Housing first is a philosophy that first emerged in the 1990s and has taken hold as a cost-effective way to reduce homelessness.

In a more traditional approach, a homeless person would be given space in an overnight shelter while trying to find work or get sober or healthy enough to secure housing. But with housing first, people are given a safe, stable place to live and offered support, whether its for substance use disorder, mental illness, physical health or employment training.

“We really feel housing is itself therapeutic,” said Hillary Colcord, the director of Huston Commons, a housing-first facility in Portland.

Portland has three separate developments dedicated to housing the long-term homeless: Logan Place, Florence House and Huston Commons. Each one was built by Avesta Housing and is staffed by the nonprofit social services agency Preble Street.

“It’s pretty remarkable to see people transitioning out of survival mode, worrying day-to-day and night-to-night about where they’re going to be … and (to see) people starting to believe they’re worth getting the medical care they have not had for a long time,” said Ali Lovejoy, the senior director of residential services at Preble Street.

Housing and Urban Development Secretary Ben Carson extolled the virtues of housing first at the National Alliance to End Homelessness’s “Solutions for Individual Homeless Adults” conference held in February in San Diego. Carson noted that the approach provides the best outcomes for the homeless and costs less money than keeping people on the streets, where they use costly emergency services like homeless shelters, emergency rooms, ambulances, police and jails.

“A man cannot beat addiction from the gutter. He will not get psychiatric help under the bridge. He will not get (a) long-term job without a long-term address,” Carson said.

Huston Commons has a front desk that is staffed 24 hours a day. It also has a food pantry and common areas such as an outdoor patio, TV room, game area and a shared kitchen, where community meals are cooked and served two or three times a week. Staff uses these common areas and group activities like stargazing and art nights to conduct informal assessments of a tenant’s needs. They also have more formal groups that meet.

“We do a lot of community events and intensive case management to help people regain a sense of who they really wanted to be before their only identity was someone who was homeless,” Colcord said. “At the end of the day, we’re really here to help people maintain their housing.”

Thomas Chalmers McLaughlin, a social work professor for the University of New England, has participated in at least four studies about housing first projects and each has shown that housing the heaviest users of emergency shelters and other emergency services saves money.

“It’s cheaper to support people in housing than it is to maintain them on the street through shelters, jails, police calls, emergency room contacts and ambulance runs,” McLaughlin said. 

One study in 2007 compared emergency service costs for 99 people before and after they were housed. A year before entering into permanent supportive housing, service costs totaled $28,045 a person. The following year, service costs were $14,009, with housing costing an additional $13,092.

Some of the most dramatic savings were in use of emergency services, since newly housed individuals were more apt to use community-based services rather than emergency rooms and ambulances.

Housing first can take several forms, ranging from dedicated apartments in existing buildings to brand new developments dedicated entirely to housing the homeless.

“I think it’s probably good to have different models, so people have some choice as to what they want,” said Nan Roman, the president and CEO of National Alliance to End Homelessness. “It’s best to get people back into housing as fast as possible. The services are going to work better after people are in housing.”

Portland’s three dedicated housing first developments each cost between $4 million and $7 million and were built by Avesta Housing, which is the landlord, and staffed by Preble Street.

Community Housing of Maine owns and manages nearly 750 units of affordable housing at 78 housing sites across the state. Nearly a third of its more than 1,000 residents experienced homelessness before entering housing, including 114 people who were long-term shelter stayers.

Cullen Ryan, the nonprofit’s CEO, recently testified on behalf of the Statewide Homelessness Council, Maine Homeless Policy Committee, Emergency Shelter Assessment Committee and the Portland-based Long Term Stayers Committee in support of legislation to create a pool of housing vouchers for people who are chronically homeless and long-term shelter stayers. An initial investment of $2.5 million to create 250 low-barrier permanent housing vouchers would be enough to “end long-term homelessness” in Maine, Ryan said in an interview.

“We are trying a full-court press on all of the remedies,” Ryan said of several bills aimed at ending long-term homelessness. “It will take investment in these remedies by policymakers for us to get there. They need to realize that not providing these remedies actually costs more than providing these remedies.”

A 2015 study commissioned by CHOM found an average annual cost savings of roughly $5,852 per person – savings attributed to lower use of emergency services. The study predicted that housing the 262 long-term stayers at shelters in 2015 would save an average of $1.5 million a year statewide.