Non-Elderly Disabled Category 2 Housing Choice Voucher Program: An Implementation and Impact Analysis. III. Impact of Ned2 Vouchers on Community Transitions


The primary purpose of the NED2 voucher program is to expand the availability of rental subsidies to people residing in institutions to enable them to make transitions to community-based settings. Although the process analysis indicates that vouchers were used to facilitate transition to the community by individuals residing in institutions, it does not answer the broader question: did the NED2 vouchers change the overall rate of transitions among eligible individuals in communities that received the vouchers?

We conducted an impact analysis to assess the change in the rate of community transitions among a group of individuals eligible for NED2 housing vouchers in PHA regions that received the vouchers (hereafter "treatment areas") relative to transitions of comparable individuals in selected regions within the same state that did not receive the vouchers (hereafter "comparison areas"), controlling for other factors that could affect transition rates. We restricted the analysis to nursing home residents, as opposed to the larger pool of people residing in institutions, because the overwhelming majority of voucher users initially resided in nursing facilities and necessary data were only available for people in such settings.

This chapter describes the methodology, data sources, and major findings from the impact analysis. It also compares the characteristics of NED2 voucher users to non-users in the treatment areas to understand how the groups differ and to inform future policies for targeting NED2-type vouchers to those most likely to need and use them.

We begin by providing an overview of the methodological approach and describe the survey and administrative data used for the analysis. We then describe NED2 voucher users' demographic, health, functional status, and institutional-related characteristics. Voucher users are found to differ from non-users on a number of characteristics, including gender, marital status, functional status, and length of stay in a nursing facility. We go on to explain the selection of treatment and comparison areas and the use of propensity score matching to select a sample of people similar to NED2 voucher users. Finally, we present findings from the analysis estimating the impact of NED2 voucher availability on transitions to the community. The estimated impacts were quite substantial in a pooled sample of three sites; in fact, the results suggest that each voucher used in these areas represents a transition that would not have otherwise occurred. We found no evidence of an impact in a pooled sample of the two other sites.

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