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Is Housing First a cure for homelessness?

Anthony Russo

Alleviating homelessness by making the housing of an individual the first step is federally sanctioned and backed by data from places as varied as Rockford, Illinois, and Abilene, Texas. But some Kansas legislators are skeptical of investing in housing homeless individuals without asking them to make other changes to their lives.

Homelessness is more visible than ever. The number of people experiencing homelessness has been on the rise for several years across the country, and close to home. Last year, volunteers counted over 2,000 homeless Kansans – and those are just the ones local agencies are aware of. There are likely hundreds more living in cars, surfing on couches or hidden in encampments.

With visibility though, comes attention, then momentum, then, hopefully, action. Urban areas like Wichita, Topeka and Kansas City are seeing more encampments pop up in the warmer months, laying bare the slim safeguards available for the homeless. The rural homeless have even less shelter to find refuge in, leaving them to choose either a frontier lifestyle or a trek toward cities for resources.

Those resources – shelters, food banks, free showers, mobile clinics – are a response to the symptoms of homelessness. But to remedy the problem, to prevent it from happening over and over to the same person, often requires a different approach.

Homelessness is a maddingly complex and persistent issue. Across Kansas and in cities such as Wichita, ideas about how to get people off the streets have run the gamut, from quickly getting as many people as possible into shelter, to legislative efforts to criminalize being homeless.
Jeff Tuttle
Homelessness is a maddingly complex and persistent issue. Across Kansas and in cities such as Wichita, ideas about how to get people off the streets have run the gamut, from quickly getting as many people as possible into shelter, to legislative efforts to criminalize being homeless.

One intervention that Kansas agencies are depending on right now: Housing First.

The Housing First model recognizes housing as a fundamental human right and posits that people experiencing homelessness deserve to be housed as the first step in the journey to being stably housed. The approach is guided by the belief that basic necessities such as food and shelter are critical needs and must be fulfilled before people are able to properly attend to other needs, such as employment or mental health counseling.

Traditionally homeless initiatives require some sort of commitment from a person experiencing homelessness – such as graduating from a series of programs or getting behavioral health treatment – before becoming eligible for housing.

Although some critics question the approach’s priorities, Housing First does not end with a lease agreement. Housing First emphasizes that getting someone into housing is just the beginning of an often complex journey into stabilization. Eliminating housing prerequisites eases the stress of transitioning from living on the street to living behind four walls, the model’s proponents argue, allowing for a greater chance of success when an individual is engaging with services that match their needs.

“For example, in a Housing First program, we wouldn’t have a requirement that they are sober, that they are med compliant, that they are engaging in treatment services. It’s really about the idea that housing is a human right and that everyone deserves housing regardless of their choices,” says Molly Mendenhall, the program director for Destination Home, a joint initiative of the Kansas Statewide Homeless Coalition and the Kansas Department for Aging and Disability Services.

Mendenhall adds that every Housing First program comes with access to mental health, substance use and employment services.

“We continually offer services even if people decline to engage,” she says. “We are always there for them. They choose what’s best for their need. That’s the ideal.”

Housing First is a federally approved model. The Department of Veterans Affairs found that adopting the model reduced the wait time for housing for homeless veterans from 223 days to 35.
Anthony Russo
Housing First is a federally approved model. The Department of Veterans Affairs found that adopting the model reduced the wait time for housing for homeless veterans from 223 days to 35.

Mendenhall is responsible for a majority of the state’s training on Housing First and making sure that programs funded by the U.S. Department of Housing and Urban Development are implementing the model correctly. She works directly with Sam Tsemberis, founder of the Housing First model. His Pathways Housing First Institute has a nearly $800,000 contract with the state to provide training and technical assistance.

Tsemberis founded Pathways to Housing in New York in 1992, which was one of the first practical applications of his house-first, treatment-second strategy. His approach has since been followed in 20 countries and across the U.S., including Kansas.

“The predominant health/homeless service system has been focused on improving the individual before they’re housed. It’s like treatment first and then housing,” Tsemberis says. “Housing First reverses that sequence, because people are not really able to or are interested in treatment when they’re worrying about their survival, which is the condition they’re in when they’re homeless.”

When someone is experiencing homelessness, it can be difficult to see beyond the next day. Without stable housing, one is forced to be in the present and prioritizing the most essential needs to stay alive: food, water and shelter. Research shows that some people experiencing homelessness turn to drugs or alcohol as a coping mechanism, which further complicates the pathway to stable, sober living.

Is it really fair, then, to expect someone surviving the elements to prove their worth for a house? State Rep. Leah Howell, a Derby Republican, thinks that may be the only way to persuade legislators to invest in such a venture.

“Of course everyone needs a place to put their head at night,” Howell says. “There is a strong pushback on the idea that we are just going to take taxpayer dollars from people who are working very hard to pay their bills every day … and just give a homeless person a house without requirements to become productive members of society.”

Jeff Tuttle

Howell, a Republican, was a member of the Special Committee on Homelessness last year, marking the first time the issue had a position of prominence in a legislative session, she says.

Many of her colleagues bristled at the idea of Housing First, labeling California’s experience as a colossal failure. The state adopted the approach in 2016 and has yet to see an overall decrease in homelessness. Now it’s considering allowing housing funds to be used on sobriety-focused programs.

But notwithstanding California’s struggles, Housing First is federally approved. The Department of Veterans Affairs found that adopting the model reduced the wait time for housing for homeless veterans from 223 days to 35. Emergency room use also significantly declined. HUD employs Housing First methods for homeless veterans, claiming that the agency’s voucher program has helped “reduce and ultimately end veteran homelessness.”

