Housing First Works, Fund It

What You Need To Know

• Housing Works was founded on the principle that housing is healthcare. 

• The Housing First model prioritizes permanent housing provided quickly without any requirements from residents. Additional wrap-around services such as drug treatment, behavioral health services, and other social and healthcare services are available. 

• A study evaluating housing first projects in ten European cities found that most people, even those who use drugs excessively, could retain their house over a long period of time (three or more years). Many people who used substances problematically said they had decreased their use thanks to housing. Participants reported a higher quality of life, reduced stress and an increase in personal safety (Busch-Geertsema 2013).

• Housing First has economic benefits which “stem from combined savings from healthcare, emergency housing, judicial services, welfare and disability costs, and benefits from increased employment.”* 

• Evidence indicates that Housing First programs successfully house families and individuals with intersecting vulnerabilities, such as veterans, individuals experiencing substance use or mental health issues, survivors of domestic violence, and individuals with chronic medical conditions such as HIV/AIDS.*

Core Principles of Housing First

1. Immediate access to permanent housing with no housing readiness requirements. The key to the Housing First philosophy is that individuals are not required to demonstrate that they are ‘ready’ for housing. Housing is not conditional on sobriety or abstinence. Program participation is also voluntary. 

2. Consumer choice and self-determination. Housing First is a rights-based, client-centered approach that emphasizes client choice in terms of housing and supports.

   1. Housing – Clients can exercise some choice regarding the location and type of accommodation they receive.

   2. Supports – Clients have choices in terms of what services they receive and when to start using services.

3. Recovery orientation. A recovery orientation focuses on individual well-being and ensures that clients have access to a range of supports that enable them to nurture and maintain social, recreational, educational, occupational, and vocational activities. For those with addiction challenges, a recovery orientation also means access to a harm reduction environment. 

4. Individualized and client-driven supports. Individuals are unique, and so are their needs. Individuals are provided with “a range of treatment and support services that are voluntary, individualized, culturally-appropriate, and portable (e.g., in mental health, substance use, physical health, employment, education). Rent supplements should ensure that individuals do not pay more than 30% of their income on rent.

5. Social and community integration. Part of the Housing First strategy is to help people integrate into their community, and this requires socially supportive engagement and the opportunity to participate in meaningful activities. 

Programs To Know

• Housing Works: Since 1990, we have provided a comprehensive array of services to more than 30,000 homeless and low-income New Yorkers living with and affected by HIV/AIDS. We believe that providing stable housing is healthcare and is the first step toward living a long and healthy life. Supportive services include but are not limited to housing, healthcare, meals and nutritional counseling, mental health and substance use treatment, job training, and legal assistance.

• Pathways to Housing PA: a community-based organization in Philadelphia that provides housing, healthcare, and wraparound services to people who are experiencing chronic homelessness and mental illness and/or substance use disorder. They have an 85% housing retention rate (after 5 years), including among people who are considered unready for housing by most other programs.

Where to Go for More Information

• Housing First Fact Sheet - National Alliance to End Homelessness

• The Truth About Housing First - National Alliance to End Homelessness

• What America Believes About Homelessness - Invisible People

• Housing People Who Use Drugs (PWUDs) Webinar Series | NASTAD

• From Homelessness to Housing: Challenges and Opportunities of Housing Transitions

• Housing First Programs Lead to Net Economic Benefits | The Community Guide

• Unlocking the Full Potential of the Housing First Approach

• Supportive Housing Helps Vulnerable People Live and Thrive in the Community

• Social Housing For All: A Vision For Thriving Communities, Renter Power, and Racial Justice

Research

• The Evidence Behind Approaches that Drive an End to Homelessness - United States Interagency Council on Homelessness

• Housing First: A Review of the Evidence | HUD USER

• Choice Matters: Housing Models that May Promote Recovery for Individuals and Families Facing Opioid Use Disorder

• Blacks And Hispanics Are Less Likely Than Whites To Complete Addiction Treatment, Largely Due To Socioeconomic Factors

• California Statewide Study of People Experiencing Homelessness | Benioff Homelessness and Housing Initiative (ucsf.edu)

• Permanent Supportive Housing With Housing First: Findings From a Community Guide Systematic Economic Review

Leaders to Know

• Keith Cylar. He co-founded Housing Works and made housing a harm reduction issue. He paved the way for people who use drugs to lead the housing programs designed to serve them. 

Case Study

In 2015, George Elias Jr. CDCA II was couch surfing he had no stable housing, was recently diagnosed with HIV, and in the midst of chaotic drug use. George was connected to the local AIDS Service Organization and received permanent supportive housing through a Housing First program in Cincinnati, Ohio. George built trusting relationships with his case managers and began to take better control of his health. With the support of his case managers, he worked towards self-directed goals. For George, these include getting his HIV viral load down to undetectable, going into drug treatment, finding full time employment, graduating out of permanent supportive housing and getting his CDCA licensure. George says ”Housing First, allowed me to have a base of operations, so I could have a foundation to grow from. Housing First saved my life.”