Health and Human Services Secretary Robert F. Kennedy Jr. appeared locally Wednesday to promote a treatment-first approach to homelessness and addiction, though it’s a strategy homeless service providers and researchers have long challenged as ineffective.
Scott Turner, secretary of Housing and Urban Development, and Sara Carter, director of the White House Office of National Drug Control Policy, joined Kennedy at a press conference at the San Diego Rescue Mission to promote the Trump Administration’s Great American Recovery Initiative.
“Self sufficiency is the key,” Turner said during the press conference. “Recovery and self sufficiency should be the rule — not the exception.”
The administration’s plan, outlined in what was dubbed a “Best Practices Toolkit,” lists self-sufficiency as the central goal and labels Housing First models as short-term interventions. Turner said Housing First has “failed miserably and horribly” over the past 10 years. He also painted spending on addressing homelessness as wasteful.
But Housing First models have long been touted by experts who work with homeless people.
Ann Oliva, the CEO of the National Alliance to End Homelessness, said the reality is that Housing First is one of the most studied interventions for people facing homelessness and “provides a sense of safety and stability from which people can address any sort of underlying issue that contributed to their homelessness.”
Stephen Russell, president and CEO of the San Diego Housing Federation, echoed that Housing First is an evidence-backed method of addressing homelessness, even if delivering enough affordable units to make up for lack of housing stock will take years.
“Housing First says that you need to provide a low barrier of entry for folks to be housed, and that in the stabilized environment, it is going to be easier to engage with the individuals and hook them up with their actual needs,” Russell said. “Housing First is not housing only.”
Kennedy, and the other Trump administration officials, all spoke about faith-based solutions Wednesday at the rescue mission’s privately funded South County Lighthouse in National City.
“Recovery requires treatment and accountability,” Kennedy said. “For many Americans it is a spiritual battle … We are giving state and local leaders a practical roadmap to help Americans win that spiritual warfare.”
San Diego Rescue Mission CEO Donnie Dee congratulated the administration for putting together a “new way of doing things in this country.”
“We’ve been saying at the rescue mission for a long time that homelessness is actually a heart issue,” Dee said to open the press conference. “It’s not just a housing issue. It’s not just an addiction issue. It’s actually a heart issue.”
The word “faith” appears over 40 times in the administration’s 37-page toolkit, with one chapter focusing on the “Integration of Faith and Medicine.” Many San Diego service providers are faith based.
“Father Joe’s Villages exists to prevent and end homelessness, one life at a time. That work has never been housing alone,” said Father Joe’s Villages, a Catholic-based organization, in a statement to Times of San Diego in response to questions about the toolkit. “Our neighbors come to us needing shelter, medical and dental care, behavioral health treatment, detox and recovery support, and a path to income and independence; we provide all of it, together, without conditions or judgment.”
While research points to Housing First as a humane and economical path to end homelessness, San Diego service providers, including Father Joe’s, have also been working to combat the shortage of detox beds. Securing enough funding to staff beds, however, has been an issue.
Last November, San Diego County supervisors Paloma Aguirre and Monica Montgomery Steppe attempted to address the gap by proposing a detox services expansion — including 44 new treatment beds downtown, enough to help 2,700 people each year.
Before the toolkit’s release, homeless service providers knew the Trump administration rejected Housing First. Even after the playbook came out, they said they’re not sure how it will affect federal funding.
“We don’t know enough about what these things actually mean,” Russell said.
The cabinet members’ visit to San Diego followed a Los Angeles appearance where Turner and Kennedy blasted the local Los Angeles Homeless Services Authority (LAHSA) for corruption while touring the faith-based Los Angeles Dream Center, where 600 people reside and receive treatment.
Turner pointed to a series of failures and scandals that have plagued Los Angeles’ main homeless agency. The overall message was that despite increased federal funding, there wasn’t measurable progress in addressing the homelessness crisis.
Turner and Kennedy said that although the homeless services authority received nearly $1 billion in federal funding over five years, homelessness doubled in Los Angeles County, to over 70,000 individuals, according to the latest point-in-time count.
That “Cancel Corruption” press conference focused on how much funding goes towards homelessness in a fractured, disorganized system.
HUD suspended all grants to LAHSA in June, instead calling on homeless service providers to bypass the agency and apply for funds directly. LAHSA is suing for release of those funds.
After their fiery LA appearance, Kennedy, Carter and Turner came south to San Diego to lay out what their “Treatment First” plan looks like. It includes phased housing in substance-free living spaces with structure, employment preparedness, standardized assessments and individualized care with the primary goal of reaching self-sufficiency.
Oliva said she finds the phrase “treatment first” to be “disingenuous” and “not aligned with the way that the homeless services field has understood that term” for the past two decades. She finds it particularly misleading as the Trump administration cuts Medicaid benefits that could cover substance abuse treatment costs for impoverished individuals.
Critics dislike the model embraced by Trump officials, also known as a staircase or linear approach, because offering care without housing can lead to more medical costs for taxpayers and emergency room visits, which are particularly expensive.
“At the end of the day, housing first works because it doesn’t require people to deserve a safe and stable place to live,” Oliva said. “It treats people like human beings.”
Russell said that mental health and substance abuse issues do not have a causal link with homelessness, which is an economic issue, but that the stress of living on the streets can exacerbate and worsen those tendencies.
“To solve the results of homelessness without addressing the causes, to me seems even less cost effective than what is being proposed with the current set of rules or the toolkit,” he said.
