Factually! with Adam Conover - Our Three Crises: Affordable Housing, Minimum Wage and Homelessness with Dr. Sam Tsemberis

Episode Date: October 3, 2019

Founder and executive director of Pathways to Housing, a Housing First program, Dr. Sam Tsemberis joins Adam this week to discuss the misconceptions about how to address the homelessness crisis, the economics of homelesness and why there are people on the street when we know how to fix it. This episode is brought to you by Kiwi Co. Learn more about your ad choices. Visit megaphone.fm/adchoices See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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So if all of that sounds good, if you want a big box of delicious snacks like this for yourself, use the code factually for $15 off your first order at Bokksu.com. That's code factually for $15 off your first order on Bokksu.com. I don't know the way I don't know what to think I don't know what to say Yeah, but that's alright Yeah, that's okay I don't know what to say Hello, welcome to Factually, I'm Adam Conover

and, you know, it's easy for us to assume that the way things are is the way they have to be or always have been. You know, we tend to assume that certain features of our society, like electoral democracy or RuPaul, are permanent and timeless, when in fact, they're quite recent and really dependent on our current time. And the same is true for social problems. Take homelessness, for instance. I know this is not the first time I've talked about homelessness on the show, and it's not going to be the last time either. Because homelessness is such an inescapable reality, especially in our cities, you know, it's easy for us to believe that this is just the way things are, right? Hey, if you're going to have a society, you're going to have some people living on the streets. Well, that's not true. The homelessness we see today is completely unique for our time.

In fact, it only really arose in the 1980s when homelessness became a major social issue for the first time since the Great Depression. And the reason homelessness arose wasn't some iron law of nature. It happened only because of policy decisions we made as a society and the social forces that resulted from those choices. For instance, if you've listened to earlier episodes we've done on this topic, you know that one of the main drivers of homelessness is the high cost of housing and that to end it, we need to build much more low cost housing. But the shocking truth is we actually had an entire sector of housing

that filled this need until we destroyed it. See, for a long time, there was something in America called single-room occupancy housing, or SROs. SROs were small, furnished apartments on floors with shared bathrooms, a style of apartment that was built in response to the Depression years. Now, I know, the idea of living in a small room with a hot plate and sharing your bathroom with

a dozen or so other people does not sound luxurious, but hey, at least it was cheap, and at least you had a roof over your head. During World War II, SROs housed workers who needed to find jobs in munitions factories to help the war effort, and after the war, SROs appealed to returning soldiers, migrants from the South looking for work in cities, and immigrants. And they were big business. In the 1950s, SROs were 10% of New York City's entire rental stock. It wasn't perfect, but they were a cheap, effective form of housing that was widely available. But despite that, SROs were seen by many as run-down, unfortunate places where, quote, poor people lived. And in 1950s America, with the American dream fixated on homeownership

for your white American suburban family, SROs began to look to people in government less like a housing solution and more like an ugly social problem that needed to be fixed. So from the 50s through the 70s, well-meaning reformers who were uncomfortable with poverty and immigrants began to legislate the SRO out of existence. New York City made it illegal to build new SROs or to have families live in them. They changed zoning regulations, they passed tax incentives, and the best SRO buildings were quickly sold

and upgraded, and those left behind increasingly looked like bad investments. So their owners started to leave them to rot in order to push out their rent-regulated tenants. And you know, the tenants who had the means to move out of these purposefully hellish SROs did, meaning that those left behind were the poorest and most vulnerable. New York's tax program even encouraged a large number of owners to burn down their SROs to get rid of their tenants. Now, look, let's say that, hey, maybe some of these reformers did have a genuine concern that SROs were a substandard form of housing. All right, well, fine, but in that case, they should have come up with a better form of housing to replace them, and that never happened. By 1985, New York City's government had destroyed more than 100,000 units of affordable housing and replaced them with nothing. And the same thing happened all across America. Between 1973 and 1983,

over a million SRO units vanished, leaving the millions of people who relied on them for a roof over their head with no affordable housing option to turn to, and thus they hit the streets. Or let's take another issue around homelessness. We know that a huge portion of the homeless are mentally ill, but how did we end up in a situation where so many of our mentally ill neighbors end up living on the streets? Well, just like with SROs, it was a campaign by well-meaning reformers that had disastrous results. See, right up until the 1960s, there was actually a massive network of state-run mental hospitals that cared for the mentally ill and gave them a place to live. But many were squalid, right? The conditions weren't

