SACRAMENTO, Calif. — President Donald Trump is vowing a brand new strategy to getting homeless folks off the streets by forcibly shifting these dwelling outdoors into giant camps whereas mandating psychological well being and dependancy remedy — an aggressive departure from the nation’s main homelessness coverage, which for many years has prioritized housing as the best strategy to fight the disaster.
“Our once-great cities have become unlivable, unsanitary nightmares,” Trump stated in a presidential campaign video. “For those who are severely mentally ill and deeply disturbed, we will bring them to mental institutions, where they belong, with the goal of reintegrating them back into society once they are well enough to manage.”
Now that he’s in workplace, the assault on “Housing First” has begun.
White House officers haven’t introduced a proper coverage however are opening the door to a treatment-first agenda, whereas engineering a serious overhaul of the housing and social service applications that kind the spine of the homelessness response system that cities and counties throughout the nation rely upon. Nearly $4 billion was earmarked last year alone. But now, Scott Turner, who heads Trump’s Department of Housing and Urban Development — the company accountable for administering housing and homelessness funding — has outlined large funding cuts and known as for a review of taxpayer spending.
“Thanks to President Trump’s leadership, we are no longer in a business-as-usual posture and the DOGE task force will play a critical role in helping to identify and eliminate waste, fraud and abuse and ultimately better serve the American people,” Turner said in an announcement.
Staffing cuts already proposed would hit the a part of the company overseeing homelessness spending and Housing First initiatives notably arduous. Trump outlined his imaginative and prescient throughout his marketing campaign, calling for brand spanking new remedy amenities to be opened on giant parcels of presidency land — “tent cities where the homeless can be relocated and their problems identified.” They might obtain remedy and rehabilitation or face arrest. Now in workplace, he has begun to show his consideration to avenue homelessness, in March ordering Washington, D.C., to sweep encampments, doubtlessly separating homeless folks from their case managers and social service suppliers, derailing their path to housing.
The administration is discouraging native governments from following the federal coverage, telling them it will not enforce homelessness contracts “to the extent that they require the project to use a housing first program model.” And, in a recent order “reducing the scope of the federal bureaucracy,” Trump slashed the U.S. Interagency Council on Homelessness, shrinking the company accountable for coordinating funding and initiatives between the federal authorities, states, and native companies, often called Continuums of Care.
“Make no mistake that Trump’s reckless attacks across the federal government will supercharge the housing and homelessness crisis in communities across the country,” Democratic U.S. Rep. Maxine Waters of Los Angeles stated in response to the order.
Support Without Forced Treatment
Housing First was applied nationally in 2004 beneath the George W. Bush administration to fight power homelessness, defined as having lived on the streets with a disabling situation for a protracted time period. It was expanded beneath President Barack Obama as America’s plan of assault on homelessness and broadened by President Joe Biden, who argued that housing was a primary want, important to well being.
The coverage goals to stabilize homeless folks in everlasting housing and supply them with case administration help and social providers with out forcing remedy, imposing job necessities, or demanding sobriety. Once housed, the speculation goes, homeless folks escape the chaos of the streets and might then work on discovering a job, caring for power well being situations, or getting sober.
“When you’re on the streets, all you’re doing every day is figuring out how to survive,” stated Ann Oliva, CEO of the National Alliance to End Homelessness. “Housing is the most important intervention that brings a sense of safety and stability, where you’re not just constantly trying to find food or a safe place to sleep.”
But Trump needs to intestine taxpayer-subsidized housing initiatives. He is pushing for a punitive strategy that may impose fines and doubtlessly jail time on homeless folks. And he needs to mandate sobriety and psychological well being remedy as the first homelessness intervention — a stark reversal from Housing First.
The shift has ignited worry and panic amongst homelessness specialists and front-line service suppliers, who argue that forcing remedy and criminalizing homeless folks by fines and jail time merely doesn’t work.
“It’s only going to make things much worse,” stated Donald Whitehead Jr., govt director of the National Coalition for the Homeless. “Throwing everybody into treatment programs just isn’t an effective strategy. The real problem is we just don’t have enough affordable housing.”
Trump obtained near ending Housing First throughout his first time period when he tapped Robert Marbut to guide the U.S. Interagency Council on Homelessness in 2019. Marbut pushed for mandating remedy and decreasing reliance on social providers, whereas curbing taxpayer-subsidized housing. He argued that forcing homeless folks to get sober and enter remedy would assist them obtain self-sufficiency and finish their homelessness. But covid-19 stalled these plans.
Now, Marbut stated, he believes the president will end the job.
“Trump knows that what we need to do is get funding back to treatment and recovery,” Marbut stated. “The Trump administration is laser-focused on ending Housing First. They realized it was wrong the first time and that’s why I was selected to change it. They still realize it’s wrong.”
