Overview
- The HUD rulemaking would sharply restrict Housing First in allocating $3.9 billion and elevate treatment-focused alternatives.
- Housing First provides long-term subsidized housing without mandatory treatment and delivers higher short-term housing retention, such as 86% housed versus 36% in a Santa Clara randomized trial.
- Major reviews, including the National Academies and The Lancet, find little consistent improvement in health outcomes and no clear mortality benefit from permanent supportive housing.
- Researchers say the HUD-VASH voucher program using Housing First principles helped cut veteran homelessness by more than half since a major expansion.
- Policy debate centers on costs and scale—about $20,000 per person annually—and on causes of rising homelessness, with critics favoring mandates and supporters citing the shortage of affordable housing.