The federal government has stopped supporting Housing First policies, and those who work with homeless people are seeing the consequences build up. The president issued an executive order directing an end to federal backing for Housing First policies, and his proposed budget for next year takes away the federal initiative that largely funds such programs. Instead, the administration now backs a “Treatment First” approach and short-term “transitional” housing.
The U.S. Department of Housing and Urban Development estimates that nearly 750,000 people were homeless last year. That figure marks a modest decline from 2024, though it remains up 31% from 2019. The share of individuals deemed chronically homeless has grown since 2019, and currently stands at roughly a quarter of the total count.
The Shift From Housing First
A New York nonprofit developed the Housing First concept during the 1990s, and it has defined federal homelessness policy since 2013. The method rests on one principle: secure permanent housing for people before delivering any other assistance.
Research has found repeatedly that Housing First programs hold people steadily housed. Certain studies suggest they perform that task more effectively than other approaches, such as “Treatment First,” which calls for required services for substance use and serious mental health conditions. The evidence on health results has not been consistent.
Who Is Homeless Today
Roughly half of adults without homes live with a disability, and up to two-thirds carry a diagnosis of mental illness. Around 2 out of 5 battle substance use disorder. Disability, heart disease and diabetes strike homeless adults at rates two to three times greater than what the general population reports.
Angel Sivado, who works as an outreach specialist in Louisville, says the numbers match the people she helps, whose circumstances make it extremely hard for them to take care of themselves, get to doctors or stay on top of their medications. In Corbin, Kentucky, planned housing projects have been canceled. In Santa Cruz County, California, there is less housing available for homeless people.
Louisville’s Day Shelter Struggle
St. John Center is a men’s day shelter in Louisville. Its executive director, Ra’Shann Martin, said “Housing is healthcare.” The shelter serves people like Johnny Henderson, 71, with one arm, heart disease and vision problems, who slept on the street the night before. Henderson said he fears dying sleeping outdoors and has nowhere to go.
A man who is blind, has congestive heart failure and is undergoing treatment for prostate cancer, James Myers, 66, was informed he should be in an apartment soon. He is part of the chronically homeless population that currently accounts for roughly a quarter of the national total.
The Numbers Behind the Crisis
There are roughly 173,000 “permanent supportive housing” beds for chronically homeless people and 235,000 for other populations, including veterans. Those numbers are under pressure as the federal initiative funding them is cut.
Across the nation, local programs are feeling the change. In Louisville, nonprofits are examining ways to turn permanent housing into temporary arrangements, with most of St. John’s 200 apartments among those being considered for such a move.
What Treatment First Actually Means
| Policy | Focus | Federal Status |
|---|---|---|
| Housing First | Stable housing first, then support | Ending federal support |
| Treatment First | Therapy and counseling first | Administration’s favored approach |
| Transitional housing | Short-term placement | Proposed budget includes it |
The Human Cost of the Shift
Those closest to the situation observe the change in practical terms. Sivado supports individuals whose circumstances make self-care nearly impossible. Henderson’s fear is death on the street. Myers is being relocated into an apartment shortly.
How the Numbers Add Up
Funding for Housing First initiatives is being cut entirely. Next year’s budget strips out the dollars that mostly supported those programs. The administration’s stated aim is to tackle underlying problems before providing housing.
There is no final answer to the health questions, even though the evidence points both ways, so it would be wrong to say Treatment First has been proven right. But on housing, the picture is plain: Housing First keeps people stably housed.
What Happens Next
Funding for next year will be decided by the proposed budget, which will show how much money is left over. Local services are already changing course, turning permanent housing into something temporary. The move from Housing First to Treatment First is no longer just talk — it is taking place in Louisville, Corbin and Santa Cruz County.
These programs’ recipients find themselves stuck between a change in policy and their very means of staying alive.
Where the paper stands
The paper backs Housing First programs and is against the federal administration’s push toward a Treatment First approach and transitional housing. The administration’s executive order directs an end to federal backing for Housing First policies, and its proposed budget strips the dollars that funded them. That is a direct attack on a system that has kept hundreds of thousands of people stably housed, and it leaves cities like Louisville, Corbin and Santa Cruz County scrambling to keep their permanent housing intact.
The shift is real, not theoretical. Nonprofits are already turning permanent housing into temporary arrangements. People like Johnny Henderson, who slept on the street the night before, and James Myers, who carries a diagnosis of mental illness, are caught in the middle of a policy choice made far from where they live.
The evidence on health results has not been consistent, so it would be wrong to say Treatment First has been proven right. On housing, however, the picture is plain: Housing First keeps people stably housed. The administration should stop cutting the funding that makes that possible and let local providers do what works best for their communities.
Source material: “Trump’s shift from 'Housing First' is causing upheaval for homelessness programs and many they serve across US,” ABC13 Houston.
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