Federal homelessness policy becomes target of the right
GOP lawmakers back linking mandates to aid
WASHINGTON — The bipartisan approach that has dominated federal homelessness policy for more than two decades is under growing conservative attack.
The policy directs billions of dollars to programs that provide homeless people with permanent housing and offer — but do not require them to accept — services such as treatment for mental illness or drug abuse. The approach, called Housing First, has been the subject of extensive study and expanded under presidents as different as George W. Bush and Barack Obama. President Biden’s homelessness plan makes Housing First its cornerstone and cites it a dozen times.
But Housing First has become a conservative epithet.
Republican lawmakers, backed by conservative think tanks and programs denied funding by Housing First rules, want to loosen the policy’s grip on federal dollars. While supporters say that housing people without preconditions saves lives by getting them off the streets, critics say it ignores clients’ underlying problems and want to shift funding to groups such as rescue missions that demand sobriety or employment. Some even blame Housing First for the growth in homelessness.
“No more Housing First!” said Representative Andy Barr, Republican of Kentucky, after introducing a bill last month that would offer more money for programs with treatment mandates.
Senator J.D. Vance, Republican of Ohio, used two recent hearings to argue that Housing First ignores the root causes of homelessness. The Cicero Institute, a Texas policy group, is promoting model state legislation that bars Housing First programs from receiving state funds.
The escalating war over an obscure social service doctrine is partly an earnest policy dispute and partly an old-fashioned rivalry between groups seeking federal funds. But it is also a new ideological and political flash point, with former president Donald Trump and others on the right using it to promote their argument that homelessness in liberal cities is an indictment of Democratic governance more broadly.
“The attack on Housing First is the most worrisome thing I’ve seen in my 30 years in this field,” said Ann Oliva, chief executive of the National Alliance to End Homelessness, an advocacy group with bipartisan roots. “When people have a safe and stable place to live, they can address other things in their lives. If critics succeed in defunding these successful programs, we’re going to see a lot more deaths on the street.”
Until Housing First emerged a generation ago, services for homeless people were built on a staircase model: Clients were meant to progress from shelters to transitional programs, where training or treatment would ready them for permanent apartments. In practice, services were weak and failure rates high, with large numbers of noncompliant people returning to the streets.
The new approach flipped the script, offering housing first — subsidized apartments with no preconditions — and hoped that residential stability would promote further advancement. Supporters emphasized that Housing First was not “housing only”; it included services such as psychiatric treatment, but on a voluntary basis.
Although skeptics feared that troubled people would leave or get evicted, early results were impressive.
After five years, 88 percent of the clients in a New York City program called Pathways to Housing remained housed, compared with 47 percent in the usual system of care. Despite the lack of treatment mandates, Pathways clients were no more likely than those in the regular system to report mental illness or substance abuse. A large experiment covering five Canadian cities achieved similar results.
Citing such studies, supporters praise Housing First as unusually “evidence based.”
Contemporaneous research also offered hopes of cost savings. While most people entering shelters were quickly rehoused, work by Dennis Culhane of the University of Pennsylvania showed that a small minority became chronically homeless and consumed tens of thousands of dollars of services in jails and emergency rooms — roughly what it cost to house them. Supporters hoped Housing First would prove “not only more humane but for some people potentially cheaper,” Culhane said.
Housing First exploded from a model to a movement under a Republican administration. Philip F. Mangano, the Bush administration’s top homelessness official, was relentless in promoting Housing First programs, and the approach, which initially targeted the chronically homeless, broadened to a wider range of people experiencing homelessness.
Some recent studies have noted limits on what the programs achieve. The National Academies of Sciences, Engineering, and Medicine in 2018 found “no substantial evidence” that supportive housing improved clients’ health. Likewise, the medical journal The Lancet found “no measurable effect” on the severity of psychiatric problems, addiction, or employment.
Still, proponents say Housing First has succeeded where it matters most — getting people off the streets.
“Getting people out of homelessness quickly is more important than anything, because life on the streets is so dangerous,” Culhane said. “The evidence shows that Housing First is a very successful policy. Undoing it would be a disaster.”