Recent months have delivered one startling headline after another from across our federal government. Regardless of where one stands on these rapid shifts in policy and approach, it’s clear we are not living in an era of stability or predictability. The housing and homelessness sector—where ImmaCare focuses its mission—is bracing for significant changes that could unravel decades of steady progress made by dedicated advocates nationwide.
At the heart of our work are the principles of harm reduction, which remind us not to view people as failures when they fall short of perfection. This philosophy allows us to celebrate progress—both small and large—without demanding the impossible. In truth, harm reduction is a value woven throughout everyday life, even when we don’t call it that. Seat belt laws, for example, are a harm reduction strategy that saves lives, even though not every crash has a perfect outcome.
Housing First is a harm reduction–based framework that ImmaCare embraced more than 20 years ago—well before it gained national recognition. By the early 2010s, Housing First had become a cornerstone of federal efforts to address homelessness, transforming the way communities respond to those in need.
Developed by Pathways Housing First, the model is built on five core principles:
- Consumer Choice: Choice in housing and services to promote self-determination.
- Separation of Housing and Treatment: Immediate access to housing without requiring treatment or sobriety beforehand.
- Services Matched to Need: Providing or coordinating supportive services.
- Recovery-Oriented Philosophy: Ongoing, hopeful, and affirming support.
- Social and Community Integration: Encouraging a life in the community, like everyone else.
Yet, much of the recent reporting about the federal government and the U.S. Department of Housing and Urban Development (HUD) points to a concerning shift away from the proven Housing First approach. Articles in national outlets such as POLITICO (“Trump Administration Looks at Deep Cuts to Homeless Housing Program”) and ProPublica (“Millions Could Lose Housing Aid Under Trump Plan”) highlight this emerging direction, echoed by advocacy and policy organizations across the country.
The proposed shift would replace Housing First with a model that conditions access to housing on being “ready”—typically defined by external measures such as completing treatment, demonstrating sobriety, or meeting employment or training requirements. While these supports are valuable, they are not prerequisites to stability—they are outcomes made possible because of stability. Housing First has always encouraged engagement in recovery, treatment, and employment, but it begins with the most basic and essential step: providing a home.
Expecting someone to secure a job or maintain treatment while sleeping under a bridge or in a bus shelter is unrealistic. Once a person has a safe, stable place to live, the path toward health, employment, and self-sufficiency becomes not only possible—but achievable.
I have long believed that our field needs a framework that bridges Housing First and recovery-based models. In medicine, we understand that not every patient receives the same treatment—care is tailored to individual needs by skilled professionals. Unfortunately, the housing sector lacks the public investment to build that level of front-line expertise capable of making accurate assessments of those seeking services. With greater investment, we could better identify who might thrive with added expectations such as treatment or employment, and who simply needs housing first.
As we face possible shifts in federal priorities, we must remember: Housing First is not Housing Only. It is the foundation from which people can rebuild their lives. Abandoning it would risk reversing years of progress and displacing thousands who have finally found stability. Let us continue to hold the line on advancing the human dignity every person deserves—whether they lack a home or a country.
Sincerely,
Lou Gilbert
Executive Director