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    A home for everyone

    A home for everyone: A key, and the help to keep the door open.

    On a night in January 2025, 155,750 people in America had chronic patterns of homelessness, the most ever counted. In a randomized trial in Denver, a home with support kept 77% of them housed three years on.

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    Ryan K. Hertel · heyitskenton

    The problem

    What we're up against.

    • Hundreds of thousands, on one night.

      745,652 people in America were homeless on a single night in January 2025, and 266,320 of them were living unsheltered.

    • The longest homeless, more than ever.

      155,750 people had chronic patterns of homelessness, the most since counting began, and six in every ten of them were unsheltered. Their number grew 81% from 2013 to 2025.

    • Who counts as chronically homeless.

      By federal definition, it means being homeless for a long time while living with a disability, such as a serious mental illness or a substance use disorder.

    • Sleeping outside is deadly.

      In a ten-year study in Boston, people sleeping outside died at almost ten times the rate of the state's population.

    • Families, too.

      230,366 people in families with children were homeless that night, 93% of them in shelters, and their number fell by 11% in a year.

    What works

    Proven, and ready to grow.

    • A home first.

      Across 26 studies in the US and Canada, Housing First programs, which offer a home without requiring treatment first, cut homelessness by 88% and improved housing stability by 41%.

    • Out of the jail cycle.

      In Denver's randomized trial, people who cycled between the streets and jail got 560 more days of housing over three years when offered supportive housing, and 77% were stably housed in the third year. Their jail days fell by 27% and their arrests by 40%.

    • From the emergency room to the doctor's office.

      The same people had 8 more office visits for mental health care and 6 fewer emergency visits, on average.

    • Housed, and staying housed.

      In a California trial with frequent users of public services, 86% of people offered supportive housing were housed, against 36% with usual care, and they stayed housed 92.9% of the time that followed.

    • Families stay together.

      In a national trial, families offered a lasting housing subsidy had less than half as many later episodes of homelessness, and far fewer children were placed in foster care.

    What a family could fund

    Where the money goes furthest.

    • A home, and the help to keep it.

      A year of supportive housing in Denver's trial, rent help and services together, cost $22,265 to $35,770 a person, depending on the provider. Across US studies, the median was $16,479 a year, in 2019 dollars.

    • Private money can go first.

      Denver's program raised $8.6 million from private investors, who were repaid only for results, and the national nonprofit CSH helped run it.

    • Lenders who build homes.

      CSH, a nonprofit lender, says it has invested more than $2.2 billion in communities.

    • A whole city's need, priced.

      Ending chronic homelessness across Denver County would cost $14.6 million to $18.7 million a year, by the trial team's estimate.

    • Results at city scale.

      Houston's partners housed 2,135 households in 2025, and 85% of people who left homelessness stayed housed over two years, by the coalition's own count.

    Honest limits

    What money can't promise.

    • A home isn't a cure.

      Experts found no substantial evidence that supportive housing improves health, except limited data for people with HIV/AIDS, and it had no measurable effect on psychiatric symptoms, substance use, income or work.

    • Lives are still at risk.

      In Denver, supportive housing had no significant effect on deaths. In California, total emergency and hospital use didn't fall.

    • Savings cover only part of the cost.

      Lower spending on other public services offset about half of Denver's cost. In Chicago, the program cut hospital stays by 29%, but its savings weren't statistically significant.

    • Not enough homes.

      Only 38 affordable homes are available for every 100 extremely low-income renter households, and a new supportive housing building can take many years to open.

    • New people keep arriving.

      Even in Houston, 7,110 people became homeless for the first time in a single year. And a review of 43 studies found most at high risk of bias.

    Hard questions

    Asked and answered.

    1. You might ask

      Doesn't a home first reward bad choices?

      Ryan

      This housing is for people who've been homeless for years while living with a disability, by federal definition, and in randomized trials, dropping sobriety rules came without an increase in problem substance use.

    2. You might ask

      Does it save money?

      Ryan

      Partly. In Denver, lower spending elsewhere offset about half the cost, and the National Academies advise not to expect net savings. Counting wider benefits, a review for the CDC's Community Guide found $1.80 of benefits for every dollar in US studies.

    3. You might ask

      Why not just more shelters?

      Ryan

      Shelters are very expensive, and they don't end homelessness. In HUD's family trial, a lasting subsidy cost only 9% more than usual care over three years, and families had less than half as many later episodes of homelessness.

    In the slider

    See what your fortune could do here.

    A home for everyone

    The slider prices this cause with these numbers:

    • A year of supportive housing, rent help and services together, cost $22,265 a person with the lower-cost provider in Denver's randomized trial.
    • The whole need is everyone counted with chronic patterns of homelessness on a night in January, 155,750.
    • A home ends homelessness for most people who get one, but on its own it hasn't been shown to improve symptoms, substance use or work.
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    More of the Blueprint

    Keep reading.

    17 more chapters on the way

    Back to Keep 100

    Sources

    Every number in this chapter, and where it came from.

