Housing First helps, but homelessness challenges remain

Confronted with the nation’s largest homeless population, Californians hold diverging viewpoints on what constitutes effective housing strategies.

According to the annual report by the U.S. Department of Housing and Urban Development in 2022, California has over 171,000 homeless individuals, 115,000 of whom are unsheltered. That adds up to an astonishing 30 percent of the nation’s homeless population and 50 percent of all unsheltered people.

The Newsom administration has put a lot of faith in its own Housing First strategies, which prioritizing permanent housing solutions, to address the problem. But not everyone is as enamored of the program as is the governor.

“Housing First has faced criticism, particularly in areas with high housing costs like California. The primary concern revolves around sustainability and cost-effectiveness,” says Jialu Streeter, Director of Partnerships at the Stanford Institute for Economic Policy Research (SIEPR) at Stanford University, who has been researching and exploring policy issues such as homelessness.

“Based on my research, permanent supportive housing, just one unit, usually one or two bedroom apartments, would cost anywhere between $500,000 to $800,000 per unit to build in the Bay Area and LA,” she says.

Streeter notes there have been considerations of more cost effective ways to address the crises, such as the Bay Area Council’s report in 2021 looking into other housing strategies at a fraction of the cost of permanent housing.

“At the end of the day, we have to think about cost. Can we provide shelters or other cost-effective interim housing to everyone who is unsheltered right now sleeping on the street? The longer we leave the homeless on the street, the more they deteriorate. So that’s the first criticism that I’ve heard in the domain,” she says.

Streeter notes another challenge for many of the clients living in permanent supportive housing: the need for efficient access to care, such as mental health or drug treatments.

At the end of the day, we have to think about cost. Can we provide shelters or other cost-effective interim housing to everyone who is unsheltered right now sleeping on the street?

In theory, she says Housing First requires permanent supportive housing to provide wrap around services that would connect their clients to care. In practice, however, she says access to care depends a lot on the quality of case managers, who often deal with far more than the ideal case load ratio.

“We need more transparency on monitoring the quality of those wrap around services and clients’ health and treatment outcomes,” says Streeter.

“If you’re lucky, your case manager is a very caring person, very attention driven, and resourceful. Then you are more likely to receive treatment for your mental illness and/or substance abuse in time,” says Streeter.  “But if you’re unlucky and your case manager has to take care of so many clients, or maybe he or she is just not giving you enough attention for some reason, then you’re out of luck.”

Recognizing these challenges, government officials have acknowledged the need for a balanced approach.

“California has adopted a housing first policy to acknowledge that the fundamental solution for homelessness was for people to have homes,” says Senator Scott Wiener (D-San Francisco), one of the Legislature’s most vocal pro-housing members.

“We provided billions of dollars to support local efforts and we’ve also made it easier to site and approve shelters and navigation centers by streamlining every moving obstacle,” says Wiener. “But most cities and counties are the ones that have to actually make it happen.”

Additionally, he acknowledges that finding housing isn’t an all for all solution, and there are other challenges to consider.

“Some people have special needs and need increased support, and some people may need to go through a transition before they have permanent housing,” he says.

Examples of the kinds of special needs Wiener is talking about include drug or alcohol addiction or mental health issues that might require specialized treatment to get stabilized before that person is healthy enough to enter into permanent housing.

Chris Weare, Director of Center of Homeless Inquiries, an organization that provides awareness of effective solutions to the housing crisis, says the solution cannot be an “either-or” scenario, but rather a combination of approaches that can offer a comprehensive solution.

“Any type of housing that you can possibly build is going to be beneficial,” she says.

But Weare notes there is oftentimes trouble getting engagement from populations not directly impacted by housing insecurity.

“This is not a crisis being felt by upper income Californians,” says Weare. “The people who are experiencing the depths of this crisis have very, very little political power, very little political influence.”

And when those who do possess that power raise their voices, it generally has not been in favor of more affordable housing in their own area, i.e. the classic Not In My Back Yard (NIMBY) opposition.

“This is not an easy solution and the politics of it are really bad,” says Weare. “Because if you go to a city council meeting, you see that people who are opposed to the construction of new housing in their neighborhoods are very vocal, and make the lives of local politicians miserable when they advocate for new housing.”

Permanent supportive housing is also expensive and rental subsidy programs have time constraints of usually two years, where thereafter individuals can’t afford their homes, according to Weare.

“They can’t afford their apartment and so they’re back out on the streets,” says Weare.

This is not a crisis being felt by upper income Californians…The people who are experiencing the depths of this crisis have very, very little political power, very little political influence.

He notes that while shelters are important, the evidence has been that shelters have no positive long term impact on people, and could even potentially traumatize individuals who are required to return back to the streets..

“It takes them off the streets, but it does not it does not help them in any way to get them out,” Weare says.

On the other hand, he emphasizes that housing vouchers like the Emergency Housing Voucher (EHV) funded by the U.S. Department Housing and Urban Development, which is designed to covering portions of a person’s rent based on income, provide a housing subsidy “for as long as a person stays alive.”

While there were 17,206 EHV awards reserved for California with approximately 4,000 left for use, according to the EHV website dashboard, Weare emphasized how this opportunity is not being used to its optimal capacity. He says there is “ample” evidence that people who received these housing vouchers stayed housed, becoming a permanent solution to their homelessness.

“But landlords who are legally required to accept people with these vouchers may refuse them when we have a housing market that’s so tight, where a landlord gets 10 to 20 applications for their apartment,” he says.  “It’s very easy for them to not want to accept one for someone who has it.”

Because of its expense, he says permanent supportive housing should be reserved for the highest levels of acuity, mental illness, and the like, but emphasized the importance of these vouchers over other housing strategies.

“The first one is that they’re permanent, so that when people get in there, there’s lots of evidence that they stay housed –they don’t fall back into homelessness,” says Weare.

Weare also noted that buying motels to put people in were a “great idea” and was supportive of similar efforts. “We should just be building those things left and right whenever we have an empty parking lot.”

Ultimately, we need to do more things to help people get back on their feet, Weare says.

“I think what’s fair to recognize is that there are people trying really hard to improve this,” says Weare, acknowledging efforts made by the government. “Things sort of move slowly in the right direction, but you know, this is not a problem where we should be moving slowly–we need significant action now.”

Sarah Chung is an intern with Capitol Weekly