Housing First Founder Faces Federal Censorship as Trump Administration Targets Proven Homelessness Approach
Sam Tsemberis, the pioneering psychologist who developed the Housing First approach to homelessness over four decades ago, finds himself in an unexpected position: censored by his own government and watching his life's work systematically dismantled by the Trump administration.
The Censorship Incident
In October, while preparing a routine presentation about homelessness and health for medical professionals, Tsemberis experienced what he called an "eye-opening experience." Federal officials at the Health Resources and Services Administration reviewed his slides and returned them with extensive redactions. They removed references to racial discrimination as a cause of homelessness, deleted terms like "harm reduction" and "trauma-informed," and systematically eliminated mentions of Housing First throughout the presentation.
"It's a big country," Tsemberis remarked. "The fact they had someone who had the time to go through my slides like that was terrifying. It was a real wake-up call." The event organizer ultimately decided to forgo federal funding rather than implement the censorship demands.
Four Decades of Evidence Versus Political Ideology
Housing First, developed by Tsemberis in the 1990s, operates on a simple but revolutionary premise: people experiencing homelessness need and deserve immediate access to safe, permanent housing without preconditions. When combined with accessible mental health services, addiction treatment, and consistent case management, research consistently shows that 85% or more of participants remain housed after 12 to 24 months.
This evidence-based approach has demonstrated remarkable success across multiple continents. In the United States, Housing First helped reduce veteran homelessness from 73,000 in 2009 to 36,000 in 2020 through a partnership between the Department of Housing and Urban Development and the Veterans Administration. Milwaukee, Wisconsin saw a 42% reduction in homelessness between 2015 and 2024 using the approach.
The Trump Administration's Alternative Approach
Despite this track record, the Trump administration has moved aggressively to replace Housing First with what's often called "Treatment First" - an approach requiring homeless individuals to resolve addiction, mental health issues, and other problems before obtaining housing. This method historically shows less than half the success rates of Housing First.
In summer 2024, Donald Trump codified this policy shift through an executive order titled "Ending Crime and Disorder on America's Streets," which specifically named and criticized Housing First for "deprioritizing accountability." The order declared that no federal dollars would support Tsemberis's approach.
International Acceptance Versus Domestic Backlash
The contrast between international reception and domestic opposition couldn't be starker. At the first European Housing First conference in Berlin, Tsemberis was treated like a celebrity, with social workers, government officials, and formerly homeless individuals from more than 20 countries seeking photos and insights. European Union representatives affirmed their commitment to Housing First as a fundamental right.
"You know, it's funny," Tsemberis observed. "Thirty-five years ago, when I started this, I was an outlaw, an outlier in the US. Then I built all this data, persisted, and Housing First became mainstream. Now, it's full circle. I'm a hero in Europe - and back to being an outlaw in the US."
Conservative Critiques and Their Flaws
Conservative critics, including those behind Project 2025, argue that Housing First represents "a far-left idea premised on the belief that homelessness is primarily circumstantial rather than behavioral." They contend that homelessness results from individual failings rather than structural issues like affordable housing shortages or inadequate wages.
Nicholas Pleace, author of the European manual on Housing First, calls this argument "deeply illogical." "It's like saying, 'Why should we have doctors if people still get sick?'" he notes. Experts point out that homelessness continues to increase due to multiple structural factors, including the affordable housing crisis, social service cuts, the fentanyl epidemic, and economic inequality - not because Housing First has failed.
The Chilling Effect on Service Providers
The administration's stance has created a palpable chill among nonprofit organizations working with homeless populations. One director of a multimillion-dollar nonprofit with Housing First success rates above 90% declined to speak on the record, citing concerns about unpredictable retaliation from the administration.
"Organizations are trying to figure out how to stay off the radar," Tsemberis explained, comparing the situation to efforts to eliminate diversity initiatives in universities. The fear extends to agencies that fund crucial services, with the administration having briefly announced nearly $2 billion in cuts to mental health and addiction services before reversing the decision.
Legal Challenges and Future Implications
Two lawsuits have been filed against HUD over proposed funding cuts that would reduce permanent housing subsidies by two-thirds, potentially jeopardizing housing for 170,000 people. One lawsuit from 20 states plus Washington D.C. mentions Housing First fifty times, calling the policy change "blatantly arbitrary and capricious."
Ann Oliva, CEO of the National Alliance to End Homelessness, warns that the administration is pushing a return to models from the 1980s and 1990s that "didn't work, and didn't produce permanent housing." Deborah Padgett, a professor at NYU's Silver School of Social Work who has known Tsemberis since the 1980s, notes that Housing First "touches a nerve in American society: the extent to which we want to help people, but also want them to help themselves."
A Crossroads for American Homelessness Policy
As Tsemberis prepares for the upcoming U.S. Housing First conference titled "Housing First in Challenging Times: Staying True, Moving Forward," the broader implications of the policy reversal continue to unfold. Experts warn that abandoning evidence-based approaches could have devastating human and financial consequences.
"There's incredible human and financial costs, as well as costs to society, when you cut back what's actually helping," Pleace concludes. "It gets into deep questions about what kind of society you want to be." For Tsemberis, after four decades of work and more than a decade of federal support, the battle to maintain Housing First represents not just a policy dispute, but a fundamental question about how America treats its most vulnerable citizens.
