Housing First Model: Program Types, Screening, and Evidence

The Housing First model places people experiencing homelessness directly into permanent housing without first requiring sobriety, completion of treatment, minimum income, or a clean rental or criminal record. Supportive services are offered alongside the housing, but participation is voluntary and cannot be used as a condition of keeping the apartment. For more than a decade this approach shaped how federal homeless-assistance dollars were awarded, and research put one-year housing retention above 85 percent. In 2025 and 2026 that footing began to change, and the model’s role in federal policy is now contested.

What Housing First Actually Means

The underlying idea is simple. A person struggling with addiction, mental illness, or long-term unemployment is more likely to stabilize with a roof over their head than while cycling through shelters and emergency rooms. Housing is treated as the foundation that makes other progress possible, not as a reward for having already made it.

The United States Interagency Council on Homelessness lays out the elements that distinguish a genuine Housing First program. Access cannot depend on sobriety, minimum income, a clean criminal record, completion of treatment, or participation in services. Programs work hard to avoid rejecting applicants for poor credit, thin rental history, or behaviors that suggest a lack of “housing readiness.” Tenants set their own goals, and supportive services focus on engagement and practical problem-solving rather than clinical compliance.¹

Harm reduction runs through the whole approach. Staff recognize that substance use is part of some tenants’ lives and respond with non-judgmental communication rather than ultimatums. Substance use alone, without an accompanying lease violation, is not grounds for eviction. Tenants receive information about safer practices and are connected to treatment when they want it, but nobody forces the issue. This is where Housing First and older models diverge most sharply. The traditional approach said get clean, then we will house you. Housing First says get housed, and we will help you get clean whenever you are ready.¹

Who Runs These Programs and How People Get In

Federally funded Housing First programs are administered locally through Continuums of Care, the regional planning bodies that receive HUD grants under 24 CFR Part 578. Permanent housing under those regulations means community-based housing with no designated length of stay, where the participant holds a lease of at least one year that is renewable and can only be terminated for cause.²

You do not walk in and fill out an apartment application. Access runs through Coordinated Entry, a community-wide intake system that every Continuum of Care is required to operate. A standardized assessment gathers information about your housing situation, service needs, health risks, and vulnerability. The community’s prioritization policy then ranks people by need, with more severe service needs and higher vulnerability moving people up the list. Finally, a referral matches the person to an available housing slot. Factors that push someone up the list include functional impairments, heavy use of emergency rooms and jails, being unsheltered, and vulnerability to illness, death, or victimization.³

In practice, chronically homeless individuals with disabilities tend to move to the front. The federal definition is precise: a person with a disability who has lived in a place not meant for habitation, a safe haven, or an emergency shelter continuously for at least 12 months, or on at least four separate occasions in the past three years totaling 12 months. Short stays in institutional settings such as jails or hospitals under 90 days do not break the clock.⁴

The Program Types That Use This Approach

Housing First is an umbrella philosophy rather than a single program. Three federally funded interventions apply it, serving different populations with different levels of intensity.

Permanent Supportive Housing

Permanent Supportive Housing pairs long-term rental assistance with ongoing supportive services for people with disabilities. There is no time limit on how long a tenant can stay. The tenant holds a real lease, pays a share of rent based on income, and has access to case management, mental health services, and other supports for as long as they need them. This is the intervention typically aimed at chronically homeless individuals.²

Rapid Rehousing

Rapid Rehousing provides shorter-term rental assistance, generally up to 24 months, together with case management to help someone stabilize quickly. It does not require a disability. Participants meet with a case manager at least once a month, and programs can continue offering supportive services for up to six months after rental assistance ends. The point is to bridge people from homelessness to self-sufficiency when they need a financial boost rather than indefinite support.⁵

HUD-VASH for Veterans

HUD-VASH combines Housing Choice Vouchers administered by local public housing agencies with clinical case management from the VA. It serves homeless veterans specifically, with services delivered through VA medical centers, community-based clinics, or contractors. The program runs under regular Housing Choice Voucher rules with some congressional flexibility built in for the population it serves.⁶

What Programs Can and Cannot Screen For

The feature that most sharply separates Housing First from older models is what programs cannot use to screen people out. Applicants cannot be rejected for lacking income, having poor credit, having no rental history, active substance use, or not having finished treatment. Documentation requirements are deliberately streamlined so that administrative barriers do not filter out the highest-need people. Intake focuses on assessing vulnerability and matching people to the right intervention rather than testing for readiness.¹

Low-barrier does not mean zero-barrier. Federal law makes two categories of people ineligible for federally assisted housing regardless of the program model. Anyone subject to a lifetime registration requirement under a state sex offender registry must be denied admission.⁷ Anyone convicted of manufacturing or producing methamphetamine on the premises of federally assisted housing is permanently barred from public housing and Section 8 assistance.⁸

People evicted from federally assisted housing for drug-related criminal activity face a three-year waiting period unless they complete an approved rehabilitation program. Beyond those mandatory rules, public housing agencies have discretion over other criminal history policies, and HUD guidance has generally pushed away from blanket bans and toward considering individual circumstances.⁹

Housing and Services Run on Separate Tracks

Once someone is in the unit, housing management and supportive services operate independently. The tenant signs a standard lease governed by landlord-tenant law, not a clinical contract tied to program participation. Missing a therapy appointment or skipping a vocational meeting is not a lease violation and cannot trigger eviction. The lease can only be terminated for the same reasons a private-market lease can: nonpayment of rent, property damage, or other standard violations.¹⁰

