The Collapse of Housing First?

HOUSING CRISIS - Since the late 2000’s, the official homeless policy at all levels of government has been Housing First, where the primary goal is to house people, preferably in their own apartment.  Once provided with stable housing, people are more likely to benefit from other supportive services like mental health, substance abuse, and employment counseling.  When first introduced, Housing First produced promising results; formerly homeless people given permanent supportive housing (PSH) stayed housed longer, were healthier, and were more likely to benefit from support services. The model was so successful, HUD adopted it as the federal government’s official housing policy, focusing most homelessness funding at PSH programs. 

Unfortunately, Housing First came at a cost, usually in terms of reduced funding for other programs. According to the US Interagency Council on Homelessness, by 2013, transitional shelter units dropped by more than 100,000, from 197,190 to 95,450[1]. 2013-14 seems to be the tipping point in homelessness. The USICH report says homelessness decreased by 31.4 percent between 2007 and 2014, but increased by 20.5 percent over the next five years. 2013 was also the year HUD began penalizing local agencies if they didn’t adopt a Housing First model. In addition, HUD required Housing First programs to use the “no barrier” model, where people were placed in housing with no pre-commitment to treatment, nor the requirement to participate in support programs once housed[2]. The State of California followed suit in 2016, telling local governments they had to follow the No Barrier Housing First Model. 

By adopting a no-barrier model, Housing First advocates virtually guaranteed its eventual failure. First, the new HUD guidelines emphasized “rapid rehousing” over transitional sheltering. An example of rapid rehousing is a Project Room key program—the object is to get people off the street as quickly as possible, and assist their transition to PSH.  The difference between rapid rehousing and transitional shelter is mostly semantic, but transitional shelters can include congregant facilities; rapid rehousing is almost exclusively a one-unit/one-person program.  As USICH pointed, out, one of the reasons for the apparent decrease in homelessness through 2013 was “reclassifying” more than 100,000 people from being considered homeless in a transitional shelter to being “housed” in rapid rehousing. As the report said, “‘Reclassifying’ ” 101,746 individuals that moved from transitional programs to rapid rehousing programs as no longer experiencing homelessness has been cited as evidence of the reduction of homelessness. This reclassification has also been used to support the effectiveness of housing first, thus this may not represent a true reduction. The conclusion from ED and HUD data is that homelessness is increasing, irrespective of how it is defined.” 

Besides obscuring the numbers, the emphasis on No Barrier Housing First dealt a double blow to providing the support services essential to successfully transitioning someone from homeless to housed. First, Housing First became Housing Alone, where construction projects and other long-term solutions took precedence over ongoing program funding; organizations followed the money.  There simply isn’t enough money to pay for housing and services.  As the report stated, “Speed of placement became the focal measuring stick supplanting robust holistic wraparound services combined with housing to optimize self-sufficiency and reduce returns to homelessness.” Second, where services could be provided, PSH residents were under no obligation to use them. Local governments, with social programs already underfunded, have little incentive to provide the intensive and consistent services needed to support many homeless, between 50 percent and 75 percent of whom have chronic mental and/or substance abuse problems.

After HUD and state governments emphasized Housing First, homelessness began increasing in 2014.  Although advocates would have us believe the increase is due to the high cost of housing and lack of housing stock, the increase has been nationwide, even in areas where housing is nowhere near as expensive as in LA.  Conversely, the City of New York, one of the few places with housing prices higher than LA, has adopted a program of shelters and robust support services that has been far more effective at reducing unsheltered homelessness. 

In Los Angeles, the net result of Housing First policies has forced local governments to deal with a population of unhoused individuals who are more difficult to integrate into traditional housing while at the same time denying them the services they need to achieve that integration. Housing First has been a regional economic powerhouse, funding thousands of jobs in outreach and construction, with little to show for it in terms of actual impact on the unhoused population. At the same time, the organizations that profit from the current structure have so ingrained the idea of Housing First as a universal solution that few civic leaders question it, and if they do, it comes at the peril of infuriating a corps of activists who define anything other than private housing as carceral or hating the homeless. 

Despite strong political support, Housing First is slowly collapsing under the weight of its own policies.  Homelessness continues to increase.  Construction of PSH units proceeds at a glacial pace. In Los Angeles and San Francisco, no barrier rapid rehousing programs have resulted in millions of dollars in damage to private and public buildings, including lawsuit payments in excess of $11 million in San Francisco.  In Los Angeles, the Skid Row Housing Trust has been driven to bankruptcy because it can no longer maintain the buildings it owns, primarily because of damage caused by unstable residents.  

LAHSA, which may be the most poorly-managed public agency in all of Los Angeles County, is coming under increased scrutiny. Its farcical 2022 point-in-time count was questioned when it was released in late 2022, after several months of delays, and has been flatly contradicted by a more professional survey by the RAND Corporation, released last month.  In the last few years, L.A. County Auditor reports have called out poor financial practices, like paying on contracts that have not been properly approved for renewal; chronic finance department understaffing, lack of employee accountability, and a near total absence of performance measures. One of the most obvious signs of the cozy relationship between LAHSA and its contractors is the recent hiring of the former Director of St. Joseph’s as LAHSA’s new CEO, at an annual salary of $430,000.  The person whose organization has made millions from LAHSA contracts now runs the agency that pays it. 

Eventually—and it may be sooner than we think—it will become obvious to everyone Housing First simply does not work.  Some members of Congress are already calling on HUD to deemphasize Housing First if it comes at the expense of other, less expensive and more effective, solutions. If LAHSA ever builds a significant number of PSH units, and the homeless population continues to climb, (which it will, as it has), simple economics will force a change of course. The five unsheltered homeless people who die every night will become too many deaths to bear.  Unless more of us are willing to speak the truth to our leaders at all levels of government, and homelessness will continue to increase. 

 

(Tim Campbell is a semi-retired public sector performance audit manager, who knows about successful and failed programs, a resident of Westchester who lives with the real-world results of years of poor policy decisions every day.)  

 

[1] USICH 2020 report. P.8 

[2] USICH 2020 report. P.11