Housing-first, a model rooted in the belief that people need a stable place to live before addressing other problems, has been central to federal government housing policy for more than a decade. That approach is disappearing under President Donald Trump’s second administration. The upheaval , providers and advocates said, threatens the most vulnerable people in the nation. Housing organizations across the United States that depend on federal funds are now reluctantly making changes to comply with new government policies that favor a treatment-first approach and short-term transitional housing, changes they fear will push people with extreme health risks back on the street or keep others there. In Oklahoma, homeless support providers said housing-first programs are working and support for the initiative is needed. Oklahoma Matches U.S. Homelessness Numbers In Upward Trend Oklahoma’s two largest cities, Oklahoma City and Tulsa, each reported a decrease in homelessness in 2026, though both cities’ unhoused populations still trend significantly higher than pre-COVID numbers. At Oklahoma City’s annual State of Homelessness address in May, city leaders and homeless support service providers credited the city’s public-private partnership, Key To Home, with the slight decrease in homelessness seen in the point-in-time count, which often undercounts people experiencing homelessness. “This one-day count is only a snapshot and is not designed to be a complete analysis of the issues surrounding homelessness,” reads Oklahoma City’s point-in-time report. According to Key To Home data, the program, implemented in 2023, has housed 3,032 people. Tulsa has a similar program, though it hasn’t been established for nearly as long. Safe Move Tulsa, implemented in 2025, has housed 725 people and aims to house 575 more by the end of the year. The nationwide homelessness trends match Oklahoma’s numbers. Across America, nearly 750,000 people were homeless last year, according to an estimate compiled by the U.S. Department of Housing and Urban Development. That number is down slightly from 2024 but up 31% from 2019. The portion considered chronically homeless, meaning they have a disability and long-term or repeated episodes of homelessness of at least a year, has also risen since 2019. It’s now about one-quarter of the total. Research shows approximately half of homeless adults live with a disability, up to two-thirds have mental illness and two in five have substance use disorder. Rates of disability, heart disease and diabetes are two to three times higher than in the general population. Housing-First Programs Across the Nation Johnny Henderson, 71, who has one arm, heart disease and vision problems, is a regular at the St. John Center men’s day shelter in Louisville, Kentucky. So are a great-grandfather in a wheelchair who has prostate cancer, a 54-year-old with four psychiatric disorders and a 66-year-old with a walker who wears a hospital bracelet warning of fall risk. All are potential candidates for permanent, government-subsidized apartments under a housing-first approach. “Housing is healthcare,” St. John executive director Ra’Shann Martin, whose organization provides housing and outreach in addition to the shelter, told the Associated Press. “The longer people stay unhoused, the more fragile they become.” Johnny Henderson poses for a portrait at the St. John Center men’s day shelter in Louisville, Ky., on Thursday, July 30, 2026. (AP Photo/Mary Conlon) Planned housing projects have been scrapped in communities such as Corbin, Kentucky. Less housing is available for homeless people in places including Santa Cruz County, California. And in cities such as Louisville, nonprofits are looking at making some permanent housing temporary, including most of St. John’s 200 apartments. In Louisville, outreach specialist Angel Sivado told the Associated Press such statistics are reflected in the people she serves, whose living conditions make it extremely difficult to care for themselves, get to doctors or keep up with medications. The same can be said for Oklahoma. Rachel Freeman, the CEO of City Care, an Oklahoma City-based night shelter and supportive housing provider, said everyone in City Care’s permanent supportive housing program was chronically homeless and has a physical or mental disability. “That intersection has been the place that City Care has specialized,” Freeman said. The Trump Administration Favors Treatment-First and Short-Term Housing Each person’s path to homelessness is unique. Determining the best solutions depends on the lens used to judge what’s best. The answer may be different if the goal is reducing overall homelessness, helping people into the job market, spending as little taxpayer money as possible, improving health outcomes or just keeping people alive. The housing-first idea was pioneered by a New York nonprofit in the 1990s and has been the basis for federal homelessness policy since 2013. Today, there are about 173,000 permanent supportive housing beds for chronically homeless people, and 235,000 for other populations, including veterans. These are long-term apartments paired with voluntary services. Tenants often must contribute 30% of their income, after certain expenses, to rent and utilities. Studies have consistently shown that housing-first programs keep people stably housed. Some research says they do so better than other models, including treatment-first, which favors mandatory services for addiction and serious mental illness. But findings on health outcomes have been mixed. “As a community of providers, we’ve been operating under the housing-first philosophy for many, many years,” Meghan Mueller, CEO of the Homeless Alliance in Oklahoma City, said. “There’s some concern that this shift to the treatment-first models will leave some gaps. Not everyone’s necessarily appropriate for those models.” Mueller said that emphasizing recovery before housing can risk further perpetuating stigmas around the homeless population that aren’t necessarily true. Last year, Trump signed an executive order calling for an end to federal support for housing-first policies. His proposed budget for fiscal 2027 calls for eliminating the federal initiative that goes mostly to housing-first programs. The administration favors housing lasting up to two years, during which people would be required to get treatment. “Housing-first has failed our most vulnerable and enabled addiction,” HUD said in an email to the Associated Press. “HUD’s proposed reforms seek to address the root causes of homelessness and advance recovery, self-sufficiency, and competition that drives accountability.” Many housing-first opponents don’t think services, including addiction and mental health treatment, should be optional. “That is the biggest difference between housing-first and not housing-first,” Devon Kurtz, the public safety policy director for the Cicero Institute, told the Associated Press. Kurtz is also concerned that permanent supportive housing was becoming a one-size-fits-all approach, including for populations better served by transitional housing. Amy