that great. They were understaffed. So people in the civil rights movement and civil libertarians agreed that the mentally ill could live better outside these institutions. And this movement to, quote, deinstitutionalized turned into legislation that caused the number of people living in these institutions to plummet. And the problem only worsened when in 1981, the Reagan administration cut federal mental illness spending massively. These reforms led to a situation in which severely mentally ill people were pushed out of hospitals and ended up on the streets where they still are today. The fact is, there is nothing natural about our homelessness crisis. We created it. But that means we can also begin to undo it if we have the will to. Because how we choose to address this problem says a lot about us. Do we want to be the kind

of society that allows people to die on the streets right in front of us or not? And of course, if our answer is the latter, and I very much hope it is, we still have to answer the question, how? Well, my guest today is someone who has the answer to that question. Dr. Sam Simbaris is the founder of Pathways Housing First. He's on the faculty of the Department of Psychology at Columbia University Medical Center, and the Housing First model he developed to bring people off the streets is in use all over the world. I really think you're going to love this interview. Please welcome Sam Simberis. Sam, thank you so much for coming on the show.

Thank you. Thank you for inviting me. It's great to be here. Would you tell our listeners just a little bit about who you are and what it is that you do? I was trained as a clinical psychologist, and I've worked with people who are homeless and mentally ill most of my career. I'm sometimes called the father of Housing First because it was a program I started back in New York in the 90s, and it's a program that's been very effective in addressing the problems of homelessness for those who are mentally ill. I've been, in the last few years,

working to help communities start Housing First programs, both in the States and Canada and Europe. So I just want to start by talking about our misconceptions about how to address homelessness, because we have this idea, you hear people say that, oh, the problem with the homeless is that they're all mentally ill, and we have to address that, or we have to address drug addiction before we can solve the housing problem. That's a misconception, correct? Correct. There are many misconceptions about people who are homeless. There are, on a one-night count, half a million people in the United States who are homeless. Wow. They represent really the tip of the iceberg because they are

only the people that we see on the street. The count only counts people visible and people in shelters. Because we focus so much on people who are on the street visible, our national conception of homelessness is that it's all people who are mentally ill or have health problems or addiction problems are in a really, really bad way. Because those are the folks you see most often on the street. Those are the people you see. And even though those people represent only maybe 20% of the entire homeless population,

in the public mind, they represent 80% or 100% of homelessness. Right. So there's one distortion to begin with. So there's one distortion to begin with. And then the conversation quickly jumps to how do we treat these people? How can we help them? They're so visibly vulnerable. And the urgency of their poor skin or their hunger, their ranting, you know, demands immediate attention. And so the conversation for many years has been all about how are we going to treat these people?

How are we going to make them well? Because they don't seem well enough to go into housing anytime soon. I just want to leave that aside for a minute and talk about the 80 or 90% we're leaving out. Yeah, who are those folks? Which is all about affordable housing crisis and not enough money on the salary, minimum wage issues, and poverty in general. That is something that's not talked about. So that 80 or 90%, that's not caused by a mental health crisis

on that person's part. That's simply, these are folks who didn't have enough money to pay the rent and they're evicted and they find themselves without a roof. Exactly. They are the victims, if you will, of the gentrification of the housing as a commodity. You know, Airbnb, the building of housing only for people who make a lot of money. And in order to clear land for that type of housing, you're taking away all of the affordable housing or the lower end of the market. And so people who are making less than $30,000, $40,000, if they lose a job or lose their housing, they don't have enough money to get back into housing. And why don't we see those, you said, you know, we don't see those folks on the street, so it's not as visible.

Where are they instead? They are better resourced than the people we see on the street. They don't have the level of addiction or mental illness that we see on the street. They don't have the level of addiction or mental illness that we see on the street. They have family or friends or other supports, and they manage in a short time to get back out of homelessness. The average amount of time that people are homelessness in America is really anywhere between one to three months. Okay. So this group that we see on the street, to get back to them, they are homeless and on the streets for years. Chronically.

