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Home > Sangre Celestial > Housing First: Where’d it come from, how successful is it?
Podcast: Sangre Celestial
Episode:

Housing First: Where’d it come from, how successful is it?
Category: Arts
Duration: 00:00:00
Publish Date: 2025-08-19 19:00:00
Description: President Trump recently said he wants to completely clear the nation’s capital of unhoused people. This follows his executive order, called “ Ending Crime and Disorder on America’s Streets ,” which makes aggressive moves against liberal policies. It includes pulling funding from cities if they don’t ban urban camping, and pulling funding from needle exchanges and other so-called harm reduction organizations (and even criminally investigating them). The order also goes after Housing First — one of the pillars of American homelessness policy. The idea: Quitting drugs/alcohol or entering treatment should not be a prerequisite for getting into housing. Trump’s order instructs the Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD) to deny funding to Housing First programs. That means permanent supportive housing sites in Los Angeles could lose federal money. KCRW hears from Sam Tsemberis , who came up with the Housing First approach. He’s also a UCLA professor and the founder and CEO of the Pathways Housing First Institute . Tsemberis clarifies that Housing First is a form of permanent housing with a rent subsidy and support services for residents. It’s not a shelter, transitional housing, or a hotel stay. Before his approach, “there was treatment and sobriety first, and then housing,” he explains. “And this gets to a fundamental belief about root causes. What is causing homelessness? … And the administration now, and other administrations going back to Reagan … even though they advocated for Housing First, the root cause belief was that … addiction and mental illness cause homelessness. In fact, only a small portion of people who are homeless have addiction and mental illness.” A much bigger proportion of people end up on the streets because they struggled to pay bills (particularly medical ones), lost their job, lost their apartment because it was sold and they couldn’t afford the new rent, he notes. “People get homeless for all kinds of reasons, and root causes are not individual characteristics. They're more about the society we live in, and the cost of living, and the cost of housing.” More: ‘There Is No Place for Us’: How Americans were pushed into homelessness Initially, Tsemberis’ approach received pushback, especially from Treatment First providers who believed people had to earn housing so it would be meaningful. ”They would hold people who had a severe mental illness and addiction, hold them hostage in treatment for as long as it would take to get that under control in order to get housing. These are psychological and health conditions that take a long time to heal, and so people were having a very hard time getting into housing. And where we were working in that system, we found people would remain homeless for years, and we needed to do something different.” And so, Tsemberis created the initial Housing First program. “And then we were able to take people from the streets, as they were, if they wanted housing, and bring them into a place of their own. And then support them with their addiction and their mental illness after they were housed.” In the first year of doing this, Tsemberis says his team housed 50 people in the Hell’s Kitchen area of New York City, and by the end of the year, 84% of those people remained housed — an unusually high number at the time. “Having a place is transforming, and many people report that it helps them to use less. They're not going to sobriety, not everyone subscribes to that. But they're not putting themselves to sleep by intoxicating themselves with drugs, so that they can survive life on the street.” Still, it took years to convince federal authorities to support Housing First and believe its success, Tsemberis says. “We ended up writing a grant, and we did a randomized control trial, and then the results were like 80% stability housing for Housing First, and about 35 or 40% for Treatment First. And we published it — American Journal of Public Health. And then people began to pay attention.” Now it’s ironic that the federal government doesn’t want to accept Housing First again, he notes, because of a difference in values and a denial of the root causes of homelessness. Public perception is tough to change, and the most visible unhoused people have substance and mental health issues, he says, though they represent 15-20% of the entire population. Another misunderstanding is that putting someone in housing costs more money than leaving them on the streets or in a shelter, Tsemberis adds. Still, Housing First hasn’t been taken to scale. Tsemberis cites a few exceptions: “The City of Milwaukee; the United States Veterans Administration has taken Housing First as an approach to ending veterans’ homelessness. They started with about 80,000 veterans on the street, and have reduced that number by 56%. There are over 100 cities now that have ended veterans’ homelessness using Housing First.” Meanwhile, Trump’s executive order presents false outcomes of moving people off the streets, Tsemberis says. “You can clean out people today off the streets. But tomorrow, there'll be more people. So you need to take care of who's on the streets today, and you also need to take care of what is it that's contributing to homelessness all the time?” If Trump cuts federal funding to homeless services in LA, Tsemberis can’t imagine how big the disaster would be, he says. He notes that hundreds of thousands of people are currently in housing thanks to rent subsidies that HUD pays. If HUD stops those payments, those tenants would be evicted. The best shot at taking people off the streets now, Tsemberis points out, is the Section 8 voucher program. “If we were willing to pay a little bit more on the voucher and support landlords with case management … in case something happens with that tenant, incentivize them by letting them know that if there's damage to the apartment, it would be covered — there are practical things you could do that would support landlords to accept the voucher.” More: Housing First helped this woman get off drugs, turn her life around
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