Second 8 is really what you make of it. I happen to have a great relationship with our S8 office and the girls that work there take care of me. I had one tenant who basically left a huge mess for me to clean up after he moved out. They demanded a itemized list of damages and my time to make the place rentable again. They set him up on a payment plan and he had to continue to pay me every month until I was repaid for all my cost.
Not all S8 tenants live in low to no income neighborhoods. My current tenant happens to be a full time student and works part time as a home health aid and she has one little baby. She is so far the perfect tenant.
As far as the lead paint issue. I haven't ran into that yet. I imagine, as with any other lead paint issue, as long as you repaint over it, it will be sealed and you won't have any problems. Remember, if your tenant has any children under 6 yrs old, you can have no flaking paint anywhere on the property, including the garage.
I have to go through a yearly dwelling inspection permit process through my city, so the yearly S8 inspection really isn't a big deal. The best part if you have any problems with your S* tenant, you call their case manager and they handle the issue, at least in my case