Homelessness in many U.S. cities has risen drastically over the past few years. In some cities, where the price of housing has put it out of reach of low-income residents, there are not enough shelter beds to accommodate the number of people that need them on a given night. That shortage and other concerns with shelters have resulted in large numbers of homeless people sleeping on sidewalks, in parks, and in other public spaces.

Cities have taken divergent approaches to address the very visible issue that has become a political flashpoint. Some have made it illegal to camp in public spaces; others are building more shelter beds and investing in tiny homes, among a range of solutions. 

To address what was the sixth-largest homeless population in the country, Houston adopted what’s called a housing-first strategy. The method prioritizes providing permanent housing to homeless individuals as quickly as possible while providing a host of voluntary supportive services to ensure they remain housed long-term.

“When we looked at all the different types of data from all the different strategies out there, housing with wrap-around support services was by far the most effective,” said Marc Eichenbaum, a special assistant to Houston’s mayor on homeless initiatives.

The first story in this series tells how the greater Houston region achieved a 63% reduction in homelessness since 2011, more than any other of the 10 largest U.S. cities. Houston accomplished this without spending any city money beyond federal funding it receives, and Eichenbaum says it spends less than what any other major city spends to address the issue. The city has to be “smarter” on how it uses those limited resources, he said. 

Other cities that have deployed housing-first models also report experiencing drops in homelessness. 

Salt Lake City, Utah, and Columbus, Ohio, were among the first large cities in the U.S. to use housing-first approaches to reduce homelessness, said Sophie House, law and policy director of the Housing Solutions Lab at New York University’s Furman Center.

Over several years, more than 90% of people placed in permanent housing in Utah remained housed, according to a 2021 report from the state’s Office of the Legislative Auditor General.

Likewise, Atlanta, a city that modeled its housing-first policy after Houston’s, has seen a nearly 40% drop in homelessness since the start of the pandemic.

The U.S. Department of Housing and Urban Development and U.S. Department of Veterans Affairs have offered robust federal financial support for permanent housing and housing-first programs in recent years. Through the housing-first model, three states and 82 communities, including Houston, had achieved net zero veteran homelessness in 2021, according to the National Low Income Housing Coalition.

Houston’s success is significant because it has provided a road map to other cities addressing the nation’s homelessness crisis. According to Eichenbaum, Houston officials are working with officials from Los Angeles; New York City; Chicago; Denver; Dallas; Austin, Texas; Spokane, Washington; and other cities in developing collaborative housing-first systems. 

Why housing first?

Shelters play an important role in Houston’s housing-first strategy because they are the largest front door to getting people on the path to housing, Eichenbaum said. But an individual experiencing homelessness in a shelter is still homeless, he said — shelters are not a long-term solution to homelessness.

Before 2012, the community was spending millions of dollars just managing the issue, Eichenbaum said. But when you just manage it, more people will continue falling into homelessness, so the rate will continue to rise, he said. 

“We said, we want to take all of our funds and really put it into solving the issue and not just running around in circles and managing it,” Eichenbaum said. 

The housing-first approach is based on the theory that people need to have access to safe, stable housing to be in the best position to receive other care and services and to make progress on achieving other goals they may have, said Alyse Oneto, a research associate at the Urban Institute’s Metropolitan Housing and Communities Policy Center, in an email.

The National Coalition to End Homelessness, the National Low-Income Housing Coalition, many scholars, other advocacy groups, and HUD all say that housing first works. 

“Housing First is the most effective approach for ending homelessness for most individuals and families,” said Diane Yentel, president and CEO of the National Low Income Housing Coalition, in an email. Due to a lack of federal resources, it’s critical that communities invest in such an approach that has been “proven to be the most successful in getting people off the streets and into housing,” she added.

As is the case in Houston, housing-first programs provide an array of voluntary supportive services to people when they are housed, said Yentel. Services such as counseling on substance use and mental health as well as employment training can help people lead stable lives and remain housed, she said.

The method has been particularly effective in providing housing stability for people with severe and persistent mental illness and those experiencing longer periods of homelessness, said NYU’s House. 

Programs operating on housing-first principles have seen better retention rates, helping people exit homelessness faster and decreasing people’s interactions with emergency service systems like hospitals, jails and shelters, the Urban Institute’s Oneto said. 