Research from the National League of Cities cites Rockford, Illinois, as a successful case study for Housing First, where the city reached functional zero, meaning that more people are exiting homelessness than entering it, for both veterans and the chronically homeless. Abilene, Texas cut wait times for housing in half for the chronically homeless, also achieving functional zero. Data from Utah shows that after implementing Housing First statewide in 2005, the state has seen a 91% decrease in chronic homelessness by the end of its 10-year plan.

Tsemberis says that once the federal government decided that homeless veterans were a “national shame,” 80,000 housing vouchers were issued, dramatically dropping the number.

“It shows you that when there’s political will, and we believe people are worthy, we can do something and effectively end homelessness,” he says.

“So if we think veterans are worthy of getting out of homelessness and supporting them to have a better life, aren’t the rest of the people in the country also worthy and deserving of support and a better life?”

The challenges of Housing First in Kansas

Housing First programs began to be implemented in the state around 2021, according to Mendenhall.

Lawrence was the first Kansas municipality Tsembaris consulted with. The city has a track record for proactive homelessness interventions, putting the principles of low barriers, supportive housing and self-determination into action. The Lawrence Community Shelter boasts of its Housing First approach on its website, although it did not respond to inquiries from The Journal.

As in most of the country, Kansas struggles to keep up with demand for affordable housing – a limiting factor for Housing First. Without an available home to fill, how can an individual transition out of homelessness?

“That is absolutely a struggle that we face here in Kansas,” Mendenhall says. She explains that HUD can grant funds for the state to build affordable housing for low-income families, something especially helpful in areas with few developers, such as western Kansas.

Tsemberis acknowledges that limited housing inventory restricts the full potential of Housing First. People wait months or years for housing – regardless of the model.

“If we talk about ending homelessness in America, then we’re talking about having to do really dramatic changes in policy and having the federal government reinvest in building public housing, like they used to before 1980,” he says. The decades-long increase in unsheltered homelessness has coincided with a lack of investment in public housing and the real estate market’s relentless increase.

Another policy change that could reduce homelessness: Medicaid expansion. Kansas is one of 10 states that have not adopted it.

“Obviously Medicaid expansion would help as well,” Mendenhall says. “It would take a lot of the burden off of individuals and families that are having to pay out of pocket for medical expenses. Without that Medicaid expansion, so much of individuals’ money is going to medical expenses and keeping them homeless.”

Current trends in the number of people living on the street tend to make homeless people more visible and close to areas where people live and work. That, in turn, makes many people anxious and sometimes afraid, even though the homeless tend to be victims of violent crime rather than perpetrators.
Jeff Tuttle
Current trends in the number of people living on the street tend to make homeless people more visible and close to areas where people live and work. That, in turn, makes many people anxious and sometimes afraid, even though the homeless tend to be victims of violent crime rather than perpetrators.

But changes in attitudes toward the homeless have a tough time gaining traction in the Legislature. Howell was glad to see homelessness rise in prominence, but worries that any momentum will fade by the next regular session.

All 165 seats in the Legislature are up for election this year, and a significant level of turnover is expected with 31 open seats.

“We have a lot of change happening right now,” Howell says. “New people get elected. That means we start over.”

She worries, too, that legislators struggle to support initiatives when they don’t necessarily see how homelessness affects their part of the state.

“Homelessness, mental health and substance abuse issues are seen as big city problems,” she says. “The rural community does not like to feel left out. They also don’t like to spend money to fix our problems. I will say there are plenty of legislators that don’t think they have those problems. And it is our problem. So that’s another hurdle.”

Eric Arganbright, the director of community engagement at the Kansas Statewide Homeless Coalition, grew up homeless in rural Kansas. He’s eager to tell his story wherever he goes to try to prove to skeptics that homelessness does exist outside of urban areas.

“Also, one of my favorite statistics that we can throw out is 87% of folks in Kansas who are experiencing homelessness have regular annual income. That’s part of what we point out,” he says.

Howell says her views could be swayed if data proved that the Housing First approach is viable. But she also thinks guardrails are needed for someone transitioning into permanent housing – something that encourages “better choices.”

“How do we balance getting them into a house where they are not on the street, where they have a roof over their head and yet, for lack of a better way to say it, forcing them to get help? Where’s that balance? There’s where we have to have a really difficult conversation that I’m not sure we’re really having yet.”

Tsemberis is all-too familiar with skepticism on Housing First. He says that the question to ask lawmakers is, ‘How are you going to spend taxpayers’ money on homelessness?’

“Because if you don’t house people, and you leave people homeless, you’re going to pay for it with taxpayers’ money. You’re going to pay for it through police interventions, through emergency room use, through jail time or all of these shelters and other kinds of programs serving people who are homeless but not giving them housing. So you’re going to pay for it one way or the other.

“The question is: Why not pay for it in a way that you have a solution to the problem as opposed to a perpetuation of the problem?”

This article was produced as part of the Wichita Journalism Collaborative (WJC). The WJC is a partnership of 11 media and community partners, including KMUW. 

Stefania Lugli is a reporter for The Journal, published by the Kansas Leadership Center. She focuses on covering issues related to homelessness in Wichita and across Kansas. Her stories are shared widely through the Wichita Journalism Collaborative. She can be reached via email slugli@kansasleadershipcenter.org