In 2013, the estimated national public cost of chronic homelessness was between $3.7 and $4.7 billion according to the United States Interagency Council on Homelessness (USICH). Through Housing First programs, chronically homeless individuals are using fewer hospital resources, spending less time in costly incarceration and requiring fewer emergency room visits. For example, a review of the impact of permanent supportive housing and case management on the health of the chronically homeless found evidence that these services have a positive impact on health outcomes such as self-reported mental health status and substance use, a large impact on health care utilization, and a reduction in Medicaid health care costs. Studies in New York City and in Utah have shown that every homeless person housed in programs such as Housing First saves taxpayers $10,000 and $8,000 a year, respectively. A research study at University of Northern Carolina also reported that a housing project for the chronically homeless called Moore Place had saved the county $2.4 million. The implementation of Housing First philosophy when working with homeless families and young adults has been shown to increase clients' enrollment in public assistance benefits, decrease involvement in the child welfare system, and have very few returning to homelessness. When comparing the effects of Housing First on older and younger homeless adults, older homeless adults have shown significantly higher rates of improvement in areas like mental component summary scores, condition specific quality of life, mental health symptom severity, and percentage of days stably housed. When comparing the effects of Housing First on homeless adults with lower or borderline intellectual functioning to homeless adults with normal intellectual functioning it has been shown that there is no significant difference. The United States Congress appropriated $25 million in the McKinney-Vento Homeless Assistance Grants for 2008 to show the effectiveness of Rapid Re-Housing programs in reducing family homelessness. In February 2009, President Obama signed the American Recovery and Reinvestment Act of 2009, part of which addressed homelessness prevention, allocating $1.5 billion for a Homeless Prevention Fund. The funding for it was called the "Homelessness Prevention and Rapid Re-Housing Program" (HPRP), and was distributed using the formula for the Emergency Shelter Grants (ESG) program. On May 20, 2009, President Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act into Public Law (Public Law 111-22 or "PL 111-22"), reauthorizing HUD's Homeless Assistance programs. It was part of the Helping Families Save Their Homes Act of 2009. The HEARTH act allows for the prevention of homelessness, rapid re-housing, consolidation of housing programs, and new homeless categories.