Case managers, mental health clinicians, and employment specialists are available and proactively offered, but the tenant decides whether to engage. The USICH checklist is explicit that participation in services or compliance with service plans is not a condition of tenancy.¹

How Rent Is Calculated

Participants in CoC-funded Permanent Supportive Housing or transitional housing pay rent based on income. The amount is the highest of three calculations: 30 percent of monthly adjusted income, 10 percent of monthly gross income, or the portion of any welfare assistance designated for housing costs. For someone with little or no income, the payment can be very small or nothing at all. In Rapid Rehousing projects, the specific rent contribution is set by the local Continuum of Care’s written standards rather than the federal formula.¹¹

Eviction as a Last Resort

Housing First goes further than standard landlord-tenant law to prevent eviction back into homelessness. The USICH checklist requires tenants to receive reasonable flexibility on rent payments, including special arrangements for back rent and help with financial management such as representative payee setups. When a tenancy is in jeopardy, programs must make every effort to transfer the tenant to a different housing situation rather than proceed with eviction.¹

Eviction remains possible for serious lease violations. Repeated nonpayment of rent, intentional property damage, and criminal activity on the premises can all lead to termination even in a Housing First program. The distinction is the process. Providers are expected to exhaust intervention strategies first and to aim for preserving the tenancy or finding an alternative placement rather than returning someone to the street.¹⁰

What the Evidence Shows

On a single night in January 2024, 771,480 people experienced homelessness in the United States, the largest number since data collection began and a 19 percent increase since 2007. Sheltered homelessness drove most of the recent surge, rising 25 percent between 2023 and 2024 alone.¹²

Housing First programs have consistently shown strong retention. Research estimates that Permanent Supportive Housing retains roughly 86 percent of participants at the one-year mark, while Rapid Rehousing retains approximately 90 percent. These are one-year snapshots rather than lifetime figures, and they vary by local implementation, but they run well ahead of shelter-based or treatment-first models.

The cost picture is similar. A widely cited evaluation of Denver’s supportive housing initiative found that emergency service costs for participants dropped substantially after placement. Emergency room visits, inpatient psychiatric stays, detox episodes, jail bookings, and shelter use all declined. Emergency-related costs fell by roughly 73 percent over two years. After accounting for the cost of providing housing and services, the program still produced net savings per participant because the emergency services it replaced were so expensive.

Where Federal Policy Stands in 2026

For fiscal years 2024 and 2025, HUD required at least 75 percent of housing project applications submitted by a Continuum of Care to use the Housing First approach: low-barrier entry, no service participation requirements for continued tenancy, and priority on rapid placement in permanent housing. Programs could accept applicants regardless of income, substance use history, victimization history, or criminal record, with narrow exceptions imposed by federal or state law.¹³

That posture has changed. HUD announced in April 2025 that its 2026 Continuum of Care funding competition would deprioritize Housing First and harm reduction. The new priorities favor transitional housing, street outreach, childcare, job training, and outpatient addiction treatment. HUD Secretary Scott Turner framed the shift as moving away from what he called failed policies that left people “trapped in addiction, untreated mental illness, and indefinite dependence on government systems.”

HUD’s proposed fiscal year 2027 budget would eliminate Continuum of Care grants entirely. Courts blocked an earlier 2025 attempt to rescind a previously approved two-year funding opportunity and issue new criteria, so the legal picture is unsettled. The fiscal year 2026 appropriations package still includes roughly $4.4 billion for Homeless Assistance Grants, but how that money moves through the 2026 competition could look very different from prior years.

For local programs built around Housing First principles, the practical result is uncertainty. A program that scored well in 2024 because of its low-barrier approach could find the same practices working against it in the 2026 competition. Programs already holding active CoC grants should continue operating under their existing grant terms, but future renewals and new applications face a different evaluation framework. The tension between statutory authority under existing law and shifting executive-branch priorities will likely continue playing out in courts and appropriations. The current debate does not center on whether Housing First keeps people housed, since the retention data is fairly clear, but on whether keeping people housed without requiring treatment counts as genuine recovery.

1
United States Interagency Council on Homelessness. Housing First Checklist – Assessing Projects and Systems for a Housing First Orientation
2
eCFR. 24 CFR Part 578 – Continuum of Care Program
3
U.S. Department of Housing and Urban Development. CPD-17-01 Notice on Coordinated Entry
4
Federal Register. Homeless Emergency Assistance and Rapid Transition to Housing – Defining Chronically Homeless
5
HUD Exchange. Rapid Re-Housing
6
U.S. Department of Housing and Urban Development. HUD-Veterans Affairs Supportive Housing (HUD-VASH)
7
Office of the Law Revision Counsel. 42 USC 13663 – Ineligibility of Dangerous Sex Offenders for Admission to Public Housing
8
Office of the Law Revision Counsel. 42 USC 1437n – Eligibility for Assisted Housing
9
HUD Exchange. Are Persons With Felony Convictions Ineligible From Participation in the Program
10
U.S. Department of Housing and Urban Development. Public Housing Occupancy Guidebook – Lease Requirements
11
HUD Exchange. CoC Rent Calculation – Step 8 – Determine the Amount of Resident Rent
12
HUD User. The 2024 Annual Homelessness Assessment Report (AHAR) to Congress – Part 1
13
U.S. Department of Housing and Urban Development. FY 2024 and FY 2025 Continuum of Care Competition and Renewal NOFO