Trump and administration officers didn’t reply to questions from KFF Health News. A request to interview Turner was not granted. Project 2025’s “Mandate for Leadership,” a conservative coverage blueprint from a few of Trump’s closest advisers, explicitly requires an finish to Housing First.
Under Attack
Housing First is beneath assault not solely from Republicans who’ve lengthy criticized taxpayer-subsidized housing for homeless folks, but additionally from Democrats responding to public frustration over homeless encampments multiplying across the nation. Last yr, the federal authorities estimated that more than 770,000 folks within the U.S. have been homeless, a file excessive. That was up 18% from 2023. And whereas housing grows more and more unaffordable, homeless camps have exploded, spilling into metropolis parks, crowding sidewalks, and polluting sensitive waterways, regardless of unprecedented public spending.
Already, cities and states, liberal and conservative, are cracking down on avenue homelessness and focusing on the psychological well being and dependancy disaster. This is true even in deep-blue states like California, the place Gov. Gavin Newsom has created a “CARE Court” initiative that may mandate remedy regardless that housing isn’t all the time out there and threatened to withhold funding from cities and counties that don’t aggressively clear encampments.
San Francisco Mayor Daniel Lurie has proposed ending harm reduction for drug customers. Los Angeles Mayor Karen Bass is prioritizing encampment sweeps regardless that the promise of housing or shelter is elusive. And San Jose Mayor Matt Mahan won initial City Council support for plans to arrest people who refuse shelter thrice in 18 months and to divert permanent housing funding to pay for an enlargement of homeless shelters.
Mahan believes liberals and advocates have been too “purist” as a result of housing isn’t being constructed quick sufficient, whereas investments in shelter and remedy have been insufficient. “It can’t only be about Housing First,” he stated.
Homelessness crackdowns have exploded for the reason that U.S. Supreme Court made it easier for elected officers and legislation enforcement companies to high-quality and arrest folks for dwelling outdoors. Since June, roughly 150 legal guidelines imposing fines or jail time have been handed, with about 45 in California alone, stated Jesse Rabinowitz, marketing campaign and communications director for the National Homelessness Law Center.
Rabinowitz and different specialists say each Republicans and Democrats are undermining Housing First by criminalizing homelessness and conducting encampment sweeps that hinder the power of front-line staff to get folks into housing and providers.
However, there’s disagreement on whether or not to thoroughly dismantle the coverage. Liberal leaders need to preserve present streams of housing and homelessness funding whereas increasing shelters and shifting folks off the streets. Conservatives blame Housing First for the rise in homelessness and are as a substitute pushing for obligatory remedy and slicing housing subsidies.
“I used to think it was just a waste of taxpayer money because it wasn’t treatment-based, but now I think it actually enables people to remain homeless and addicted,” Marbut stated of the Housing First strategy. He favors requiring behavioral well being remedy as a prerequisite to housing.
Evidence reveals Housing First has been profitable in shifting weak, chronically homeless folks into everlasting housing. For occasion, a systematic review of 26 research indicated that, in contrast with treatment-first, “Housing First programs decreased homelessness by 88%.”And the strategy has proven remarkable improvements in well being, decreasing expensive hospital and emergency room care.
Experts say Housing First has been severely underfunded and applied inconsistently, with some homelessness companies taking federal cash however not offering applicable providers or housing placements.
“Making it the broad policy to all homelessness leaves it vulnerable to being attacked the way it’s currently being attacked,” stated Philip Mangano, a Republican who spearheaded the event of Housing First because the lead homelessness adviser to George W. Bush. “The truth is it’s a mixed bag. For some people like those who are using substances, the evidence just isn’t there yet.”
Others say it has been ineffective in some locations due to rampant misspending, abuse, and a lack of accountability.
“This works when it’s done right,” stated Marc Dones, a coverage director for homelessness initiatives on the University of California-San Francisco, arguing that housing can save lives and decrease spending on expensive well being care. “But I think we have been too polite and too nice for too long about some real incompetence.”
Jeff Olivet, who succeeded Marbut on the U.S. Interagency Council on Homelessness beneath Biden, stated Marbut and Trump’s positions are misguided. He argues that Housing First has labored for many who have gotten indoors, but the variety of folks falling into homelessness outpaces these getting housing. And he says there was by no means sufficient cash to offer housing and supportive providers for everybody in want.
“Housing First is not just about sticking somebody in an apartment and hoping for the best,” Olivet stated. “It’s really about providing stable housing and access to health care, mental health and substance use treatment, and to support people, but not forcing it on people.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation.
Angela Hart:
ahart@kff.org,
@ahartreports
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