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Getting Priorities Straight: Housing First

“The human right to adequate housing, which is thus derived from the right to an adequate standard of living, is of
central importance for the enjoyment of all economic, social and cultural rights.”1

Housing First is a strategy that aims to move people directly from homelessness into

permanent housing without requiring treatment for addictive or mental illnesses. The Housing

First philosophy recognizes that housing is a right, not a reward, and that people should not have

to wait until they are deemed “housing ready.” Once the chaos of living on the streets or in

shelters is eliminated, the Housing First model provides supportive services such as case

management, treatment options and job training to help clients address the underlying causes of

their homelessness. Harm reduction – the recognition that homeless individuals who have not

yet clinically stabilized or are still active users require housing in order to begin the recovery

process – is a central tenet of the Housing First philosophy that has proved successful in keeping

people housed while they work towards personal goals in a stable environment.

Housing First responds to the prevailing strategy to combat homelessness, which

emphasizes a linear trajectory in which an individual experiencing homelessness moves from

emergency shelters to transitional housing to permanent housing. Evidence over the past two

decades demonstrates that this model, where the goal is permanent housing, fails to “graduate” a

significant percentage of people from emergency shelters. Many individuals cycle through the

system for extended periods of time while affordable housing, employment and personal stability

remain out of grasp. The chronically homeless often face significant barriers which this model

proves unable to alleviate, given the instability unaddressed and often exacerbated by shelter life

and the lack of sufficient support services.

Homelessness is a growing crisis nationally and Charlotte-Mecklenburg is no exception.


1
ICESCR, General Comment 4 on Article 11.1.
In January 2010, a comprehensive survey estimated that 7,000 homeless individuals lived in the

community, up 33% from two years prior.2 Recognizing this trend, Charlotte’s Ten Year Plan to

End Homelessness, “More than Shelter!,” calls for a shift in resources away from the traditional

shelter-based model towards a housing-based strategy that places people in permanent housing

and links them with supportive services. While emergency shelters are necessary for the

transitionally homeless, short-term shelters must no longer be the primary approach to alleviate

homelessness because they fail to address its root causes. The Ten Year Plan aims to secure

2,500 units of supportive and service-enriched housing units.3 This new direction recognizes that

homelessness is a housing issue and that combating homelessness requires sufficient affordable

housing.

In addition to simply providing units of affordable housing, it is important to ensure that

the housing is available to the most vulnerable populations by not imposing behavioral

requirements for eligibility that mandate abstaining from substance use, demand clinical

stabilization or assign obligatory treatment and counseling sessions. For any “normal” member

of society to maintain housing, one is required only to maintain timely payment of rent and

responsibility as a tenant or neighbor. The dignity and rights of those most vulnerable should be

equally respected by not imposing extra requirements to stay housed.4

Housing First departs from abstinence-based programs, instead upholding harm

reduction5 as the most effective strategy to help tenants work through their personal issues while

maintaining stable housing. Recovery from substance abuse, mental illness, and the trauma of
2
Consolidated Plan, 14.
3
Five hundred of these supportive units will be for the chronically homeless, which make up approximately 15% of
Charlotte’s homeless population. More than Shelter, 4.
4
Many Housing First projects require residents to pay 30% of their income towards their apartment’s rent. Thirty
percent is the widely accepted percentage of income that should be allocated to housing costs.
5
Harm reduction is understandably controversial; some view it as enabling and implicitly condoning illegal or
harmful behavior.
time spent on the street is a lengthy process. Individual progress arises from strong personal

relationships with caseworkers and support groups, and one’s gradual improvement

fundamentally requires the stability that comes with being housed. Housing First providers

design these supportive services to entice clients to participate but diverge from coercive or

obligatory services that typically accompany housing programs. The flexibility for caseworkers

to support tenants as they progress through individual stages of change without the constant risk

of losing their housing enables tenants to work towards the long-term goals of sobriety and

normalcy. Abstinence-based strategies certainly play a part in a city’s comprehensive plan, but a

diversified strategy including harm reduction as a core component is the most effective tool to

reducing the number of chronically homeless.

