Housing First Models

Full Fidelity Pathways to Housing

• The Pathways to Housing model centers these five principles:
  
  
  1. Consumer choice: consumers (program participants) give input during the housing search process and choose which supportive services to use (except case management)
     
     
  2. Separation of housing and treatment: participants get immediate access to housing without treatment or sobriety as prerequisites, and housing & treatment are provided by different staffs
     
     
  3. Provide services to match needs: program provides or coordinates services
     
     
  4. Recovery oriented service philosophy: ongoing, positive, hopeful, affirming support
     
     
  5. Social community integration: the program supports engagement of tenants with the wider community
     
     
• Services are provided through Assertive Community Treatment (ACT), which provides a higher, more intense level of care. The ACT team includes social workers, nurses, psychiatrists, vocational and substance abuse counselors, a nurse practitioner, and a housing specialist (source).
  
  
• Tenants pay 30% of their income (usually Supplemental Security Income) toward rent (source). 
  
  
• The Pathways model is a scattered site model- staff help participants find and lease an apartment on the private market. 
  
  
  • Participants choose who, if anyone, will live with them.
    
    
• Does not evict into homelessness. If a participant needs to leave their apartment, program staff do all they can to help the participant find another apartment.
  
  
• Pathways employs a harm reduction approach. 
  
  
  • Harm reduction= a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use (National Harm Reduction Coalition)

Medium-to-Low Fidelity Housing First Models

• Low barrier: should not reject applicants from the program because of substance use disorder, having low/no credit, having evictions on their record, or having a criminal record.
  
  
• Offer a variety of supportive services to help a person maintain their housing (such as employment support, health care, mediation with landlords or other tenants, and others). Tenants are encouraged but not required to use these services. 
  
  
  • Services may come not in the form of ACT.
    
    
• May be implemented through a scattered site model (people in the programs lived in apartments scattered across the city), or a single-site model (people in the program live in apartments in the same building). 
  
  
  • Some scattered site models may house tenants in buildings with only affordable housing, while others may offer tenants housing in market rate mixed income housing. 
    
    
  • At single site housing first programs, services might be provided on site, or residents might travel off-site to access services.