Tag Archives: Housing First

A new strategy to house homeless people

Originally published in Vox on May 29, 2024.
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Sometime in the next month, the Supreme Court could grant permission for cities to more easily criminalize people experiencing homelessness. 

Some are eagerly awaiting that permission. In April, Donald Trump released a video declaring that if he were president, he’d ban outdoor camping in most places, erect sanctioned campsites for “treatment,” and send people to jail who refused to go.

Yet even among Americans opposed to a punitive approach, it’s become common to sigh regretfully, lament that affordable housing is in short supply, and point out that unhoused people often turn down shelter — so what can cities really do? If the US Supreme Court rules in favor of the homeless plaintiffs in Grants Pass v. Johnson, local governments might just invest more money into building emergency shelters, so they can prove there were adequate shelter options available before anyone resorted to fines or arrests. 

But emergency shelters don’t end homelessness, they just get people indoors for brief periods. And there are better options available. 

This message is being shouted to anyone who will listen by Mandy Chapman Semple, the architect of Houston’s nationally recognized homelessness strategy, which reduced the city’s homelessness rate by 60 percent between 2012 and 2016.  

Semple was Houston’s first special assistant to the mayor for homeless initiatives, and she’s credited with helping to design the city’s “street-to-home” encampment response, which prioritizes getting people quickly into housing, permanently closing tent encampments, and working closely with landlords so they feel comfortable renting to tenants with more serious problems. 

“I am truly concerned that we are unintentionally giving up on reducing homelessness,” Marc Eichenbaum, the current special assistant to Houston’s mayor for homeless initiatives, told Vox. “Many acknowledge that housing is the long-term solution to homelessness, only to psych themselves out from being able to respond because of a lack of affordable housing. That is when cities chase expensive, short-term options to manage the situation or resort strictly to enforcement.”

Semple has since taken her work beyond Houston, and through her company — Clutch Consulting — she’s working with cities including New Orleans, Oklahoma City, Dallas, and Hartford, Connecticut. She brings an unapologetic approach to her consulting, rejecting both the idea that homeless people belong in jail, or should be allowed to camp wherever they feel most comfortable. She insists there is a better path forward if leaders and service providers approach their work in a new way. 

Her model works like this: Public subsidies can be used to pay rent for people experiencing homelessness, but private donations, which are not subject to the same federal rules and restrictions, can help finance things that make moving unhoused people into apartments more feasible — like apartment hold fees, application fees, security deposits, and furniture. Oh, you have a unit in your building opening up in a few weeks? We’ll pay you an extra $1,000 if you offer it to us, first. Her team spends time scouting and building relationships with landlords, then tries to house everyone living in an encampment at once.

“Every market has movement, even tight markets, even expensive markets,” Semple said. “You can get into that by using flexible private dollars to incentivize landlords. We’re creating a business relationship that provides us an advantage.”

Once people have moved into housing from a tent encampment, Semple ensures that landlords have a team they can call to help with any problems that may arise. The formerly homeless individuals have case managers to help them access social services, and the landlords, too, have their own liaisons they can call. The city permanently closes down the encampment, puts up signs and sometimes fencing, and uses law enforcement to bar anyone else from returning to the area. 

“I think we really hurt ourselves as advocates when we say that at the core homelessness is an affordability problem,” said Semple. “It is, but we do not have to wait for that affordability to be solved to move people into housing.” 

Semple’s “street-to-home” encampment response has helped dispel the idea that everyone sleeping outside just doesn’t want to be inside. Clutch and its clients say that over 90 percent of people offered the option to move into an apartment say yes, even if they’ve repeatedly rejected invitations before to sleep in congregate emergency shelters.

The approach is not without criticism or challenges. Not all homeless providers are inclined to abandon their focus on getting people into shelters, and some social workers say Clutch’s methods have been abrasive and too dismissive of client concerns. 

Some advocates argue that Clutch’s encampment approach has led to more inequitable distribution of resources by focusing help on those living in areas causing leaders the most political headaches, rather than necessarily the most vulnerable in a city. Others worry the solution is not really scalable, especially as rents continue to spike. 

Angela Owczarek, a New Orleans social worker who previously worked at an organization providing street outreach services in encampments being closed by Clutch, said she felt the company used inappropriate tactics to rush people into apartments.

