The Department of Health and Human Services, the Office of National Drug Control Policy and the Department of Housing and Urban Development jointly released a first-of-its-kind toolkit to help communities integrate substance abuse treatment with housing intervention on Aug. 12.
The Treatment First approach represents a philosophical departure from Housing First models that provide housing before requiring sobriety or treatment participation, according to HHS. The toolkit directs localities on how to sequence treatment and housing assistance for people experiencing both homelessness and substance use disorders.
The three-agency collaboration is described as the first joint initiative of its kind linking all three departments on the intersection of homelessness, housing and addiction. No new funding was announced alongside the toolkit.
The shift challenges the dominant framework that has guided federal homelessness policy for roughly two decades. Housing First has been the primary model endorsed by HUD since the George W. Bush administration and is supported by a body of research showing that stable housing improves treatment outcomes.
Treatment First proponents argue that providing housing without addressing underlying addiction enables continued substance abuse and fails to achieve lasting stability. Critics counter that requiring treatment before housing creates barriers that keep vulnerable people on the streets.
For the estimated 650,000 Americans experiencing homelessness on any given night, a figure that reached a record high in recent federal counts, the policy framework governing their access to services has direct, life-altering consequences.
Local service providers who receive federal homelessness funding will need to assess how the new toolkit affects their program design and eligibility requirements, even in the absence of new funding mandates.