Meeting people where they are: the Housing First model

For some people, it evoked the hobo camps of the Depression years. For some nearby homeowners, it was unnerving. For those concerned about the city’s tourism revenues, it was not a good thing.

Victoria’s ‘tent city’, on the land just across from the provincial courthouse, was closed down in 2016, after almost a year, and 300 people were relocated. One of the places they went to was My Place, an old fire hall turned into a temporary home for 40 of the tent city residents. 

When they were looking for volunteers, I signed up. I helped in the kitchen twice a week, and picked up garbage in the surrounding blocks. And I learned a lot about homelessness.

I was particularly interested in how My Place had come to be. I learned that the executive director of Our Place had spent time at the tent city, talking with people and asking what they needed and wanted. And My Place reflected what he had learned. It had tents in the main gymnasium area, so each person had their own place, and could sleep in safety. It had storage space, so their belongings would be safe. It provided three meals a day, so people got good nutrition. And the residents had regular community meetings.

“Residents will have privacy, mental health and addiction support, hot meals, showers, programming, income opportunities, and the ability to work one-on-one with housing support workers to secure permanent housing. “We’ll be working with the new residents to build a community of support and belonging,” said Our Place Executive Director Don Evans. “We’ve found in our other transitional housing that when we provide people with a safe and secure home, it makes a huge difference in their physical and emotional well-being.”

While volunteering, I learned things I hadn’t known. Living on the street isn’t safe, so people rarely sleep at night. Instead they sleep during the day, when most agencies make appointments. Keeping clean and fed while on the street is a challenge, especially if substance abuse is involved. There is a long waiting list to get into substance abuse programs. Some people who are homeless are employed. And most surprising to me – people on the street didn’t feel seen, because people would walk by without looking at them.

I also saw how systems could change. Over time, social services started to come to My Place to help people complete paperwork. When people were in one place, they could be reminded of appointments with housing agencies. And I saw the difference in connections when staff had lived experience of homelessness and substance abuse themselves, and knew how to use a vulnerability checklist to assess peoples’ situation.

Photo by Jon Tyson on Unsplash

I became interested in solutions, like ‘housing first’ – which is exactly what it says. House people first and then work with them to address their challenges. I began reading everything I could find out about it, and discovered that like many such great ideas, how it was implemented was key to success. It needed to be done collaboratively and involve everyone.

Salt Lake City

I keep coming back to a TED talk by Lloyd Pendleton, who led a housing first pilot project in Salt Lake City, Utah, and over its course, developed an empathy for the homeless that he hadn’t previously felt, raised as he was on a ranch with the ethos of ‘rugged individualism’. When he first heard about ‘housing first’ and ‘harm reduction’, he was skeptical.

But then, at a 2003 conference to discuss the government’s ‘housing first’ plan, he heard three things that changed his mind:

  1. The chronically homeless, while only 15% of the homeless, “can consume 50 to 60% of the homeless resources available in a community” and cost $20,000 to $45,000 a year per person in emergency services costs. It was a small, but expensive, population.
  2. Moving mentally ill homeless people to move directly from the street into housing, letting them continue to use drugs and drink, and offering services by on-site case managers, worked: 85% were still housed after 12 months.
  3. Clean needles, condoms and low-barrier housing were part of developing trust with people who had experienced so much abuse that they hardly trusted anyone.

When the US government began inviting states, cities and counties to develop a plan to end chronic homelessness over 10 years, and Utah accepted the invitation, Pendleton was asked to lead the effort. The first challenge was that while an affordable housing group was willing to build 100 units, no one was sure what would happen if 100 chronically homeless people were in the same building.

Back on the ranch, when chopping wood for the fire, he had learned to tackle the big end of the log first. So he asked the agencies to identify the 17 most problematic clients. “Twenty-two months later, all 17 were still housed, including Keta, who today, 11 years later, is sleeping in her own bed and is sober,” he said. And by 2015, ten years after the plan was approved, “we reported a reduction in our chronic homeless population of 91% statewide.”

The key seemed to be that all the agencies had worked together, and the case managers stopped debating what was the best strategy and did anything necessary to keep people housed. In other words, they looked at people as individuals. There was no one-size-fits-all.