Empirical evidence demonstrates that Housing First enables greater success in terms of

allowing for recovery from addiction and illness, for keeping people housed and for saving

taxpayers money. The housing development at 1811 Eastlake in Seattle pioneered the Housing

First principles of “screening-in” the most vulnerable population, in this case chronic alcoholics,

and providing housing without mandatory treatment. The program found that, while recovery

time varied widely from person to person, the longer time spent in housing directly correlated

with reductions of alcoholism. Seattle City Attorney Tom Carr dubbed the project an “anti-

crime” initiative, observing that its tenants no longer frequented the county courthouse. Given

the unprecedented success in sheltering those least likely to be housed, the model has since been

emulated with similar success in other regions of the country. An 85-unit supportive housing

project called Moore Place is slated for construction in August 2010 in Charlotte, North

Carolina, the city’s first Housing First initiative.

While human compassion and the universal right to housing should be the primary
motivation for expanding Housing First, housing the chronically homeless is also attractive

because of its economic benefits. Housing First saves money, on aggregate, that is not spent on

emergency services like hospital and jail visits. A 2009 study conducted by the Journal of the

American Medical Association demonstrated significant annual savings from Seattle’s 1811

Eastlake,6 and Moore Place is similarly expected to save Charlotte $2 million in its first year

alone. Chronically homeless individuals use a disproportionate amount of the resources

available to the homeless,7 and Housing First presents a cost-effective way to free up

overburdened soup kitchens and emergency shelters. Housing First programs also have positive

net social impacts on urban areas; whether scattered-site or project-based, they are not the

Cabrini-Green-esque, tower-in-the-park eyesores of the 1960s that proved detrimental to

inhabitants and toxic to the city as a whole. Studies show that property values near Housing First

projects actually rise several years after construction,8 and anecdotal observations demonstrate

the high level of integration of these projects in the larger community.

When addressing a social issue as complex and multi-faceted as homelessness, it

becomes easy to be paralyzed in the face of what appears to be an insurmountable obstacle.

Housing First provides a holistic strategy that addresses the underlying issues of homelessness

while respecting the human right to housing. Despite a somewhat high learning curve for

acceptance among policy makers and the general public, the efficacy of Housing First’s harm

reduction supported by wrap-around services is not only the smart option when combating

homelessness, but more importantly, it is the compassionate way to answer the call to house our

neighbors.
6
The study of 95 participants of 1811 Eastlake found total cost reductions of 53% relative to those on the wait list
over six months, JAMA study.
7
Twenty percent of the homeless population (the chronically homeless) use eighty percent of the resources intended
for the entire homeless population.
8
Study by the Furman Center on New York Housing First projects.
Works Cited

“City of Charlotte and Charlotte-Mecklenburg Consortium Five-Year Consolidated Plan 2011-


2015: Working Draft,” May 2010
<http://www.charmeck.org/Departments/Neighborhood+Dev/Provide+Affordable+Housi
ng/Consolidated+Plan.htm>.

Larimer, Mary E., Daniel K. Malone, et. al, “Health Care and Public Service Use and

Costs Before and After Provision of Housing for Chronically Homeless Persons With
Severe Alcohol Problems,” Journal of the American Medical Association 301.13 (2009):
1349-1357 < http://jama.ama-assn.org/>.

“More Than Shelter! Charlotte-Mecklenburg’s Ten-Year Implementation Plan to End and

Prevent Homelessness—One Person/One Family at a Time,” Oct. 2006


<http://www.awayhome.org/>.

“The Impact of Supportive Housing on Surrounding Neighborhoods: Evidence from New York
City,” Furman Center for Real Estate and Urban Policy, New York University, 2008
<http://furmancenter.org/files/FurmanCenterPolicyBriefonSupportiveHousing_LowRes.p
df>.

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