"Housing First" at HCH
As the nation divested in affordable housing over the past three decades, the resulting phenomenon of homelessness curiously was treated by many service providers as anything but a housing problem. Fortunately, recent research confirms the experience of Health Care for the Homeless that even the most vulnerable individuals can remain stably housed with the necessary supportive services. 
In September 2005, with assistance from the City, HCH housed 30 people living in a downtown park. Many had been homeless for most of their adult lives. Participation in treatment or services was not a prerequisite. Two years later, all but three were still housed. Two thirds contributed financially to their housing. Half took medications for chronic illnesses.
Such remarkable success was predictable. In an older and larger program in New York, 85% of their 500 Housing First participants remained housed after five years. Similar results are seen in San Francisco, Philadelphia, New York, Cleveland, and other cities.
Rightly impressed by the Baltimore Experience, the Federal Substance Abuse and Mental Health Services Administration funded in 2007 a partnership among HCH, Baltimore Housing, Baltimore Homeless Services, Baltimore Substance Abuse Systems, and Baltimore Mental Health Systems to expand the pilot project to an additional 100 people over a three-year period. The resulting program – Homeward Bound – uses an Assertive Community Treatment (ACT) team model to target difficult-to-serve individuals with histories of mental illness, addiction, complicated medical problems, and long histories of homelessness.
In January 2008, Mayor Sheila Dixon unveiled her visionary “Ten Year Plan to End Homelessness,” which was built upon an underlying “housing first” philosophy rather than the “housing readiness” approach that had guided homeless services for decades. Baltimore Homeless Services again collaborated with HCH to create Archways, a program providing housing and intensive case management to an additional 60 individuals.
At the end of 2009, HCH was awarded two significant grants to implement further the “housing first” approach outlined in the Ten Year Plan. First, through the Phoenix Project, HCH will house 90 vulnerable individuals returning to the community from jail or prison. Secondly, federal stimulus dollars will make possible the Isaac Project, a new collaboration with the City to rapidly re-house more than 100 additional homeless individuals living in shelters or on the streets.
Through this range of initiatives using a “housing first” philosophy, HCH will maintain more than 400 individuals in permanent housing by 2012.
In concert with HCH’s full range of services and our advocacy for the production of affordable housing, “housing first” represents yet another way we’re building a future without homelessness – from the ground, up.