Chronically, right? That's the definition that but but there's also government has come up with but there and so you said half a million people on the street uh on a one night count correct that's right but that other population you're saying there's there's you know many times more people who this is someone who say uh is evicted so they're, what, living out of their car in their friend's driveway or something like that. That's right. That's right. Or in a garage or moved back with their grandmother outside of town temporarily because they can tolerate that kind of crowding. Or I know that, you know, in New York City, I didn't realize this, I lived in New York City for a decade and you would see, you know, I thought homelessness in New York was the person on the street corner, which, you know, in New York is not as intense as it is, say, here in LA, right? You don't have encampments,

at least at the time I was there, you didn't have encampments in New York, you had, oh, there's one guy on, there's one guy per block, or something like that, is sort of what it felt like. And then I only realized years later, that actually what there is in New York is a huge shelter network way out in the outer boroughs that is because New York has a mandate to provide shelters. But that means that it's basically like this incredibly low quality housing that people are bumping around from shelter to shelter. And so there's actually a large homeless population in New York that is simply invisible to most people who live there because it's not on the street. And so we don't

have a proper conception of what it really is. That's exactly right. The number of people who are homeless on the one night count, if you count street and shelter, is slightly higher in New York than it is in Los Angeles. Really? Yeah. It's about 60,000 in New York and about 58,000. This is the 2018 count. So, you know, you're absolutely right in your description that it's more hidden in New York City. And also because New York City is often thought of as Manhattan Island, the shelters being in Brooklyn and Bronx definitely export people who are homeless into the outer boroughs So if we're talking about how many people

because this is a question I've often had how many people are homeless in America at any given time if you had to extrapolate beyond that one night count how many would you estimate? Well if you estimate that people in general are homeless three months let's say, on average, then if a half a million is the one-night count, then it would be at least four times that in the course of a year. So two million just sort of on the street. But the people that we don't see, people have done all kinds of surveys.

One was a phone survey just randomly to anyone in your family ever been homeless. So already, you know, someone who has a phone is already up there. But that came up with an estimate of somewhere between 6 and 12 million people a year. 6 and 12 million people a year? Experience homelessness, yeah. Wow. And so when we're talking about, now that's a type of homelessness that we often don't consider when we're talking about homelessness. We're not talking about the person who is maybe on our block who became homeless and is sleeping out of their car for a couple months until they're able to scrape something together. But returning to the chronic homelessness, which is what I think most people think of, is the person who lives at the bus stop, right, on their corner, as, you know, I have in my neighborhood.

Or under the 405 or 10 or any of the other highways or along the ocean or in any of the tents, you know, that are springing up everywhere across Los Angeles. So when we, you're completely correct, when we first have our experiences with those folks, we often think, well, how can this person be helped? This person is so profoundly in need of every type of help imaginable, to such a degree that I don't even know how to go about offering it. I'm so frightened or upset by the person. I can't even begin as a person to go about helping. Overwhelming. It's overwhelming. Yeah. So how do we address that need?

Well, if we pull back for a second from the human dimension of it and look at it just economically, so just to kind of make that parallel between the people we see and the people we don't see and the similarities between them. Let's say the person has a severe psychiatric disability. They would be qualified for something called SSI, you know, Social Security income. I think it's about $ seven or $800 a month, seven or $800 a month in a city like Los Angeles is not going to put you anywhere close to being able to get back into housing. You can't afford the security deposit. You can't afford the one month's rent that's needed. And also where are you going to find rent for $700 a month in Los Angeles? No units, no, no way in. So if this person is mentally in the living, let's say, with elderly parent who dies, you know, and then they lose the apartment.

They have a psychotic break and they're in the hospital for a while in the hospital. So they lose their residence because the hospital stay was long. Yeah. And then they're discharged back into homelessness, which happens often, where they get arrested for being homeless to begin with, and, you know, they're out of jail back in the street. Yeah. However it is that people lose their housing,

and there's a million stories because there's a million people. Yeah. Once they're on the street with only that much money, they are priced out of the market forever. Yeah. They cannot get back in unless there's an intervention, a program, a rent supplement, someone that's going to help them with supported housing or rent. So in that regard, the homeless mentally ill and the not so mentally ill homeless are really more about homelessness and the economics of homelessness.

are really more about homelessness and the economics of homelessness. The fact that so many people on the street are mentally ill is because there's something else going on, which is they're mentally ill, therefore they're very, very poor. They have no income. They don't have jobs, and so they're all on SSI. So that's both. It's a confound in a way. Yeah.