“We cannot participate in things that coerce people; the ends do not justify the means,” Owczarek told Vox. “Not only is that bad ethically, but it also makes it harder to do our job in the future, because then people will be like, ‘Oh yeah, you guys were part of that effort that threw out my tent and told me I had two days to agree to an apartment I didn’t want to live in or who made me feel rushed or not listened to, even if I ended up living somewhere I liked.’ How we treat people matters every moment.” 

Semple acknowledged that some outreach workers “have struggled in some cases with this shift in expectations and it takes time to help them understand why and how they need to adjust their practices.” 

But she rejected the idea that living outside in encampments is acceptable for human beings, even if they may not feel ready to move indoors. 

“Staying on the streets can be their choice, but they will need to move if they choose [that],” she said. “Living in this location under these conditions cannot continue.”

System leaders have shown more enthusiasm than frontline workers for the Clutch approach. Jamie Caves, who is implementing the Clutch strategy in Oklahoma City, said it has been “fantastic” so far, and they’ve housed 126 people since launching in September. 

“It’s new and we’re building the plane while we’re flying it so there’s certainly things we’re learning and streamlining, but it is really, really powerful,” she told Vox. “We’re really beginning to close multiple encampments in a month and really move aggressively toward our goal, which is to house 500 unsheltered people by the end of 2025.”

Sarah Pavone, the director of strategy at Journey Home in Hartford, Connecticut, echoed the excitement. 

“Up to this point we never thought about prioritizing the unsheltered for any specific resources, we never had a different approach to those living outside than those who were in [emergency] shelters even though they have very different needs,” she said. “We also didn’t engage our systems to overcome systemic barriers that delayed people from entering housing quickly.” 

The fine print of Clutch’s model 

As Houston was bringing down homelessness, the number of unhoused people in Dallas was climbing: a 45 percent increase between 2015 and 2021. Armed with tens of millions of dollars from Covid-19 relief funds and new private donations, local government and civic leaders in Dallas decided to team up and try the Clutch model, setting a goal to move 2,700 people into housing by October 2023. 

More than 10,000 people have been rehoused since the effort began in 2021, and Dallas recently reported its lowest total number of people experiencing homelessness in nearly a decade. The latest Point in Time Count — an annual nationwide survey to estimate the number of people experiencing homelessness on a single night in January — showed Dallas with a 19 percent reduction in homelessness overall since 2021 and a 24 percent reduction in unsheltered homelessness. Last year, only 27 percent of communities nationwide reported reductions in homelessness.

“To scale we had to get more and more creative about master leasing,” Semple said. “So we said how do we consider new business relationships that give us access to whole buildings, or a whole bunch of units, or future units at a new property?” 

Despite the rare progress, convincing the public to stay the course and stick with the street-to-housing model isn’t easy. Sarah Kahn, the president and CEO of Housing Forward, which leads the homelessness response in the Dallas region, told Vox there’s been political pressure to divert resources to more short-term solutions like tiny home shelters.

“Honestly the challenge is that it doesn’t matter what the result of the Grants Pass case is, it still [will] not give local governments or communities any tools to resolve these issues,” Kahn said. “There’s clear evidence that you can’t actually enforce your way out of homelessness. Really the only solution is resolving homelessness and we do that by moving people into housing.”

In Oklahoma City, leaders currently implementing the Clutch model are focused on how it could save them money in the long run. Armed with a $12.5 million investment to reduce unsheltered homelessness by 75 percent in two years (with at least $5 million coming from private donations) the city says it’ll be spending about $24,000 per person to house 500 people. According to the National Alliance to End Homelessness, a chronically homeless person costs taxpayers $35,578 per year. 

“You can still do a traditional pathway and go to a shelter, but now we have new pathways for those unsheltered homeless, where we build rapport, get them document-ready, and it’s very streamlined and aggressive to get those things done in four to five weeks so we can move them directly into housing,” said Caves. “I think it’s a positive solution that makes economic sense and is also the dignified answer to those who are experiencing homelessness.” 

Clutch Consulting won’t work with communities that aren’t sufficiently bought into its theory of change. Last year leaders in St. Louis hired Semple to conduct a needs assessment to gauge a potential partnership and ultimately she concluded it would not be a good fit. 

St. Louis, which has cold winters and hot summers, has long been focused on emergency shelters as a harm-reduction approach, and Semple determined the city’s service providers were too invested in increasing the number of emergency shelter beds in the city.

Samantha Stangl, the executive director of House Everyone STL, has been trying to push back on her community’s reliance on congregate shelters. “What if the real problem were not an inadequate supply of shelters but rather a bottleneck of demand caused by a lack of exits from shelters?” she asked in a January op-ed. 

