Is ‘Housing First’ Worth the Cost to House the Homeless?

Many people who experience homelessness choose to sleep on the streets of Fort Wayne rather than leave their beloved pets behind to enter a shelter. Others can’t stand the idea of being separated from a spouse or a partner who is not allowed to stay there. Still, others who struggle with addiction find they can’t honor a promise to stay drug and alcohol-free in a shelter.  

Those restrictions are among dozens of barriers to homeless shelter admission for people without a place to live, said Jim Atz, Community Development Manager for the city’s Office of Housing and Neighborhood Development. Atz said all the homeless shelters operating in Fort Wayne erect barriers to admission. 

“Fort Wayne’s homeless population is much more diverse than we might think,” Atz said. “Sometimes, our homeless are not Christian. They can’t give up their pets or their partners. This is not meant as a criticism, but there need to be additional options. Homelessness isn’t what people think it is. It’s single moms and kids who are most dependent on the homeless system of care.” 

Among the barriers to admission at the Fort Wayne Rescue Mission, the towering edifice at 404 E. Washington Blvd., residents must agree not to use drugs and alcohol; must submit to random drug/alcohol tests, adhere to a lengthy list of other rules and regulations, and meet regularly with a mission case worker.  

“I will say that anecdotally, there are lots of unsheltered people that won’t go there because they don’t feel safe, and a lot are banned,” said Kelly Lundberg, Deputy Director of the Office of Housing and Neighborhood Services. “It’s a delicate situation for us. (The Mission) is a big piece of the homeless system of care. When I talk to people in the community about homelessness, they say, ‘But we have a rescue mission.’ And because of that, they believe that all homelessness is solved.”

Though an exact number is impossible to determine, more than 2,000 people are homeless at any given time in Fort Wayne, according to an estimate in March by Jennifer Rutkowski-Smith, the city’s homeless strategy manager.   

With a goal of helping chronically homeless Fort Wayne residents find stable and permanent housing, city officials hope to move away from the cobbled together “system of care” to embrace the example of cities around the country that have adopted the “Housing First” philosophy. Housing First offers low-barrier stable, permanent housing to individuals who deal with chronic homelessness, often exacerbated by mental illness, addiction, or other challenges.

The city’s “Everyone Home” report, researched and written by Homebase, a nonprofit, public interest law firm, and released in March, pledges to harness available resources to create and run a “no barrier” or “low-barrier” housing program. People experiencing homelessness would be offered mental health treatment and other services, but would not be required to accept the assistance. Residents would be encouraged to avoid substance use, but it would not be required as a condition of admission. 

Housing First advocates argue that a roof over one’s head is a fundamental human right, and critical to solving the personal crises that made them homeless in the first place. 

“If there’s a theory of Housing First, I would say it’s about consumer choice,” said Deborah Padgett, a professor of Social Work at New York University. “It’s more about a human right to housing. If we can take care of fundamental needs, then you’ll be able to achieve higher levels of functioning.”

“It’s permanent in the sense that it’s the idea that your housing is not contingent on your behavior,” she added. “For people who have psychiatric episodes, you do have to follow the tenancy agreements, but the idea is that it is permanent.” 

Padgett said the Housing First philosophy relies on psychologist Abraham Maslow’s hierarchy of needs, which social workers often use to assess clients’ basic needs: food, water, clothing, sleep and shelter are the most basic, followed by safety and security. When those needs are met, individuals can learn to focus on higher needs: love and belonging, esteem and self-actualization. Padgett said people whose basic needs are met have a natural incentive to overcome the problems that contributed to their homelessness in the first place. 

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The Housing First philosophy didn’t rise up out of nowhere. It evolved. 

In the mid-20^th century, when homeless people were routinely diagnosed with severe mental illness and confined to mental hospitals, often for life, psychiatrists assumed that all homeless people had a severe mental illness. However, by the mid-1980s, researchers began to question that assumption and look for another way to help homeless people establish meaningful lives in stable homes. 

They developed the “staircase” model, which created a series of steps that homeless people had to perform to earn a stable home. Participants had to undergo regular psychiatric treatment, take all prescribed medications, and refrain from using alcohol or drugs. Many people weren’t able to follow the protocol and were often kicked out of the programs. The ranks of homeless individuals swelled in American cities and threatened to overwhelm the best efforts of housing officials to provide shelter for the most vulnerable citizens.

Enter Dr. Sam Tsemberis, a psychiatrist at New York University, who developed what appeared to be a deceptively simple plan: Offer homeless individuals what became known as “permanent supportive housing” with no strings attached or hoops to jump through, a stable permanent home. All Housing First signees were offered mental health care but were not required to accept it. Residents were advised to abstain from drug or alcohol use, but it was not required. 