And then you attribute the homelessness to the mental illness, not thinking that also, you know, it's really about the poverty. Right. Because when you think about mental illness in the population, 3% of the population, when you look at epidemiological studies, has schizophrenia. Yeah. That's millions and millions of people, you know, 3% of 400 million, right? Yeah. But most people with schizophrenia are living with their families or supports or in group homes. So it's not mental illness equals homelessness,

because there's lots of mental illness that does not equal homelessness when you have the resources. Yeah. And the idea that we would need to somehow cure mental illness in order to stop homelessness first is, I mean, when you say it that way, 3% struggle with schizophrenia and just that mental illness, right? And there's many, many more. The question, once you look at it that way, the question becomes, well, are we as a society going to care for people with mental illness. Like I had a really profound experience where Housing Works California, which is a group here that we featured on Adam Ruins Everything on our episode about housing. That's how I became introduced to them. And they work to, you know, get folks into housing within a permanent sport of housing model, which I hope you'll tell us more about. The Adam Ruins Everything

staff went down there last time we were working to one of their residences to like, you know, just like it was a volunteer day for our staff, but also just to hang out with the residents. We brought pizzas and we played board games and we had a good time. You know, it was really wonderful. But meeting the folks who are being helped by this program, all of them were disabled. Like in, you know, one was, one fellow was, you know, very kind man, he's developmentally disabled, folks in wheelchairs, you know. And what I realized is these are not, these aren't disabilities that you need to cure, you need to treat or something like that. These are folks who, like the disability contributed to their poverty, as you said. And really what's happening is these are folks who need care and we're not caring for them. And that's why they're on the street. And so the question for me becomes, look, if we've built a society where in order to have a house, you need to not be poor, right? You need to like

be able to work for a living or have someone else support you, right? Well, there's a certain number of people who can't work for a living and who don't have someone else to support them. And so, what do we as a society want to have happen to those people? Do we want them to die on the street in front of us? Or do we want to provide them with like a minimum standard of care, you know? It's kind of, that was, that really made me do a 180 about how I thought about the problem. Yeah. Well, it's, do we want to wait until people are poor to give them housing in the programs that were set up to address homelessness for people with mental illness? Because this whole problem, by the way, we didn't really put it into context yet, but it's only been around for like since 1980.

Oh, I talked about the introduction to the show. Yeah, that homelessness, modern homelessness is very new. Very new. And so what we did was create a system that we basically borrowed from the psychiatric hospital system. You go into a psychiatric hospital, you're very upset, emotionally distraught,

and you get treatment and medication until you calm down, basically, and then you're discharged with continued care. So, there's this assumption that people need to be, even though they have a severe mental illness, they need to be appearing like they don't. And the same criteria was used to provide housing for people with mental illness. So even though the housing was set up, like Housing Works and other organizations that provide supported housing, before this kind of housing first or harm reduction housing idea was introduced, people needed to show up for housing for the homeless mentally ill. I put that in quotes. Being neither homeless or mentally ill, they had to appear like they were like any other tenant. And that required a lot of time spent in shelters and transitional housing and other kinds of programs designed to get people ready for housing.

They called it housing readiness. Because it's that idea that, oh, you need to be mentally fit or you need to be not drug addicted. You need to have solved all your problems before you've earned housing. Right. Which is? You've earned housing, and I don't know if that's the societal indicator or whether you're worthy of housing because we don't want to give

homeless, mentally ill drug addicts a free ride. There is a very strong judgment quality to programs that require people to demonstrate their worthiness. And, well, there's also this idea that, you know, I think some people have a pragmatic idea that, well, if you're addicted to drugs, you're from mentally ill, then it doesn't matter if we put you in housing, you're going to bounce right out again. But again, I'm not sure that holds up. Like I was talking to my neighbor and nice guy, but you know, we were talking about the homeless population in our neighborhood. And

he said, you know, I've heard the real problem is all these folks are addicted to drugs and that's why they can't stay in housing. And I said to him, like, hey, man, I've done drugs in my life. You know what I mean? The difference between me and them, and maybe you've done drugs too, right? The difference between us and them is that when we do drugs, we don't lose our housing, right? Like you and I have the ability. I could start doing heroin right now.

