HUD, the White House Office of National Drug Control Policy and HHS jointly launched a first-of-its-kind federal toolkit Aug. 12 designed to shift homeless services toward treatment-centered approaches, replacing the Housing First model that has dominated federal homelessness policy for over a decade.
The Treatment First framework is the most consequential shift in federal homelessness policy in two decades, affecting billions in federal grants and directly challenging the model used in cities like Los Angeles, San Francisco and New York.
HUD Secretary Turner and HHS Secretary Robert F. Kennedy Jr. visited Los Angeles on Aug. 11 to announce the administration would not fund what they termed the homeless industrial complex, according to HUD. The visit to the nation’s homelessness epicenter underscored the political and policy stakes of the pivot.
The policy shift affects how federal grants for homeless services will be evaluated and awarded. Organizations applying for HUD Continuum of Care grants and other federal homelessness funding will be assessed based on their adoption of treatment-centered models rather than housing-only approaches.
Housing First programs prioritize providing permanent housing without preconditions such as sobriety or treatment participation. The approach has been endorsed by multiple peer-reviewed studies and was the official federal policy framework under both the Obama and Biden administrations.
Treatment First proponents argue that addressing substance use disorders and mental health conditions must precede or accompany housing placement to achieve lasting outcomes. Critics say requiring treatment as a precondition for shelter effectively denies housing to people with untreated addiction or mental illness.
The toolkit provides guidance for local service providers and governments seeking to align with the new federal framework.