As the U.S. emerges from the Covid-19 pandemic, homelessness remains one of the most pressing

challenges of cities. The many causes of homelessness—lack of affordable housing, untreated

mental illness, un- and under-employment, incarceration and criminal recidivism, addiction—

complicate the policy response.

For two decades, that response has been dominated by the “Housing First” philosophy. Housing

First emphasizes immediate access to permanent housing with voluntary support services—yet

no behavioral requirements. The most prevalent Housing First model is Permanent Supportive

Housing (PSH), targeting the “chronically” homeless population, defined as those with longterm

experience of homelessness, coupled with a physical or mental disability. In recent years,

programs or housing models that do not operate in accord with Housing First principles or

that do not target chronically homeless individuals have found it difficult to access government

financial support.