THE CASE FOR
HOUSING FIRST
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ousing First is a proven model for addressing homelessness that prioritizes access to permanent,
stable housing, linked with voluntary services as needed. Housing First recognizes that stable
housing is a prerequisite for effective psychiatric and substance abuse treatment and for improving
quality of life. Once stably housed, individuals are better able to take advantage of wrap-around services –
to help support housing stability, employment, and recovery. Without stable housing, attaining these goals
becomes much more difcult.
Because federal resources to address homelessness are scarce, it is critical that communities use these
resources effectively to serve as many people as possible by investing in approaches like Housing First that
have proven to be the most successful in getting people off the streets and into housing.
THE EVIDENCE FOR HOUSING FIRST
Housing First rapidly ends homelessness, is cost-effective, and positively impacts quality of life and
community functioning. This model is particularly effective among people who have been homeless
for long periods of time and have serious psychiatric disabilities, substance use disorders, and/or other
disabilities. Housing First results in higher rates of housing retention.
The Community Preventive Services Task Force (CPSTF), an independent panel of public health and
prevention experts appointed by the director of the U.S. Centers for Disease Control and Prevention (CDC),
recommends Housing First programs. The CPSTF recommendation is based on evidence from a systematic
review of 26 studies, which found that Housing First programs decrease homelessness, increase housing
stability, and improve quality of life for people experiencing homelessness. The CPSTF also found that the
economic benets exceed the intervention cost for Housing First programs; in fact, every dollar invested in
Housing First programs results in $1.44 in cost savings.
Despite the clear benets of Housing First, Congress has not funded long-term solutions at the scale
necessary. To address homelessness, Congress should expand rental assistance to all eligible households,
build and preserve homes affordable to people with the lowest incomes, and expand voluntary supportive
services. Without this investment, more people are pushed into homelessness every day. For example,
while 207 people experiencing homelessness secure housing every day in Los Angeles County, 227
people enter homelessness daily.
EARLY EVALUATIONS
The Pathways to Housing program, one of the early versions of Housing First, has greatly informed the eld
of homeless services. Between 2000 and 2004, there were three major studies of the Pathways model in
New York City. These initial studies found:
• A 2000 study found that after ve years, 88 percent of Pathway participants remained housed,
compared to only 47 percent of the residents in the control group.
• A 2004 study found that after 24 months, Pathways participants spent almost no time experiencing
homelessness, while participants in the city’s residential treatment program spent about a quarter of
their time experiencing homelessness on average.
• A 2004 random assignment study found that homelessness programs that eliminated barriers to
services, like Housing First, were more successful in reducing homelessness than programs where
housing and services were contingent on sobriety and progress in treatment. When individuals were
provided access to stable, affordable housing, with services under their control, 79% remained stably
housing at the end of 6 months, compared to 27% in the control group.