That's right. And I could do that for 15 years and never have a problem, right? As long as you're quiet about it and you're not having all your buddies over and you're not selling the heroin out of your apartment, which are lease violations. If you maintain your housing according to the terms and conditions of a standard lease, then you're entitled to be a tenant. And most people who have addiction are not on the street. They're in housing somewhere. I mean, the level of addiction is much greater than what we see on the street and also true for mental illness. Yeah. And so that's evidence that those are not really the causes of homelessness. And

they're also not something that we need to fix in the person before they can get housing, correct? that we need to fix in the person before they can get housing, correct? Correct. You don't have to fix them before. And in fact, if you fix them after people are housed or try to fix them after people are housed, you have a much better chance at it. Right. Also, this assumption that mental illness and addiction can be cured or fixed

is another one of those. This whole conversation started with myths about belief systems around the homeless who have mental illness and addiction. And mental illness and addiction, we don't actually have a cure for. We have some pretty good ideas about how to, but you know, it's been around for ever since humanity, right? So, these are ongoing challenges. And if you wait to cure that before you give someone housing this is why people have been housing for years and years homeless for years and years right these conditions are sort of part of the human experience like cancer and heart disease and age and you know chronic and they're uh also there's relapses involved people do better for a while and then they don't. Some people recover completely.

It's all possible. But to wait until that happens before you get the crisis is homelessness. The crisis is not mental illness and addiction. So let's talk about the housing first model, which is what we're working our way towards. towards the idea that instead of trying to solve those issues first, if you put someone in housing first, if you solve that immediate need, which is the name of the problem, homelessness. So, if you solve the homelessness problem, those other problems become easier to treat or just the idea that that's the most effective solution. Can you walk us through that? Well, you know, the way I walk you through it, the way I learned about it, which is by talking to people.

I used to take people from the street that appeared to be so compromised that they may have been a danger to themselves. Like we didn't think they'd make it through the night because of their medical conditions. They're coughing up blood, for example, or their legs were oozing pus and we were afraid they were going to lose them. Or they were ranting lose them, or they were ranting at any passerby. And so if they were appearing to be a danger to themselves or others, we would take them to the hospital involuntarily. There were very few people, like we would see 30, 40 people a day, and maybe one we would take to the hospital. In those conversations, in asking people how they're doing and how they got there.

And you learn about their street experience, what was lost, the support that was lost, or the way they were evicted from their place and they haven't been able to get back. And because we were a mental health team, we were like, well, what about treatment? And people would say to us, look, I've had this problem hearing voices. I've been hearing voices since I was like in my 20s. This is a 50-year-old man talking. And he says, you know, I know what hearing voices is about and how to manage that. That's not my problem. So, well, what about the drinking? You know, is that what's contributing to, you know, losing your house? He says, I've been drinking since high school.

I know the difference between drinking and homelessness. My problem is I don't have a place to live. These other things are problems, but they're not my most immediate problem. There was, from that lived experience of the person who's actually going through these things, and most people will report something similar to that, that they are aware of themselves and the conditions that they're struggling with. The urgency of the housing

was made clear through those interviews. The problem that I had was that I couldn't do anything with this information because there were no housing programs that would accept someone as compelling as the people I was talking to on the street that say, you know, we have criteria. You have to be sober, often 6, 12, or 18 months of sobriety, mandatory to get into housing for the homeless, mentally ill drug addict. But don't show up addicted, show up sober for this housing. And then also people didn't want to participate in traditional mental health, like taking medication and going to groups. They were dealing with things on their own terms.

So we had to create a new way of honoring people's experience and providing for them what they most urgently wanted. That's how we started Housing First. We created an agency that basically got a grant from the government to provide rent and case management support because we weren't going to leave people alone once we housed them. Clearly, they were in need of follow-up. And we just prayed that the thing would work out because it hadn't been tried before. I was worried about the people that were going into the apartments. Are they actually going to be okay? Can I really believe them? Because now that was going to be tested. And what about the other people in the apartments?

