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Houston’s free housing-first program has cut homelessness by roughly 63 percent since 2011, more than any of the ten largest U.S. cities.
They achieved this by pairing free permanent housing with voluntary support services, including addiction treatment, for people experiencing homelessness. It is becoming a model for how free housing and low-cost rehabs can work together.
What Houston Did
Houston’s housing-first system moves people from the street into permanent housing as quickly as possible, then wraps voluntary services around them, including mental health care, case management, and substance use treatment.
Since 2012 the model has housed more than 26,000 people, with about 90 percent still housed two or more years later.
The region has also reported large drops in family and chronic homelessness and effectively ended veteran homelessness by 2015.
The region did this largely with federal funding rather than city dollars, and officials say it spends less per person than other major cities.
Other cities using housing-first approaches, from Salt Lake City to Columbus, have reported similar declines.
Why Housing and Recovery Go Together
Stable housing is not a reward for getting sober. For many people it is what makes recovery possible. It is hard to keep appointments, take medication or stay connected to a support group while sleeping outside or moving between shelters.
Housing-first programs recognize this and do not require sobriety as a condition of getting a roof overhead, an approach grounded in harm reduction and public health evidence.
Who Qualifies for Free or Low-Cost Help
Publicly funded housing and treatment programs generally serve people who are uninsured, on Medicaid, or living on very low incomes. If you are priced out of private rehab, these are the systems built for you.
Coordinated entry systems in many cities assess need and connect people to housing, and Medicaid often covers the addiction treatment that accompanies it.
Many communities also fund the work through federal grants and the safety net of nonprofits, so the help does not depend on being able to pay out of pocket.
How to Access These Resources
You do not need to untangle this alone. Start with your local 211 line, which can point you to housing assistance, coordinated entry and free or low-cost rehabs in your area.
Call SAMHSA’s national helpline at 1-800-662-4357 for free, confidential referrals to treatment, including programs that accept Medicaid insurance or offer sliding-scale fees.
Finding Affordable Treatment
Cost should not decide whether you get care. Rehabs.org lists free and low-cost treatment centers near you.
You can ask about sliding-scale fees, scholarships and coordination with housing support. Call
800-914-7089
(
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to speak with a treatment specialist to discuss affordable care options.
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