PUBLIC HEALTH SERVICES TO INDIVIDUALS The Health Services Administration and the Alcohol, Drug Abuse, and Mental Health Administration of HEW, through grants to public and private nonprofit agencies, provide a variety of special health services to certain population groups most in need of the services. This mechanism for provision of health care primarily serves lower income groups. Some of these services are listed in table 1 together with actual 1973 costs and estimated costs for fiscal years 1974 and 1975. The family planning project grants are made mostly to State and local health agencies for the delivery of family planning services to female clients. Grants are also made for the training of family planning workers and for the development of educational and informational materials. Migrant health grants are used to fund the delivery of comprehensive health services to migratory farmworkers and their families. Grants may be made to public or private nonprofit agencies. In 1975, 355,000 persons are expected to receive services. Community health center project grants are to upgrade ambulatory health services, especially in underserved areas. Comprehensive public health services are strengthened through Federal formula grants to State health and mental health agencies. The funds are used to establish and maintain adequate community, mental, and environmental public health services. Funds may be used to train State and local public health workers. Health Maintenance Organization (HMO) grants and loans are to promote the expansion of health maintenance organizations as a health care option. Grants and contracts will be available only to public and nonprofit HMO's. The National Health Service Corps provides health professionals to communities which are designated as critical health manpower shortage areas. In 1975, the program will support approximately 531 health professionals in about 245 communities, an increase of 45 communities over the 1974 level. Maternal and child health services are financed through formula grants to State health agencies and project grants to State health agencies and to institutions of higher learning. The funds are used to provide a wide variety of health services to mothers and children in need of care. The purpose of the program is to reduce infant mortality and improve the health status of mothers and children, especially in rural areas and in economically depressed areas, and to improve services for crippled children. In 1975 approximately 520,000 women will receive prenatal and postpartum care in maternity clinics. Mental health community assistance project grants are made to public or private nonprofit community agencies to aid in general mental health and prevention and control of narcotic addiction and alcoholism. Services provided include outreach, rehabilitation, and informational services. HOUSING: INCOME-TESTED U.S. Department of Housing and Urban Development Programs LOW RENT PUBLIC HOUSING BASIC PROGRAM INFORMATION LEGISLATIVE OBJECTIVE. To provide decent, safe, and sanitary lowrent housing and related facilities for low-income families. TYPE OF ASSISTANCE.-Loans and grants to local public housing agencies for acquisition, construction, or leasing of housing; grants (annual contributions) to housing authorities to guarantee debt service, to assure the low-rent character of the projects and to achieve and maintain adequate operating and maintenance services and reserve funds. For leased housing annual contributions are made to cover the difference between rents paid by tenants and rent payable to the owner plus the local public housing agency's operating expenses. Tenants benefit from low rents for adequate housing not otherwise available to them. DATE ENACTED.-1937, with subsequent amendments. FINANCING. This program is funded through annual budget appropriations. ADMINISTRATIVE AGENCY.-Department of Housing and Urban Development, through area offices and local public housing authorities established under State laws. A local housing authority (LHA) may contract out the management of its projects to a qualified group ranging from a private profitmaking management firm to a nonprofit, tenant-organized management cooperative. TYPE OF HOUSING.-Housing may be new or rehabilitated multifamily, semidetached or detached units. High-rise, elevator-type projects for families with children may not be constructed unless it is determined that there is no other practical alternative. Projects. may be developed for elderly, disabled, or handicapped persons only, for nonelderly families with children, or for both type families with provision for separate facilities for the elderly. Congregate housing may be constructed for elderly tenants; that is, housing with central kitchen and dining facilities and in which some or all of the units do not have kitchen facilities. Single-room occupant housing ma be constructed for single nonelderly displaced persons. (243) LOCATION OF HOUSING.-Housing sites are selected by the local housing authority, subject to HUD approval, taking into consideration such factors as the need for such housing, suitability of the site in relation to the surrounding neighborhood and city plans, proximity to public transportation and community facilities, feasibility of relocating site occupants, and compliance with equal opportunity requirements. Local housing authorities are expected to consider the use of HUDor VA-owned housing acquired through their mortgage insurance or loan guaranty programs. A project may be on a single site or on scattered sites; that is, one or more sites with one or more dwelling units on each site. The proposed program must be approved by the local governing body. New criteria for approval of housing assistance applications have been added by the Housing and Community Development Act of 1974. These are described in the section on the lower income housing assistance program. LIMIT ON COST.-Costs of construction and equipment may not exceed by more than 10 percent the appropriate prototype cost for the area (costs of comparable new construction in the area taking into consideration durability design features and related facilities needed for the project). TENANT ELIGIBILITY CRITERIA FAMILY COMPOSITION.-Families must consist of two or more related persons, or a single elderly, disabled, handicapped, or displaced person, or the remaining member of a tenant family (the last member of an eligible family after other members, such as children, have left the home). An "elderly" person is one who has attained 62 years of age or is disabled or handicapped. The term "elderly families" includes two or more elderly, disabled, or handicapped individuals living together, or one or more such individuals living with another person who is determined under regulations of the HUD Secretary to be a person essential to their care or well-being. Disability means "inability to engage in any gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or which can be expected to last for a continuous period of not less than 12 months." Handicapped is defined to mean "determined to have a physical impairment which (1) is expected to be of long continued and indefinite duration, (2) substantially impedes his ability to live independently, and (3) is of such nature that such ability could be improved by more suitable housing conditions." A displaced person is one who has been displaced by urban renewal or other Government action or by the occurrence of a natural disaster. INCOME TEST Income limits.-Families must be unable to afford decent, safe and sanitary housing supplied by private enterprise. Income limits are set by local housing authorities and vary according to housing costs in the area. In 1972 the median income of families moving into public housing was $1,990 for elderly families and $2,816 for all families. At least 20 percent of the dwelling units in any project placed under annual contribution contracts should be occupied by "very low income families." These are families whose incomes do not exceed 50 percent |