HUD's New Toolkit Shifts Focus from Housing-First to Treatment-First Approach

The U.S. Department of Housing and Urban Development (HUD) joined other federal agencies this month in unveiling a “Treatment First” Toolkit for local leaders, a resource designed to shift the focus from housing-first models toward addiction treatment and recovery.

The playbook arrives as the Trump administration encourages localities to move away from the longstanding “housing first” approach in tackling the nation’s homelessness crisis. HUD Secretary Scott Turner has criticized housing-first policies as ineffectual, arguing they have “misused taxpayer funded resources without any expectation of results and too often leave individuals trapped in addiction.” In contrast, some homeless advocacy organizations, such as the National Alliance to End Homelessness, describe housing-first as essential.

The toolkit is billed as a resource to provide communities with strategies that aim to “help Americans transition from homelessness and addiction to recovery and self-sufficiency.” It was developed jointly by HUD, the White House Office of National Drug Control Policy, and the Department of Health and Human Services.

“Housing is essential, but housing alone is not enough,” Turner said in an Aug. 12 press release. “This toolkit gives communities a practical playbook designed by experts across the country to put treatment first and help more homeless Americans achieve lasting recovery, stability, and independence.”

The toolkit does not prescribe a single model for addressing homelessness and addiction. Instead, it outlines a set of best practices for localities, prioritizing self-sufficiency and urging accountability for those experiencing homelessness and addiction by utilizing services. It also encourages localities to mandate substance-free living spaces.

Measures of success must be defined by “meaningful progress toward long-term recovery-oriented outcomes,” according to the playbook, “... rather than by service utilization alone.”

The Disability Rights Education and Defense Fund (DREDF) criticized the toolkit, calling it a “blueprint for conditioning shelter on compliance.”

The toolkit embraces a “whole-of-community” approach, encouraging local leaders to work closely with organizations within their communities to coordinate homeless and addiction services. It also emphasizes collaboration with faith-based organizations.

It introduces a five-phase approach for measuring outcomes for those experiencing homelessness and addiction. The phases progress from crisis, stabilization, treatment, and early recovery to “thriving,” which the toolkit characterizes as long-term abstinence from addiction, mental health stability, full-time employment, and living in non-subsidized housing.

Regarding encampments, the guidance highlights the Homeless Outreach Services Team, a model used by LA County Homeless and Housing. According to the playbook, this street-based multidisciplinary outreach program cleared more than 1,500 encampments with no arrests, use of force, or litigation. The program deployed specialized law enforcement teams, homeless outreach and housing navigation services, substance use and mental health treatment providers, public works and environmental remediation teams, and community-based organizations.

“Rather than reacting once a crisis occurs, the model emphasizes repeated outreach, trauma-informed engagement, and deliberately planned pathways off the street,” the toolkit states.

The U.S. recorded an overall 3% decline in homelessness last year, following a record spike the year prior.