An Urban Institute evaluation of Denver’s housing-first program, published last year, showed that over the course of three years, 77% of participants remained in stable housing. They also experienced a 40% reduction in shelter visits, a 40% reduction in arrests, a 30% reduction in jail stays and a 40% reduction in emergency department visits, the report stated. 

About half of the total cost per person of participating in the program was offset by avoided costs associated with those “positive outcomes,” said Oneto. 

“In addition to being a proven strategy to end homelessness, Housing First is a responsible, accountable way to spend taxpayer dollars on homelessness issues,” said Yentel.

The strategy of providing housing with no strings attached, and supportive services if participants want it, makes receiving that needed help an attractive option for a person experiencing homelessness, Eichenbaum said. It has allowed the engagement rate with supportive services to exponentially increase, he said. 

“We discovered that when an individual feels like they are being made to do something, they’re less likely to do it,” versus when they decide to seek out services under their own volition, said Eichenbaum, even if that person is “being strategically encouraged by trained social workers.”

Housing-first challenges

Not everyone agrees that the housing-first model is the best solution to the problem of homelessness. 

Christopher Rufo, a conservative activist and senior fellow at the Manhattan Institute has railed against housing-first policies. In a 2020 report for the conservative think tank the Heritage Foundation, Rufo said that despite demonstrating strong rates of short-term housing retention, housing-first policies do “not improve symptoms related to drug addiction, mental illness, and general well-being — and have not reduced overall rates of homelessness.”

Rufo argues that policymakers instead should reorient federal homelessness policy toward better outcomes, prioritizing programs that require treatment, accountability and a path to self-sufficiency. 

Even experts who believe housing first is the best approach to homelessness say such a program comes with challenges.

The viability of a housing-first approach depends on the availability of affordable rental housing that meets the needs of a wide range of populations, said House. 

Despite its population size, Houston is less densely populated than other major U.S. cities. That, coupled with lax zoning restrictions and other factors, makes buying a home there much cheaper than it is in cities like New York, San Francisco or Los Angeles that still struggle to serve their homeless populations.

“It can be more challenging to implement a housing-first approach in cities where tighter housing markets drive up costs and limit the availability of rental housing,” House said. Still, Houston is a growing city with a lot of demand for housing, so studying its successful implementation “could provide valuable lessons for similar large cities,” said House.

Houston received an influx of federal funds through the CARES Act and the American Rescue Plan Act that local leaders have used to support its homeless system, Eichenbaum said. But finding housing for homeless individuals has become increasingly challenging since the pandemic, he said. Recently, occupancy rates in affordable housing have been at 95% or above, slowing progress, said Sara Martinez, vice president of communications & development at the Coalition for the Homeless. 

The coalition, the lead agency for The Way Home, the greater Houston area’s HUD-designated Continuum of Care, oversees a dedicated landlord team that works with property owners to secure their participation in the program and a cross-sector work group focused on finding innovative new ideas for securing access to affordable units, said Martinez. 

Still, “actually finding the multifamily unit from a landlord willing to lease to our clients with challenging backgrounds,” Eichenbaum said, “that is getting very difficult, and it is a crisis for our homeless response system here in Houston and across the country.”

Eichenbaum said city officials and coalition liaisons work with the Houston Apartment Association and other groups, set up meetings with landlords, sometimes cold-calling them and knocking on doors, trying to find new units across the region. They also provide landlords with incentive fees and a nonrefundable property damage deposit.  

“The housing market is so strong right now, it’s very, very challenging,” Eichenbaum said in August. “It’s been an uphill battle.” Despite signs of a slowdown in the housing market this fall attributed to higher interest rates, Houston’s housing crunch has remained unchanged, he said last week. 

According to Oneto, cities adopting housing-first policies face a host of other challenges: Such policies don’t tend to address how quickly people are entering homelessness, so cities need to develop preventive strategies to help people before they start experiencing homelessness, she said. 

Cities need to design a program that meets the needs of their particular community. They also need to find the appropriate level of funding and staffing to support the program, as well as coordinate with other agencies and explain to the community what the program is to get buy-in, Oneto said. 

The biggest challenge Houston faced in the rollout of its housing-first strategy was “getting everyone to understand the concept and get on board as a system” versus individual agencies using their own judgment about which clients can get into housing, said Thao Costis, president and CEO of SEARCH Homeless Services, a Houston-based agency that is a member of The Way Home system. 

Ultimately, in Houston, the political will of city leaders and mayors, as well as a willingness by agencies and funders to work together, has allowed the effort to succeed, Costis said.