants may be used for community and supportive services. In addition, public housing agencies use the HOPE VI revitalization grant to leverage additional funds from sources such as other HUD funds, state or local contributions, or public and private loans. In 2002, we reported that housing agencies expected to leverage—for every dollar received in HOPE VI revitalization grants awarded through fiscal year 2001—an additional $1.85 in funds from other sources. We also found that housing agencies that had received revitalization grants expected to leverage $295 million in additional funds for community and supportive services. In addition to leveraging funds from a variety of sources, housing agencies may use Low-Income Housing Tax Credits—which are federal tax credits for the acquisition, rehabilitation, or new construction of affordable rental housing—as well as Medicaid Home and Community-Based Services waivers, which allow flexibility in providing healthcare or long-term care services to Medicaid-eligible individuals outside of an institutional setting. Residents of public housing who are elderly or have disabilities may have more special needs, compared with other residents, due to their age and type of disability. According to a 2002 study by the Housing Research Foundation, elderly public housing residents are more likely to be “frail” or have disabilities, compared with other elderly persons not living in public housing. The researchers reported that more than one in five elderly public housing residents were classified as persons with disabilities, compared with only 13 percent of U.S. elderly persons. In addition, the report found that over 30 percent of elderly public housing residents have at least one functional problem, such as difficulty with cooking, seeing, and hearing, compared with just over 20 percent of all elderly persons. Some elderly persons or persons with disabilities may require assistance with the basic tasks of everyday life, such as eating, bathing, and dressing. In addition, the needs of the elderly or persons with disabilities result in a need for physical features in residences that adequately accommodate physical limitations. According to 2005 HUD data, 64 percent of the approximately 1 million occupied public housing units are occupied by at least one elderly person or a person with a disability, and 50 percent of all heads of public housing households are either elderly (31 percent) or non-elderly persons with disabilities (19 percent), as shown in figure 1. Residents who are elderly or have disabilities live in a variety of public housing settings, including developments that are occupied primarily by elderly residents or residents with disabilities as well as developments that are occupied primarily by families. According to 2005 HUD data, of approximately 500,000 public housing units that are occupied by a head of household who is elderly or has a disability, 47 percent are in developments that are occupied primarily by elderly persons or persons with disabilities, 40 percent are in developments that are occupied primarily by families (family housing developments), and 13 percent are in developments that include buildings that are occupied by families and buildings that are occupied by elderly persons and persons with disabilities (mixed developments). While HUD collects data for several elements describing the physical and social conditions that exist at its public housing developments, the data do not sufficiently establish whether a housing development is severely distressed. Based on survey responses from public housing directors— covering 66 housing developments with indications of potential distress and occupied primarily by the elderly or persons with disabilities—we found that 11 developments exhibited signs of severe physical distress; 12 had signs of severe social distress; and an additional 5 developments had signs of both severe physical and social distress. Although the remainder of the 66 developments had fewer signs of severe distress, the public housing directors we surveyed pointed out several conditions that adversely affected the quality of life for their tenants who are elderly or have disabilities. The factors they most frequently cited were (1) aging buildings and systems, including inadequate air-conditioning; (2) lack of accessibility for residents with disabilities; (3) small studio apartments; (4) tension between elderly residents and non-elderly residents with disabilities; (5) lack of supportive services; and (6) security and crime issues. As previously discussed, Congress expanded the statutory definition of “severely distressed public housing” in 2003 to include, among other factors, housing developments in severe distress because of a lack of sufficient appropriate transportation, supportive services, economic opportunity, schools, civic and religious institutions, and public services. However, HUD data do not indicate whether a development has these kinds of public and other supportive services. HUD collects, maintains, and analyzes data on public housing primarily through a database system and a management center. HUD uses the Public and Indian Housing Information Center (PIC) system—which was designed to facilitate Web-based exchange of data between public housing agencies and local HUD offices—to monitor the housing agencies, detect fraud, and analyze and provide information to Congress and other interested parties. PIC contains a detailed inventory of public housing units and tenant (household) information about occupants. For example, the PIC database maintains information on the number of developments and units, age of the development, extent to which apartment units are accessible for persons with disabilities, and tenant information such as the age, disability status, and income of families who participate in public housing programs. HUD’s Real Estate Assessment Center (REAC) monitors and evaluates the physical condition of public housing and other properties that receive financial assistance from HUD and also assesses their financial condition. For example, the Physical Assessment Subsystem within REAC maintains information about the physical condition of HUD properties, based on on-site physical inspections, which identifies housing developments that are physically deteriorated, have health and safety hazards, or deficiencies such as tripping hazards on sidewalks or parking lots, damaged fences or gates, blocked emergency exits, or inoperable smoke detectors inside apartments. Using the limited data that were available from HUD and other sources, we defined eight measures to indicate potential severe distress for developments: (1) REAC physical inspection results; (2) adjusted physical inspection results provided by the Urban Institute; (3) building age; (4) vacancy rate; (5) total household income by unit; (6) poverty rate for the census tract; (7) accessibility of units to persons with disabilities; and (8) whether developments applied for HOPE VI or were approved for demolition, disposition, or HOPE VI funding. As noted previously, we then developed an “index of distress” to score conditions at public housing developments. We found that 76 (2 percent) of the 3,537 housing developments mainly occupied by the elderly and non-elderly persons with disabilities showed indications of severe distress. In contrast, other developments were more likely to show indications of severe distress. We found that 958 (12 percent) of 7,932 family housing developments and 69 (15 percent) of 466 mixed housing developments showed indications of severe distress. In addition, some public housing directors we interviewed reported that family housing developments, near or adjacent to their developments occupied primarily by elderly residents and residents with disabilities, were more likely to be in worse condition or afflicted by neighborhood crime or illicit activities. According to HUD’s data, the following characteristics describe the 76 housing developments that were occupied by mostly elderly persons and non-elderly persons with disabilities: 21 had been approved for demolition, disposition, or HOPE VI 72 had a building that was more than 30 years old; 64 had few units (less than 5 percent) that met accessibility standards; 24 had a physical inspection score under 60 percent; 41 were in a census tract with a poverty rate greater than 35 percent; 26 had households with a total median income under $7,000. Responses to our survey of public housing directors indicated that some of the 76 public housing developments occupied primarily by elderly persons and non-elderly persons with disabilities were severely distressed and that, among those that were not, certain characteristics nevertheless adversely affected the quality of life for their residents. We received responses covering 66 of these 76 developments and found that 11 showed signs of severe physical distress, 12 had signs of severe social distress, and five others had signs of both physical and social distress. In developments where survey data indicated signs of severe distress, housing directors reported deterioration and obsolescence in key systems. However, housing directors described the condition of the physical structures at 34 developments as either, “not at all deteriorated” or “a little deteriorated” (see fig. 2).