Since its beginnings in the early 1990s, the results have been steadily positive, and in some cases spectacular. Homelessness was virtually eliminated in Seattle, Houston, Columbia S.C., and Milwaukee. 

The programs were so successful that the U.S. Department of Housing and Urban Development adopted Housing First as the housing program of choice for all cities that receive federal funds for housing programs. HUD sweetens the grant funding pot for Housing First-based programs - offering more funding to local governments that partner with nonprofit organizations. Housing First is supported by the U.S. Department of Veterans Affairs (VA) in its two largest homelessness programs– Supportive Services for Veteran Families (SSVF) and HUD-Veterans Affairs Supportive Housing (HUD-VASH). Padgett said the VA’s success in virtually ending homelessness for veterans was extraordinary.

Critics, most of whom were associated with the conservative Heritage Foundation, pounced on Housing First, arguing that the programs are expensive to adopt and don’t institute uniform rules and regulations for admission. 

Padgett said that the critics oppose Housing First programs for ideological reasons, meaning that they have political reasons for opposing assistance to homeless people. But even advocates say there are some significant downsides to adopting a Housing First program.

It’s expensive to provide permanent supportive housing for everyone or nearly everyone who’s homeless, and critics complain that government-run Housing First programs take valuable housing stock away from prospective renters, contributing to the shortage of affordable housing that bedevils most communities in the United States. 

After its initial success in reducing the number of homeless people, New York City reverted to a shelter system that Padgett said operates very similarly to the “staircase” model the city moved away from in the 1990s. 

In May, the architect of New York Mayor Eric Adams’s housing plan resigned. The departure of Chief Housing Officer Jessica Katz underscored the city’s struggle to respond to the ongoing housing affordability and homeless crises as the city’s homeless shelter population reached record levels.

“In general, Housing First has been very successful,” said Brendan Bow, a policy analyst at the Center for Research on Inclusion and Social Policy at the O’Neill School of Public and Environmental Affairs at Indiana University-Purdue University-Indianapolis. “The feds are big advocates of the Housing First methodology. Houston, Texas moved 25,000 people into houses. Few folks are unsheltered in Milwaukee, which is kind of the gold standard in housing policy. It has definitely been shown to work in many communities.”


So is Housing First a success?

“That depends on your definition of success,” he added. “There has been an overall reduction in the number of homeless individuals, current homeless, and those who have become homeless four times over three years, adding up to a total reduction in Housing First communities. On the downside, Housing First requires a high number of homes. Critics argue that you’re taking housing stock away from people who can pay for it.”

They may be expensive, but Housing First programs have been demonstrated to save money for cities that adopt them because people living in permanent supportive housing often don’t use other expensive government services. 

“Obviously Housing First is not free to the community, but they save money on medical care, food assistance and other services,” Bow said. “If you criminalize homelessness, and send people to jail for homelessness, you’re going to save money when you don’t use those programs.”

Bow said a recent study on the cost of homelessness found that local governments spend about $35,000 each year to provide services to every homeless person, but just about $12,000 for each Housing First recipient.

Fort Wayne housing officials argue that the lead time to secure funding and develop a low-barrier housing program to serve homeless people in Fort Wayne is long and complex. 

“We don’t have real specific plans yet that we’re ready to talk about, but Housing First is the underlying core principle,” Lundberg said. “There are lots of competitive awards out there from HUD that we would like to pursue to improve our services.”

“We’re relying on a patchwork solution of providers,” Atz said. “There’s not one shelter in this city that is low-barrier and open to all folks - regardless of their veteran status, gender, gender identity, or need for shelter. It’s not no barrier, but it has to be open to folks who have a pet, to couples. There are so many individual situations in our community.”

About the Fort Wayne Media Collaborative
The Fort Wayne Media Collaborative was formed in 2021 to bring together local media outlets to address complex community challenges. Input Fort Wayne was one of its founding partners.

As a group, FWMC strives to transform the nature of local journalism by providing the community with greater access to solutions-oriented news that encourages civic engagement. The group’s current focus is affordable housing issues throughout the Northeast Indiana region.

FWMC is part of the Solutions Journalism Network and is currently in year one of grant funding from the Knight Foundation. In addition to Input, the Fort Wayne Media Collaborative is comprised of the following members: WANE-TV, WBOI-FM Public Radio, Fort Wayne Ink Spot, Fort Wayne Magazine, El Mexicano, Blacklight Media, Lofthouse Films, Purdue Fort Wayne, University of Saint Francis, Indiana Institute of Technology, and Allen County Public Library.