Housing First

What Is Housing First?

Housing First is an approach to ending homelessness that puts people into permanent housing quickly, with as few preconditions as possible, and then offers support services. It reverses the older “treatment first” or “staircase” model, in which people moved from shelter to transitional housing to permanent housing only after meeting conditions such as sobriety.

The model is usually traced to Pathways to Housing in New York City, founded in 1992. A 2007 HUD-commissioned study describes how the program gave people with psychiatric or substance use disorders direct access to permanent apartments of their own, without requiring treatment or sobriety first. Tenants paid 30% of their income in rent and agreed to two case manager visits a month. Treatment teams were available around the clock.

How Housing First Works

Housing First programs generally share a few principles:

• Low barriers to entry. Sobriety, treatment and service participation are not conditions of getting housing.
• Voluntary services. Case management, health care and addiction treatment are offered and encouraged, but not required.
• Ordinary tenant rights. Residents sign standard leases and can be evicted for lease violations, but not for relapse or for declining services.
• Harm reduction. Staff work to reduce the damage from substance use rather than requiring abstinence.

The approach is used in permanent supportive housing and in shorter-term rapid rehousing.

What the Evidence Shows

Studies find that Housing First programs keep most participants housed. Evidence on other outcomes is weaker.

• HUD’s 2007 study tracked 80 clients in three programs. After 12 months, 84% were still enrolled, though about half of those had left their housing temporarily at least once.
• A 2018 National Academies review of supportive housing found that it keeps most chronically homeless people stably housed in studies lasting one to two years. It found no substantial published evidence yet of better health outcomes or lower health care costs, except for people with HIV/AIDS.

Criticisms and the 2025 Policy Shift

Critics argue that Housing First does too little about addiction and serious mental illness. They also say it favors expensive permanent units over shelter capacity, and note that homelessness has risen in places that adopted it. Supporters respond that rising homelessness reflects housing shortages and high rents, not the model itself.

On July 24, 2025, Executive Order 14321 directed HUD and the Department of Health and Human Services to end support for “housing first” policies that, in the order’s words, “deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency.” It also told HUD to require more participants with substance use disorders or serious mental illness to use treatment as a condition of assistance.

HUD then redesigned its Continuum of Care competition to favor transitional housing and supportive services projects. Lawsuits followed. On August 7, 2026, a federal judge ruled that a $1.3 billion set-aside in the FY 2026 funding notice was unlawful. On September 16, 2026, an appeals court let HUD proceed with the competition while it considers the appeal. As of October 2026, the long-term federal stance on Housing First remained unsettled.