In an interview with Vox, Stangl went further. “What a lot of communities that have found success have done is come to the realization that shelter should actually be the absolute last resort because it is kind of a crisis environment,” she said. “I’m not interested in the status quo in St. Louis. We need more rapid rehousing and more permanent supportive housing to do things like that.” 

Owczarek, the social worker from New Orleans, says more skepticism should be brought to bear when interpreting Clutch’s reported results on offering housing to everyone in encampments. 

“The idea that everyone is offered housing needs an asterisk after ‘everyone,’” Owczarek said, noting that anyone who arrives at a camp after the city establishes its list of residents to house is not given the same housing opportunities. (Semple told me their approach is to house everyone eventually but designed in a way to discourage people from moving to encampments to get housing faster. “These are high-risk encampments deemed public health hazards,” she said. “We don’t want to encourage folks to come live at this site to get housed.”)

Owczarek also pointed out that “offering” someone housing does not mean there was always housing available for everyone by the time an encampment actually closed. Some residents had nowhere to go even after their encampment cleared. Semple said in those situations individuals are offered emergency shelter or in some cases motels.

Criminalization will make this housing work harder

Though Semple helps cities work with landlords to assuage their concerns, there are limits to how many people are willing to rent units to those with criminal records. Given that 1 in 3 US adults has a criminal record, this creates a significant barrier to the street-to-housing encampment response model.

Arresting, fining, and ticketing unhoused people — which local governments will be more easily able to do if Grants Pass is overturned — makes it harder for those people, who already struggle to afford shelter, to obtain permanent housing. 

Owing fines can exacerbate an unhoused person’s already poor financial situation and prolong their homelessness. One study of people experiencing homelessness in Seattle found those with outstanding legal debt spent roughly two more years without stable housing than those without such debt.

“Every time we’re pushing someone needlessly through the criminal justice system it affects their ability to get housed because every landlord is running a criminal background check,” said Semple. “These nuisance charges create the perception that they’re a criminal and not a good tenant and it’s just a tremendous waste of law enforcement capacity too.”

‘Housing First’ Policy for Addressing Homelessness Hamstrung By Funding Issues

Originally published in The American Prospect on January 27, 2015.
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In an era of shrinking financial resources, policymakers, providers, and activists who work on homelessness prevention and care in the United States have been forced to develop new strategies. There was a time when officials at the Department of Housing and Urban Development (HUD) saw it as their responsibility to provide both housing and supportive services for homeless individuals, but now HUD now is refocusing its budget predominately on rent and housing—with the hope that other local, state, and federal agencies will play a greater role in providing supportive care. However, whether other organizations will actually be able to pick up those costs and responsibilities remains unclear.

The first major federal legislative response to homelessness was the McKinney-Vento Act of 1987, which passed both the House and Senate with large bipartisan majorities. The McKinney Act—which Bill Clinton later renamed the McKinney-Vento Homeless Assistance Act—provided funds not only for emergency shelter, transitional housing, and permanent housing, but also for job training, primary health care, mental health care, drug and alcohol treatment, education programs, and other supportive services. The consensus was that homelessness is a complex problem whose solution requires more than simply a roof and a bed.

The statutory goal of the McKinney Act was to gradually move homeless people toward stable housing and independence—a model that came to be known as “Housing Readiness.” Though this sprung from well-meaning intentions, it eventually became clear that this “gradual” approach frequently led to unwise and unfair ways of distributing welfare.

“We had this system that said homeless people essentially have to earn their way to permanent housing,” explained Ed Stellon, the senior director of the Midwest Harm Reduction Institute, and someone who has worked within the substance use and mental health treatment systems for more than 20 years. “Homeless people had to earn their way into transitional housing, make progress on certain goals, and finally when they were deemed well enough, they would earn their spot in permanent housing.”

A different model, known as “Housing First”, has been gaining steam over the past decade. What at first sounded revolutionary now feels fairly obvious: The Housing First approach posits that the only requirement for housing should be homelessness—that shelter is a right, not a privilege. “Plus, if you have conditions like out-of-control diabetes, congestive heart failure, or schizophrenia, housing is actually part of the solution,” adds Stellon. “It’s hard to make any meaningful progress on these chronic conditions without stable housing.”

Though exact estimates are hard to come by, HUD recently reported that as of January 2014, the chronically homeless numbered some 84,291, with 63 percent of those individuals living on the streets. HUD says this number has declined by 21 percent, or 22,937 persons, since 2010—in large part because of the embrace of Housing First. (Some, however, have accused the federal government of using data gimmicks to paint a more cheery picture of progress than has actually been made.)

