Jun. 25, 2019 11:00 am

What does ‘Housing First’ mean? We ask Pathways to Housing PA to explain

The Housing First model focuses on people experiencing chronic homelessness — and on long-term housing retention and supportive services.

#ItsThatSimple was a 2019 art installation with 133 silhouettes in the shape of a home, each representing 50 people experiencing homelessness in Philadelphia. The green houses represents those who have been housed by Pathways to Housing PA. (Photo by Zari Tarazona)

Update: All references to housing-first in the article and headline have been changed to Housing First, to reflect the usage of the stakeholders. (6/27/19, 11:58 a.m.)
In Philadelphia, about 10,300 people experiencing homelessness entered an emergency shelter, safe haven, transitional housing or permanent housing project in the fiscal year of 2018, according to the City of Philadelphia’s Office of Homeless Services data.

So, how do some of these permanent housing projects work?

Pathways to Housing PA, an organization working to end homelessness in Philadelphia, uses a Housing First model to place people experiencing chronic homelessness into permanent supportive housing.

To explain that model, Generocity spoke to Matt Tice, director of clinical services, and Renee Frink-Boyd, a certified peer specialist, at Pathways.

What is Housing First?

During the 1990s, Sam Tsemberis founded Housing First while running a homelessness program in New York. Nonprofit Horizon House was the first to use the model in Philadelphia.

Housing programs tend to put up a lot of unnecessary barriers for people experiencing chronic homelessness, Tice said. Those barriers can be sobriety, medication or a drawn-out application process, he added.

Housing First doesn’t have those requirements.

“We don’t think that there should be any precondition for housing, especially if you are trying to work on recovery from mental health symptoms, substance use,” Tice said. “We think that the key to being able to really establish that wholeness and wellness is coming into housing and then we can work on everything else from there.”

During the intake process, Pathways asks participants which areas in the city they want to live in. Participants with incomes are required to pay 30% of their rent. After an apartment is secured, which takes about three weeks on average, the staff works with a participant to define what their goals are, Tice said.

“It’s not about telling the person this is how your care is going to be defined,” Tice added. “It’s working very collaboratively with them to set up goals, to find out what their priorities are, and then supporting those within our multidisciplinary teams.”

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Pathways has an 85% housing retention rate, which means that percentage of those served retained housing for more than five years.

The teams include certified peer specialists, social workers, vocational specialists, benefits specialists, a nurse and more. Frink-Boyd said certified peer specialists have experience with homelessness, substance use or mental health, and their job is to engage and support the participants.

“A certified peer specialist, they have that special, unique role where they have walked some of the same walks as the participant,” Frink-Boyd added. “And we can kind of role model and show them how to be successful when they become housed in the community that they chose to live in.”

The peer specialists work out of Pathways’s community inclusion department.

How is Housing First different than low-barrier shelter?

Low-barrier shelters are similar to Housing First because they provide shelter for those experiencing homelessness without imposing requirements like sobriety. The difference is that low-barrier shelters aren’t designed for long-term support, Tice said.

“When a person moves in with us, they can stay there indefinitely, as long as they need support,” Tice added.

What are some of the challenges in Housing First?

Frink-Boyd previously worked in an agency,without a Housing First model, where she saw the barriers people experienced. Because of those barriers, a lot of the people Pathways approaches on the street are suspicious when they are first approached.

“When we approach them and we offer housing, it’s [a need for] a lot of engagement,” she said, “because we have to build rapport and try to get them to trust us. They don’t believe the Housing First model [exists].”

Tice said one of the people they’ve helped told a staff member the difference between Pathways and the others who had offered him housing is that Pathways kept engaging with him, and then helped him get an apartment.

What does Housing First work in the long-term?

Pathways participant, Linda Sams, at the #ItsThatSimple art installation. Read Sams’ personal story here. (Photo by Zari Tarazona)

Pathways has an 85% housing retention rate, which means that percentage of those served retained housing for more than five years

“In the long run,” Frink-Boyd said. “I think [the support services help people] become more independent and helps them become more of a citizens in their community because everything we do, we give them the choice.”

Tice said it leads to better outcomes since they’re honoring their own choices.

“When a person is invested in their own future, rather than us saying, ‘This is what we recommend,’ or ‘This is what we say that you ought to do,’” Tice said, “there’s much more likelihood that  they’re going to be willing to engage.”

“But one of the other things we do,” he added, “is a lot of work around is the concept of harm reduction.”


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