Coldren, the advocacy and communications director for Mental Health Association Oklahoma, said that while the organization still advocates for housing-first solutions, it is not the only option it offers clients. “If the client that is living in an encampment is eligible for housing, but wants to seek treatment first, that is also an option for them,” Coldren said. “There are many instances where a client may go through a detox and a recovery program before entering into housing.” Mental Health Association Oklahoma is one partner to Key To Home, Oklahoma City’s housing initiative. “For many of the individuals that we serve, stable housing, safe housing, is really an essential part of being able to manage ongoing treatment,” Coldren said. Providers Said Short-Term Housing Won’t Work for Some People Freeman, the City Care CEO, said she’s concerned agencies won’t be able to recover quickly enough or find alternative funding sources to keep serving clients who need long-term support. She said her other concern is that people with the greatest support needs will face more barriers. Cryslynn Barnes, an outreach worker with Mental Health Association Oklahoma, gathers information on a potential client. Mental Health Association Oklahoma partners with Key To Homes, Oklahoma City’s public-private housing program for people experiencing homelessness. (Jake Ramsey/Oklahoma Watch) The new model the federal government is implementing emphasizes economic self-sufficiency and workforce production. “While that, on its face, is not a bad thing, it will be a really high bar for folks who have complex psychiatric symptoms or disabilities or even just families experiencing homelessness with small children,” Freeman said. “Ultimately, there will be some people who struggle to participate because of the difficulties they are facing.” National service providers acknowledge that transitional housing is a good option for some people, such as those getting on their feet after evictions. But they say most chronically homeless people can’t pull their lives together within two years and would likely wind up homeless again. “If you want to gradually work on reducing social services that are funded by the federal government, OK,” Jennifer Clark, CEO and executive director of St. Vincent de Paul Louisville, told the Associated Press. “But you cannot make a huge sweeping change and big cuts and take an axe to everything and think that there aren’t going to be consequences for some people who are really in need.” Freeman emphasized it’s not just people already experiencing homelessness that are vulnerable, but that renters who are considered extremely low-income and cost-burdened are also vulnerable. Large Inflows Into Oklahoma’s Homeless Response System No state has enough housing for low-income renters, according to the National Low-Income Housing Coalition. In Oklahoma, the coalition estimates the state lacks 84,125 units to house low-income families. Most renters considered extremely low-income are either in the labor force, seniors or have a disability. The extremely low-income group makes up 26% of Oklahoma renters. Within the extremely low-income renter population, 83% are considered severely cost-burdened. “What you have is folks choosing between health care, treatment, food and rent,” Freeman said. “And when one thing happens to put this very fragile scale off balance, people end up on the streets.” Congress recently passed the largest housing bill in decades, notably without the president’s signature, to solve the country’s affordable housing crisis. The effects are expected to take years to be felt. Meanwhile, Oklahoma housing experts said more needs to happen at the local level to prevent a large inflow into the homeless response system. “The cost of housing is the systemic issue and is the reason so many people are falling into homelessness,” Freeman said. “The response system is doing their best ot plug the holes and get people reconnected, but affordable housing has to be available, and we already in the state of Oklahoma and nationwide don’t have enough, and that is only going to be compounded in January.” Policy Changes Rock Communities After HUD tried to rework its homelessness grants to fit the administration’s favored policies, a consortium of local governments and advocates for people experiencing homelessness sued. A federal judge agreed with them. But in September, an appeals court said the administration could move ahead. Meanwhile, Trump’s proposed budget calls for eliminating the $4 billion Continuum of Care program, which awarded money to 6,500 projects in 2024. At that time, more than 60% went to permanent supportive housing, mostly to continue existing efforts. Just 1% went to transitional housing. Trump’s proposed changes have left homelessness organizations scrambling to adjust their housing strategies so they can keep getting federal money. “It’s like psychological warfare the last two years, trying to figure out how to navigate these changes that are looming right over us,” Martin, the St. John director, told the Associated Press. Dr. Robert Ratner, director of housing for health in Santa Cruz County, California, told the Associated Press that losing permanent supportive housing funds would exacerbate problems caused by the winding down of another federal program: pandemic-era emergency housing vouchers. People set to lose those vouchers are being prioritized for available housing, meaning the county can’t help as many people who are homeless now. A similar dynamic is playing out at The Delores Project in Denver, Colorado. Program leaders expect people already in the permanent housing on their campus will stay because they won’t have access to vouchers to move out into the community. That will mean fewer spots for new people. In Louisiana, the state housing agency applied to redirect federal money away from rental assistance and toward the establishment of a 200-bed shelter with strict mandates for participants. That effort was rejected by local coalitions in charge of the money, but local housing advocates worry it’s a harbinger of what’s to come. Many nonprofit leaders feel forced to shift toward transitional housing. In Louisville, St. Vincent de Paul and Family Health Centers-Phoenix Health Care for the Homeless are looking at converting some permanent supportive housing apartments into transitional units. In Oklahoma, Mueller, Homeless Alliance’s CEO, said that while there’s unease among service providers, they will still find ways to serve the homeless community. “We can continue to house people whether it’s in a permanent supportive housing model or a transitional housing model,” Mueller said. “As a community, we’re really creative, and we’re good at finding ways to get additional support for folks who may need longer-term supports than what transitional housing allows.” Jake Ramsey covers evictions, housing and homelessness. Contact him at (405) 370-3798 or [email protected]. The post Oklahoma Housing Providers Say Housing-First Is Working. The Federal Government Is Done With It. appeared first on Oklahoma Watch. ...read more read less