States seek alternatives to failed Housing First strategy

Florida state Rep. Sam Garrison says his state is charting a new course in addressing chronic homelessness. A statewide camping ban went into effect in October, though provisions of the law won’t be enacted until January 2025.

“It’s had a pronounced change on how the state addresses chronic homelessness, and we are still in the early stages,” said Garrison, who sponsored the bill in the Florida House of Representatives. The Republican represents District 11 in central Florida. “So I’m very encouraged and excited that we may be onto something that not just works here in Florida, but can become a model for the nation.”

Before drafting the bill, Garrison visited communities across the nation struggling to address chronic homelessness in a quest to find out what works—and what doesn’t. Most cities and states subscribe to an approach known as Housing First. That model, which is currently also the official policy of the federal government, focuses on moving individuals off the streets and into permanent housing as quickly as possible, often overlooking deeper needs driving their homelessness. Critics claim it also squanders billions of taxpayer dollars.

Garrison and a growing number of lawmakers and homelessness experts across the country argue that for the chronically homeless, the Housing First approach misidentifies the root of the problem. They believe treatment, not permanent housing, should be the first step. A widespread strategy shift is unlikely unless the federal government gets on board, but the incoming presidential administration has signaled a willingness to reconsider Housing First at the federal level.

The Florida law bans homeless encampments throughout the state and, starting Jan. 1, allows residents and business owners to take cities and counties to court if they fail to enforce the camping ban. It also mandates that local governments use state funding to provide temporary shelter and treatment instead of permanent housing.

Provided basic safety measures are followed, the legislation authorizes municipalities to create state-sanctioned camps, designated areas where the homeless can set up their tents and remain outside if they choose—with a few caveats. Alcohol and drug use are prohibited onsite, and municipalities must provide access to substance abuse rehab and mental health treatment, along with running water and restrooms.

The approach diverges from the Department of Housing and Urban Development’s Housing First strategy, which the federal agency defines as rapidly rehousing individuals and families without prerequisites such as sobriety or class participation. Ideally, case managers check in with newly housed individuals to connect them with substance abuse and mental health treatment or other needed services. But officials often don’t push the services, and, critics argue, recipients rarely accept them. Ministries or housing providers who receive federal or state funding tied to Housing First policies can’t require things like sober living or class participation.

“I just haven’t seen it work,” Garrison said of the Housing First model. “The definition of insanity is doing the same thing over and over, expecting a different result, and it seemed like that’s what we were doing as it relates to the millions upon millions of dollars in federal money.”

Nationwide, homelessness rose 12% last year. It jumped by about 19% in Florida, which has the third-largest homeless population in the country. In California, where the state enshrined Housing First into state law in 2016, homelessness has climbed 53% over the past decade despite the state spending nearly $24 billion since 2018 on the approach.

Housing First fails to distinguish between two very different subsets of the homeless population, said Devon Kurtz, who is the policy director for public safety at the Cicero Institute. The Texas-based think tank helped craft Florida’s new homeless policy and has assisted lawmakers in other states with similar measures.

For individuals who find themselves homeless due to a job loss, financial crisis, or similar situations, housing assistance can be the logical first step. But the chronically homeless—individuals with disabling conditions, including addiction, who have been unsheltered for 12 months or at least four times in the last three years—suffer disproportionately from substance abuse and mental illness, Kurtz noted. In these situations, people may not be able to transition straight off the streets to independent living.

“The problem with Housing First is not so much just the idea that housing is an important component of this, but that it’s the only thing that matters,” he said.

Florida lawmakers allocated $30 million dollars in the 2024 General Appropriations Act to help communities implement the state’s new approach. The state budget requires homeless service agencies receiving the funds to prioritize mental health and substance abuse treatment and short-term and transitional shelters instead of permanent housing.

Kurtz said the funds will help “build out” an approach he called the transitional housing model. “You have housing that has more intensive requirements and expectations,” he said. For high-need individuals, Kurtz said this model could guide them into more independent living situations but also “[meet] them where they’re at, as opposed to sort of assuming that they can just live on their own.”

Florida isn’t the only state pushing back against Housing First, Kurtz noted. Earlier this year, Georgia lawmakers set aside funding for stable housing accountability programs throughout the state. The programs provide individuals with temporary housing for up to 18 months but require participants to seek substance abuse and mental health treatment, participate in job training, and “sustain an honest, good-faith effort” to remain sober. Programs must remove residents who flout these requirements. The goal is to move the individual into long-term housing, but only after a period of accountability.

In March, Utah lawmakers allocated more than $50 million to short-term shelter and behavioral health programs. Missouri Gov. Mike Parson signed a camping ban in 2022 that also shifted state funding away from constructing affordable housing to temporary, state-sanctioned camps where individuals could receive substance abuse and mental health treatment. The state Supreme Court struck down the law last year over a technical issue. In April of this year, Oklahoma Gov. Kevin Stitt signed a bill similar to the Missouri law.

Homeless policy consultant Michele Steeb said it will be difficult for more states to move away from the Housing First model unless the federal government also shifts its approach. Continuums of Care, the regional networks of agencies and nonprofits that coordinate to deliver services, receive a significant portion of their funding from HUD. Most states don’t have enough financial leverage to completely reject the model.

But Steeb believes the federal government may shift to a more treatment-oriented model after President-elect Donald Trump takes office. In an April 2023 campaign video, Trump laid out a plan similar to Florida’s law that includes banning public camping while setting aside sanctioned encampments where the homeless can receive services and treatment.

“This strategy will be far better and far less expensive than spending millions to house the homeless in luxury hotels without addressing their underlying issues and needs,” Trump said.

In Florida, communities across the state are preparing for the rest of the new law to take effect in January. Ron Book chairs the Miami-Dade Homeless Trust, which organizes the region’s homeless strategy and administers funding. Book, who spoke in support of the law’s ban on public camping, said the crackdown will incentivize more people to seek help. But he doesn’t agree with the state’s pivot to focusing on temporary shelter and sanctioned encampments where people can receive treatment.

“If you believe that you’re going to move people into encampments overnight and they’re immediately going to stop drug use and alcohol use … [that] they’re going to immediately accept behavioral health services … it’s just not a reality,” Book told WORLD. He added that he would firmly oppose any effort to create a sanctioned camp in Miami-Dade county.

Rep. Garrison acknowledged that not every individual in a state-sanctioned encampment or temporary shelter will accept treatment. But he still believes the law is a step toward the accountability that’s lacking in many Housing First programs. He pointed to his Christian faith as a large part of the reason he advocated for the bill’s new direction.

“To me, it’s a moral issue. It’s motivated by my faith,” he said. “It seems unconscionable to me to be spending hundreds of millions of dollars on Housing First models where we have people literally camping out on the side of the road.”