    1. Source 1: The 2025 Annual Homelessness Assessment Report (AHAR) to Congress, Part 1: Point-in-Time Estimates of Homelessness (opens in a new tab)

      US Department of Housing and Urban Development, May 2026. Checked 16 October 2026.

      A count on one night, which likely misses some people sleeping outside.

    2. Source 2: Breaking the Homelessness-Jail Cycle with Housing First: Results from the Denver Supportive Housing Social Impact Bond Initiative (opens in a new tab)

      Urban Institute, 15 July 2021. Checked 16 October 2026.

      A randomized trial with 724 people who cycled between the streets and jail.

    3. Source 3: HUD Releases 2025 Annual Homelessness Assessment Report to Congress (opens in a new tab)

      US Department of Housing and Urban Development, 29 May 2026. Checked 16 October 2026.

    4. Source 4: Defining Chronically Homeless (opens in a new tab)

      Federal Register, 4 December 2015. Checked 16 October 2026.

      HUD's final rule.

    5. Source 5: Mortality Among Unsheltered Homeless Adults in Boston, Massachusetts, 2000-2009 (Roncarati and others) (opens in a new tab)

      JAMA Internal Medicine, September 2018. Checked 16 October 2026.

    6. Source 6: Permanent Supportive Housing With Housing First to Reduce Homelessness and Promote Health Among Homeless Populations With Disability: A Community Guide Systematic Review (Peng and others) (opens in a new tab)

      Journal of Public Health Management and Practice, September 2020. Checked 16 October 2026.

      A systematic review for the US Community Preventive Services Task Force.

    7. Source 7: Housing First Increased Psychiatric Care Office Visits And Prescriptions While Reducing Emergency Visits (Hanson and Gillespie) (opens in a new tab)

      Health Affairs, February 2024. Checked 16 October 2026.

      The Denver trial, followed into health care.

    8. Source 8: A randomized trial of permanent supportive housing for chronically homeless persons with high use of publicly funded services (Raven, Niedzwiecki and Kushel) (opens in a new tab)

      Health Services Research, October 2020. Checked 16 October 2026.

      A randomized trial with 423 people in Santa Clara County, California.

    9. Source 9: Family Options Study: 3-Year Impacts of Housing and Services Interventions for Homeless Families (opens in a new tab)

      US Department of Housing and Urban Development, 25 October 2016. Checked 16 October 2026.

      A randomized trial with 2,282 families in twelve communities.

    10. Source 10: Can Housing and Service Interventions Reduce Family Separations for Families Who Experience Homelessness? (Shinn, Brown and Gubits) (opens in a new tab)

      American Journal of Community Psychology, September 2017. Checked 16 October 2026.

    11. Source 11: Costs and Offsets of Providing Supportive Housing to Break the Homelessness-Jail Cycle (opens in a new tab)

      Urban Institute, 15 July 2021. Checked 16 October 2026.

    12. Source 12: Permanent Supportive Housing With Housing First: Findings From a Community Guide Systematic Economic Review (Jacob and others) (opens in a new tab)

      American Journal of Preventive Medicine, 10 November 2021. Checked 16 October 2026.

      Benefits include wider ones, such as lower health care costs.

    13. Source 13: About CSH (opens in a new tab)

      CSH. Checked 16 October 2026.

      The organization's own account.

    14. Source 14: CFTH Releases 2026 Point-In-Time Count Results as Part of New State of Homelessness in Houston Report (opens in a new tab)

      Coalition for the Homeless of Houston/Harris County, 12 June 2026. Checked 16 October 2026.

      The coalition's own count.

    15. Source 15: Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness (Conclusions) (opens in a new tab)

      National Academies of Sciences, Engineering, and Medicine, 2018. Checked 16 October 2026.

    16. Source 16: Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review (Aubry and others) (opens in a new tab)

      The Lancet Public Health, June 2020. Checked 16 October 2026.

    17. Source 17: Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults (Sadowski and others) (opens in a new tab)

      JAMA, May 2009. Checked 16 October 2026.

      A randomized trial in Chicago.

    18. Source 18: Comparative cost analysis of housing and case management program for chronically ill homeless adults compared to usual care (Basu and others) (opens in a new tab)

      Health Services Research, February 2012. Checked 16 October 2026.

    19. Source 19: Worst Case Housing Needs: 2025 Report to Congress (opens in a new tab)

      US Department of Housing and Urban Development, 20 November 2025. Checked 16 October 2026.

    20. Source 20: Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis (Munthe-Kaas, Berg and Blaasvaer) (opens in a new tab)

      Campbell Systematic Reviews, 2018. Checked 16 October 2026.

    21. Source 21: Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials (Baxter and others) (opens in a new tab)

      Journal of Epidemiology and Community Health, May 2019. Checked 16 October 2026.

    22. Source 22: Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness (Summary) (opens in a new tab)

      National Academies of Sciences, Engineering, and Medicine, 2018. Checked 16 October 2026.

    23. Source 23: Family Options Study: Summary Report (opens in a new tab)

      US Department of Housing and Urban Development, October 2016. Checked 16 October 2026.