Project 50 – Housing First & Ending Homelessness Across the Country

Article from the Massachusetts Housing & Shelter Alliance

Project 50 – Housing First and Ending Homelessness

The Commonwealth of Massachusetts has been leading the way in ending homelessness through its Housing First initiatives. Other cities across the country such as New York City and Seattle have also demonstrated success in ending homelessness and reducing costs through Housing First programs.

In 2007, Los Angeles County officials started “Project 50.” The project targeted the 50 “most-at-risk-of-dying-on-the-streets” chronically homeless individuals and placed them into apartments with minimum restrictions.

Sparked by the controversy of Project 50, Jon Morgenstern wrote an opinion piece for the Los Angeles Times entitled “Housing first” and helping the homeless.

Click here to read the full article.

Morgenstern discusses the concept of Housing First and its potential to solve chronic homelessness and save taxpayer money. He writes: Bolding added for emphasis.

Housing first programs are thought to save money because homeless substance abusers are perpetually in crisis and, as a result, use such expensive services such as emergency rooms, ambulances and hospital detoxification services. The cost of these crisis services can run well over $100,000 a person in one year, far greater than the cost of a housing first program.

Is that actually what happens in practice? Early findings are promising. In one study, chronically homeless alcoholics in Seattle were selected on the basis of their extensive use of crisis services in the prior year and placed in a housing first program. After one year, the cost of services was $13,400 a client, a savings of more than $42,000 a client.

As often happens around hot-button social issues, rhetoric on each side of the issue threatens to eclipse informed debate. Though more studies are needed, evidence to date supports housing first for active substance abusers as a helpful solution to chronic homelessness and a possible cost-saver.

Many advocates and researchers strongly support the Housing First movement. In a response to Project 50, Dr. Dennis Culhane states it should be increased to Project 5,000 or 10,000. He states, “Permanent supported housing for people who are chronically homeless, even with no strings attached, is a scientifically proven intervention.” Click here to read his full response on Project 50.

Despite promising findings, Morgenstern references skeptics who have questioned Project 50 and other Housing First initiatives. He writes:

Skeptics have asserted that the program is both wasteful and immoral because it simply warehouses substance abusers, enabling them to continue their self-destructive lifestyles with the support of taxpayer dollars.

One could argue that the shelter system, also supported by taxpayer dollars, does the same. While it was never its original intention, the expensive emergency shelter system has become permanent housing for many chronically homeless individuals.

While most shelters do provide case management, the experience of homelessness itself creates instability, which can make it difficult to overcome mental health and substance abuse issues. Being in a home with case management and having a secure foundation increases self-sufficiency and improves health, which creates cost savings in other systems of care. Once in permanent housing, it is often easier for individuals to address their health issues.

As Morgenstern stated, early findings are promising but more studies are needed. MHSA is committed to rigorous analysis of Housing First programs such as Home & Healthy for Good and other initiatives across the state. In Massachusetts, we will continue evaluate our Housing First initiatives and measure outcomes from both qualitative and cost-benefit perspectives to ensure that scarce resources are being used to best serve our poorest, most vulnerable neighbors: homeless individuals.

To learn more about Housing First cost savings in Massachusetts, click here to read about MHSA’s Home & Healthy for Good initiative.

To view the four-part series, photos and media clips from Los Angeles Times’ Project 50: Four walls and a bed, click the links below:

Four Part Series Landing Page
Part 1 – Whatever it takes
Part 2 – The Baddest of them all
Part 3 – From penthouse to gutter
Part 4 – No tidy endings


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