Conferenza Internazionale Housing First “C’è solo una strada: la casa” (Torino 2016) IMic70 Wikimedia

Now Houston

I thought about this when I read about how Houston, Texas, has housed more than 25,000 homeless people during the past decade, with most remaining housed after two years. “The number of people deemed homeless in the Houston region has been cut by 63 percent since 2011,” the New York Times reported, and according to a 2020 federal report, “Houston did more than twice as well as the rest of the country at reducing homelessness over the previous decade.”

So how did they do it? Well, I am sure Lloyd Pendleton wouldn’t be surprised. They began to talk to each other, and to work together. “Houston has gotten this far by teaming with county agencies and persuading scores of local service providers, corporations and charitable nonprofits — organizations that often bicker and compete with one another — to row in unison.”

The US government has seen the value of such a coordinated strategy. In 2009, the Hearth Act required cities to adopt a ‘housing first’ policy and homeless organizations to work together in ‘continuums of care’ under a single lead agency, coordinating programs and sharing data, in order to get federal dollars, the Times notes. “The federal government had recommended these continuums of care since 1994, but not until the Hearth Act was funding tied to specific metrics of effectiveness.”

And they approached the task with empathy. ““Through our son, I had an up close and personal look at what life was like for somebody on the streets who was treated as disposable,” said Annise Parker, who was mayor of Houston at the time. “Different organizations were all working in their own lanes, according to their own rules and procedures, doing what they wanted to do. There might be 100 open shelter beds on a given night designated for mothers with kids, but we didn’t have mothers with kids who needed beds.”

They called it The Way Home. The nonprofit Coalition for the Homeless of Houston/Harris County became the lead agency and more than 100 local and regional organizations signed on. When the Houston Housing Authority joined the continuum, it agreed that 250 homeless clients a year could move to the top of the waiting list for vouchers, and that meant thousands have been housed, the story notes.They began to collect data in real time, rather than once a year.

“It helped that back then we still had slack in our housing market and reasonably priced land,” Ms. Parker said. “It also helped that we created a center for sobriety, stopped arresting 20,000 people a year for public intoxication and started handing out taxi vouchers to homeless people so they wouldn’t use ambulances as personal taxis. All that saved us a fortune and made sense. But the bottom line is that nearly everybody in Houston involved in homelessness got together around what works. That’s our secret sauce.”

Partners of The Way Home meet (photo: The Way Home)

That coordinated approach helped, too, after Hurricane Harvey in 2017, because city officials used private money and federal emergency relief dollars to house unhoused Houstonians. And Covid money is paying the rent for thousands of apartments for the continuum’s homeless clients.

Houston has tweaked the federal ‘vulnerability index’ so it suits local conditions. The chronically homeless become eligible for permanent supportive housing, which means that as well as housing, they get money for rent, utilities, bus fare and other necessities, and a case manager who helps with access to employment programs, psychiatric and substance abuse treatment.

People who score a bit lower on the vulnerability index qualify for “rapid rehousing”, which gets them an apartment for a year and help from a case manager. In 2021, that was 4,233 people. In Houston, three quarters of those who have been rapidly rehoused are still housed a year later.

Meeting People Where They Are

I find these stories so hopeful. When people come together this way, not only do they help solve a problem – they also build their capacity to work together on other things.

As Lloyd Pendleton said: “No one grows up saying, “My goal in life is to become homeless.” And that’s the beauty of the harm reduction and Housing First model. It recognizes the complexities of the different factors that can shape a human life. These models meet people where they are, not where we are or where we think they should be.”

“I have learned over and over again that when you listen to somebody’s story with an open heart, walk in their shoes with them, you can’t help but love and care for them and want to serve them,” he says. “This is why I’m committed to continuing to bring hope and support to our homeless citizens, who I consider to be my brothers and sisters.”


Final goodbye to tent city, ramshackle Victoria B.C. camp dismantled. CBC News, Aug. 12, 2016.

The Housing First Approach to Homelessness – Lloyd Pendleton. TED Talks, TEDMED 2016.

How Houston Moved 25,000 People From the Streets Into Homes of Their Own. New York Times, Jun. 14, 2022.