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Housing First

Shifting the paradigm in addressing homelessness

Housing First

The Housing First model provides permanent housing to individuals and families experiencing homelessness without barriers to entry such as sobriety, treatment, or service participation requirements. Housing First is built upon the principles that homelessness is fundamentally a housing crisis and that having necessities like a stable place to live must come before other less critical needs.

Housing First programs provide rental assistance based on the individual or family’s need. Participants sign a standard lease. Supportive services are available to people in Housing First permanent housing but they are not required to participate in these programs.

There are two common program models following the Housing First approach:

1. Permanent Supportive Housing: provides individuals and families with chronic illnesses, disabilities, mental health issues, or substance use disorders who have experienced long-term or repeated homelessness with housing and support services. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a Permanent Supportive Housing Evidence-Based Practices Toolkit to help implement this effective model.

2. Rapid Re-Housing: provides individuals and families with short-term rental assistance and services. It offers housing identification, rent and move-in assistance, and case management and services.

Housing First in Massachusetts

The Massachusetts Housing and Shelter Alliance (MHSA) operates the Home & Healthy for Good (HHG) program with funding provided by the MA Legislature. Since 2006, HHG has placed 1045 chronically homeless adults into permanent housing with supportive services, including 206 veterans. HHG results show a trend toward tremendous savings in health care costs, especially hospitalizations, when people who are chronically homeless receive housing with services. Once in housing, individuals are safer than they were on the streets or in shelter, experiencing fewer accidents and injuries that require immediate attention.


Chronically homeless adults have been placed into permanent housing with supportive services since MHSA founding in 2006.


Of the total HHG population is either housed through HHG, left the program to move on to another type of permanent housing, or transitioned to long-term treatment or a more appropriate health care setting.


Of HHG population, 55 individuals, are known to have recidivated to homelessness after obtaining permanent housing.


Annual savings per housed tenant HHG provides the Commonwealth.