Editor’s Note: The following article was originally published by Robert Davis from Invisible People on July 4, 2025.
Denver Housing First Program Shows Promise Over First Two Years
A first-of-its-kind housing program in Denver may provide a model for addressing chronic homelessness.
The program, known as Housing to Health (H2H), is a seven-year, pay-for-success pilot. It was launched in 2022 with more than $11.75 million in funding provided by six private investors and a Social Impact Partnership Pay for Results Act grant from the U.S. Treasury Department. It was designed to support 125 people who were chronically homeless, had multiple encounters with the criminal legal system, and have unmet health needs.
H2H works by placing eligible participants with housing vouchers in single-site supportive housing buildings. Once housed, participants were connected with health care and other supportive services. Program partners also conducted regular outreach with participants and coordinated warm hand-offs between service providers to ensure it did not interfere with a patient’s treatment schedule.
Over the first two years of the program, H2H helped 105 people remain stably housed for a full year and reduced the number of jail and hospital stays for participants. H2H also created nearly 73,000 days of stable housing for participants.
“Housing and health are inextricably linked,” said Sarah Gillespie of the Urban Institute, who is leading the evaluation team. “Through innovative partnerships and a data-driven commitment to serving those with the highest unmet health care needs, the Housing to Health program is poised to provide rigorous, long-term evidence about cost-effective models to end homelessness and improve health care outcomes.”
Building on Successful Local Models
Denver is no stranger to creating innovative Housing First programs. The city’s Social Impact Bond programprovided 560 more days of housing to participants than to those who received other community assistance. Denver’s House1000 initiative, which was launched during the pandemic with funds from the American Rescue Plan Act, reduced unsheltered homelessness by 45% over two years, according to data from the Denver mayor’s office.
H2H builds on the successes of those programs by connecting participants with healthcare providers to address their unmet needs. Connecting with physicians and attending doctor’s visits are often aspects of someone’s housing stability journey that they are expected to complete on their own. H2H takes a different approach by connecting people who are homeless with physicians and doctors directly.
Overall, the model helped reduce Medicaid expenditures for participants from roughly $8,300 per person to $2,112 per person, a savings of about 75%.
“Directly connecting at-risk patients to lifesaving housing and wraparound supports through the H2H program enables us to treat patients holistically by addressing a major driver of poor health outcomes,” said Sarah Stella, a physician with Denver Health, a hospital that supports the H2H program.
A Promising Program in a Politically Precarious Time
Despite its successes, the H2H program is happening at a politically fraught time. Federal lawmakers are debating President Donald Trump’s Fiscal Year 2026 budget, which could significantly slash funding for homeless services, affordable housing, and Medicaid. At the same time, rates of homelessness continue to climb across the country as the lack of affordable housing leaves low-income earning Americans out in the cold.
Trump’s budget seeks to cut more than $700 billion in spending from safety net programs like Medicaid and Medicare. While H2H itself would not be impacted by any of the budget cuts, having less money for Medicaid would make it more difficult for states and cities to provide care for people experiencing homelessness. This would not only limit people’s options for receiving care, but it would also make it more challenging to serve them in the future.
Meanwhile, homelessness continues to increase.
In Denver, homelessness increased by roughly 7% year-over-year to nearly 11,000 people, according to the latest survey. At the same time, roughly 52,000 Coloradans accessed homeless services last year, including 33,000 in the Denver metro area alone, according to the Metro Denver Homeless Initiative, a local Continuum of Care.
“Every dollar we invest in coordinated housing approaches saves taxpayers more than two dollars in reduced hospital visits, emergency responses, and police interactions,” said Jason Johnson, MDHI’s executive director. “We’ve proven homelessness is solvable—we need to continue investing in what works to efficiently help more people find stable housing.”
A Shift Away from Evidence-Based Solutions
Federal and state lawmakers have also increasingly turned away from Housing First initiatives and embraced criminalization to address homelessness. Since 2024, more than 150 cities have adopted new laws criminalizing aspects of homelessness, such as panhandling, sitting down, or eating food in public, according to the National Homelessness Law Center.
The Trump administration has paved the way for these efforts to continue. Scott Turner, the Secretary of the Department of Housing and Urban Development, has called on the agency to discontinue its Housing First efforts. That is despite federal research that shows Housing First is a key component in the more than 50% reduction in veteran homelessness over the last decade.
Project 2025, a 900-page document guiding the Trump administration’s policies, also calls for an end to the Housing First approach. The document says HUD should “end Housing First policies so that the department prioritizes mental health and substance abuse issues before jumping to permanent interventions in homelessness.”
This would effectively set the country on a path toward embracing “treatment first” options to address homelessness. As Invisible People’s Kayla Robbins noted, this method is incredibly burdensome for people who are homeless. It also produces inconsistent outcomes that can prolong someone’s experience of homelessness.
“Treatment First focuses more on an individual’s health and behavior challenges, seeking to eliminate those so that the person is ‘ready’ to receive permanent housing,” Robbins wrote in a recent article. “But a lot of people never reach that point. Even those who do may need to go through several rounds of treatment and relapse before seeing sufficient results, making the method not as easy on the budget as it would appear at first glance.”
Now Is the Time to Demand Compassionate, Effective Policy
Now is not the time to be silent about homelessness in the U.S. or anywhere else. Unhoused people deserve safe and sanitary housing just as much as those who can afford rent or mortgage.
Poverty and homelessness are both policy choices, not personal failures. That’s why we need you to contact your officials and tell them you support legislation that:
– Streamlines the development of affordable housing
– Reduces barriers for people experiencing homelessness to enter permanent housing
– Bolsters government response to homelessness
Together, we can end homelessness.
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