Nevertheless, the reality is that at the same time policymakers are embracing the idea of Housing First, fewer affordable housing units exist than ever before. According to the National Low Income Housing Coalition, federal support for low-income housing has fallen 49 percent between 1980 and 2003, and the Joint Center for Housing Studies found about 200,000 rental units are destroyed annually. Research also suggests that a supply of 8.2 million more units would be needed to house extremely low-income households, up from a gap of 5.2 million a decade earlier. Though Congress recently authorized funding for the National Housing Trust Fund—an entity that was created in 2008 to fund affordable housing proects—its budget is nowhere near large enough to meet the demand.

“We’re not doing enough to expand housing availability, and HUD can’t expand its services unless Congress allocates it more funding,” says Barbara DiPietro, the director of policy for the National Health Care for the Homeless Council.

Given the fiscal climate, HUD is looking for new ways to spend its increasingly limited budget. Consequently, the agency is moving away from the supportive services that, through the McKinney-Vento Act, once accounted for most of its spending. In 1998, for instance, 55 percent of HUD’s budget was spent on supportive services, and 45 percent was awarded for housing. By 2013, just 26 percent of HUD’s competitive homeless assistance funds went to supportive services, and 66 percent was spent on housing. According to Ann Oliva, director of HUD’s Office of Special Needs Assistance Programs, the department’s goal now is to help local communities become more strategic with existing resources and available opportunities.

To do this, HUD has been working closely with other federal agencies, especially the Department of Health and Human Services (HHS), the Department of Veterans Affairs (VA), and the U.S. Interagency Council on Homelessness. In 2008, a joint program known as HUD-Veterans Affairs Supportive Housing (HUD-VASH) launched, combining housing vouchers for homeless veterans provided by HUD, with case management and clinical services provided by the V.A. Experts agree that HUD-VASH has been quite successful in helping both vets and their families, and it’s typically held up as the poster child for future interagency collaborative efforts. However, the program came with additional appropriated dollars, and it is typically easier to convince Congress to fund programs for impoverished military veterans compared to other downtrodden groups.

One of the most significant recent changes to homelessness policy has come through the expansion of Medicaid—a key feature of the Affordable Care Act. Now that nearly all individuals with incomes up to 138 percent of the federal poverty level are eligible for health insurance in states that opt for the expansion, agencies are scrambling to enroll thousands of homeless people so that they may benefit from new streams of mandatory government spending.

But Medicaid is, at its heart, a program controlled by the states. And with some states still vigorously opposed to expanding Medicaid—despite the ACA’s mandate for the federal government to pick up nearly all of the tab for the expansion—let alone some of the flexible legislative adaptations that HHS is encouraging, consistent and widespread changes to supportive services seem unlikely in the near future.

Though Medicaid expansion presents great opportunities for providing services to the homeless, some are concerned that the more flexible federal dollars currently set aside to work with homeless people will eventually just be funneled into the larger health insurance pool, with little, if any, allocated to doing what it takes to bring those with no homes into the government support system, which is needed in order to provide preventive care.

“Going out four or five times to visit with a woman living alone under a bridge, just trying to form a relationship and build trust with her so she will feel comfortable coming in to get more help—those types of health encounters are not typically billable through health insurance,” adds Stellon, who says outreach can be one of the hardest things for him to fund. “In our current system, it’s easier to pay for someone’s amputated fingers than to build a human relationship.”

Ultimately, there is only so much the government can do to advance the goal of Housing First with a depleting stock of housing units and a shrinking budget for supportive services.

“It’s a big mistake to come up with a good solution like Housing First and then to hamstring it because we don’t actually have the money for it,” says Todd Stull, the clinical director at a JOURNEYS | The Road Home, an organization that provides services and shelter to families and individuals in Illinois’s North and Northwest suburban Cook County. “One of the worst things you can do is get someone into housing for a short period of time and then they lose it. Then they lose trust in the providers.”

“We have not done well as a nation taking on poverty and implementing policies needed to address homelessness,” says Dr. Sam Tsemberis, the founder and CEO of Pathways to Housing, a national organization that first pioneered the Housing First model in 1992. “So we end up taking care of homelessness out of desperation, but we’ll be taking care of homelessness forever if we don’t take care of poverty.”

“We need more money,” adds DiPietro. “Until then, we’re just rearranging the priority list.”