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Housing First

Housing First is an approach to ending homelessness first proposed by Sam Tsemberis, founder of Pathways to Housing in New York City.

"Housing First.  A program that provides immediate access to permanent housing and person-centered supports to people experiencing homelessness and struggling with problems of mental health and addiction. " - Housing First Institute website.



Tsemberis, Dr. Sam, Housing First, Simon and Schuster, 2015.

Padgett, Deborah; Henwood, Benjamin. Housing FIrst: Ending Homelessness, Transforming Systems, and Changing Lives. Oxford University Press, 2015.

Levy, Jay S., Homeless Outreach & Housing First: Lessons Learned. Loving Healing Press, 2011.

Levy, Jay S., Pretreatment Guide for Homeless Outreach & Housing First: Helping Couples, Youth, and Unaccompanied Adults. Loving Healing Press, 2013


USICH and Housing First

Housing First Checklist


HUD and Housing First

HUD supports the approach as well. See

*Housing First Implementation Resources - Model, Checklist, Overvew, Toolkit

*Continuum of Care (COC) Competition Focus: Housing First

Housing First in Permanent Supportive Housing Brief.


Is Rhode Island "all in" on Housing First?

I'm not sure.

Some organizations in Rhode Island champion the "Housing First" approach to ending homelessness. For instance, Thrive Behavioral Health and Crossroads RI feature this philosophy on their websites. \

References to Housing First on websites, in no particular order, but I'm aiming to put the most significant ones at the top:

In the minutes of the last meeting of the Interagency Council on Homelessness filed with the Secretary of State's Open Meetings portal (May 11, 2016), attendees appeared to be successfully following the methodology:

"Report on Progress of Zero:2016 – Maria Cimini, RI Coalition for the Homeless Copy of presentation is attached Maria gave an update on the Zero:2016 Ending Homelessness in Rhode Island. There are population specific groups to work on goals; Veterans, Chronic, and Families. These groups meet by-weekly and work is done by utilizing a by-name list to prioritize housing by acuity, sharing resources, creating move-on strategies and identifying policy and procedure driven barriers to housing. Challenges and difficulties that have arisen in these committees were then discussed."

What happened to this council?

List of Organizations to Receive Funding from governor's RI Rebounds Initiative, funded through ARPA. Press Release, May 26, 2022.

"RI Coalition to End Homelessness (RICH) – will receive $180,233 to organize and implement a comprehensive training program for RI’s continuum of care and for organizations serving the homeless. Training will focus on Housing First and best practices in delivering services to the homeless."

State Fiscal Recovery Report, July 2022, p 53

Key performance indicator: Staff receiving the Housing First and Best Practice Training
Description: Number of provider staff receiving housing first/other best practice training
Performance to date: 103
Key performance indicator: Staff comprehension of the Housing First and Best Practices Training
Description: Percentage of trainees able to display increased knowledge in Housing First and Best Practices Training
Performance to date: 95%

*State of RI Consolidated Plan 2020-2024 Final, for HUD Submission - 335pp. - numerous references (at least 11)

RI Consolidated Plan 2015-2019. Revised FInal Draft October 16th, 2015. 289pp. - numerous references


“Coordinated Entry changes a COC from a project-focused system into a person-focused system by asking that ‘communities prioritize people who are most in need of assistance’ and ‘strategically allocate their current resources and identify the need for additional resources’” (Coordinated Entry Notice p. 2; Coordinated Entry Core Elements, p. 8). This change to a person-focused approach for prioritization of RICOC shelter, housing and services aligns with Housing First.

"Housing First is an approach to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions or barriers to entry. For the policies and procedure for Coordinated Entry go to: Rhode Island CES Statewide Strategy Manual. [sic - link does not work on the BHDDH page]

Office of Housing and Community Development page:

Housing First - At the end of 2011, the program housed 190 families. Participants in this program were homeless an average of 335 days the year prior to entering the program and were off and on homeless for an average of 7.6 years. Housing proved to be stable, with 80% of placements still housed after 12 months.

Consolidated Homeless Fund Policies and Procedures Manual, 2021 - 3 references

 ""The CHF encourages providers to follow the Housing First Principles established by the RI CoC, when appropriate, to ensure a systematic approach to ending homelessness. Housing First is an approach to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements (except that RRH providers are required to provide case management in accordance with 24 CFR 576.104)." ...

"...3. Diversion from Shelter: Based on screening results, individuals and families should be diverted when appropriate to the most stable housing available including supportive or subsidized permanent housing using the Housing First or Rapid Rehousing service models."

Opioid Settlement Advisory Committee - Nov 29, 2022 -  3 refs

Opening Doors RI, 2012, 5 refs - including  these 3

"Permanent supportive housing using the Housing First model has been demonstrated to be successful in solving chronic homelessness and other long term homeless situations. It is also a cost effective intervention. Multiple studies including one on Housing First Rhode Island have documented cost savings when the total publicly funded cost is compared pre‐ and post‐ Housing First for chronically homeless persons. Across the board the most significant cost savings have been in Medicaid expenditures for emergency room, inpatient, detoxification, and ambulance costs"

Spending Plan for Implementation ofAmerican Rescue Plan Act of 2021, Section 9817 - Draft. EOHHS. 1 reference, p. 61 re eviction


Here is a story about a leader in Utah who at first didn't believe in Housing First (2015):

A Doubter Becomes Director Of Housing First Efforts

The idea of Housing First is that housing comes first, services later. Clients do have to pay some rent — either 30 percent of income or up to $50 a month, whichever is greater...

..."And I said you guys are smoking something, because there's no way on this earth that you're going to end homelessness," says Lloyd Pendleton, who at the time ran humanitarian services for the Church of Jesus Christ of Latter-day Saints....

As a conservative, Lloyd Pendleton didn't think the government should simply give people a place to live. But he changed his mind after learning about the Housing First model and now heads Utah's Homeless Task Force.....

...Then in 2003, Lloyd Pendleton went to a conference on homelessness in Chicago.

At that conference, a founder of the Housing First philosophy, Sam Tsemberis, told him that chronically homeless people cost the government a lot of money when they're living on the street, because of services like emergency room visits and jail time.

HUD estimates that annual cost as between $30,000 and $50,000 per person.

Housing them simply costs a lot less....


National Alliance to End Homelessness: Housing First, March 20, 2022


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