Are they going to be safe given who we're housing? And given all of that trepidation, and I think some of that trepidation today, even after years and years of research that talks about how effective this program is, we have lots of data. It's one of the few well-researched programs. There are still people who are nervous and unwilling to give people a chance unless they prove stability first. Yeah. Well, what did you find? And I just want to say that perspective is so pervasive, you know, that somehow folks experiencing homelessness have to like prove something or earn something or that, you you know it's really up to them first uh and that has shaped so many parts of how we treat homelessness in this country and in our

society beyond this country yes but what did you find once that program was set up what were your what were your results well the results were spectacular in several different ways. Here's another myth to put on our list of myths about homelessness. Oh, people just want to be homeless. They're out there because they've offered them shelters, they've offered them treatment, and they don't want to go. They're choosing to be homeless. well that engagement question i guess you'd call it and the reluctance to accept programs is not that's what this is what we found finding number one it wasn't that people were reluctant to engage they just didn't like what was being offered to them they didn't want to go to a

show they were afraid to go to a shelter you know know, these New York City shelters you described in the early days had over a thousand beds, less than 12 inches apart, you know, a thousand men sleeping in a, basically was an armory converted into a shelter. The level of criminality and threat, you know, in terms of territoriality, you know, it was just a, it was not a place where someone who was mentally ill felt safe at all. They felt safer being in a storefront sleeping in a cardboard box than they did in the shelter. So when people say, I don't want to go to the shelter, they're not refusing the shelter. They're choosing the street over the shelter because given the choices, that's what they felt better. Yeah. I've heard homeless folks say, yeah, oh, I can't go to the shelter. It's not safe. Yeah.

Like your things will be stolen. You'll be beaten up if you go to the shelter. If you have money, it'll be taken. It's not a good environment. So the ability to offer housing to someone on the street, there was more of a sense of disbelief rather than reluctance. But people were overjoyed. They're like, what, is this a prank? Yeah, yeah. You know, it was like they had heard a lot of stories about, we'll get you housing, come with me.

Yes. And then it ended up being like a drop-in center or like, oh, this is step one, you know, step one. Yeah. But always with the lure, you know, the lure on the hook was housing. Come to our church for long enough. Yes, yes, yes.

We'll get housing, come to our church first, you know, eat and pray. But this was legitimate. And one of the things we did very quickly, some people believed us and we delivered and it was good. And then we would take people we had just housed with us on the outreach team so that it wasn't like me or another staff member saying it was someone who had actually benefited from the program. And they would say, no, you can try. I used to be where you are, man. And like this is, you know, on the level.

Yeah. So that helped our credibility. We always worked with people on our team as professionals who had the lived experience because that also informed our expectations about what happens next and what happens after that because these folks had been through it. So it reduced the amount of time you needed to engage people people were in a very short time you know just like in every community ours and the homeless community word on the street was hey you talk to this guy you get an apartment so it was really more like oh do you qualify you know because we needed people we were funded to only fund the most, to support the most vulnerable. So we needed to know that people had a mental illness and met the other conditions of the program. You know, and we were looking for people who were the most at risk.

And so these are folks who, by that everyday conception that we have, you know, by the lights of the misconception, folks would say, oh, there's no way this person could stay in housing. Because they're on drugs and they're mentally ill and they're going to bounce right out. They're going to hit the streets again immediately. What did you find actually happened? You know, because it was such a risky thing and we were counting, measuring, evaluating from the very first year we started the program. And we had learned that about 30 or 40% of the people who had to get clean and sober would make it into housing eventually, because New York City kept data on these things, the shelters and placements. Well, we thought, well, if we could do at least as well as that with a group that doesn't even engage in that system, we'd be doing okay.

So with that rationale, we're looking around at the end of year one, we had housed about 50 people. Of those 50 people, 84% were still housed at the end of year one. It's like, oh my God, we are onto something here. This is incredible. And so I began to talk about it, because know, because it took a while to set up. And I thought this was like such useful information. I wanted to share it with the provider community. And I would go to meetings like the National Alliance to End Homelessness in Washington. It was like a big provider group.

And I'd say, hey, we got some great news here. We don't really, we can do things all differently. And people were like, what are you talking about? There's no way. There's no way that this is working. This would never work in Detroit, Chicago, Cleveland. Where were you doing this? We were doing, the first program was in New York.

Okay. So it's like something about New York. The benefits are different or, you know, like the water is different. You know, it's like something, like you're homeless. They got real bagels there, you know. That's right. That's right. That's right.

And it was like, this might work in New York, but there's no way that it's working here. Yeah. So it was, well, how do you demonstrate that the people we're housing are the same as the people that you're not housing? So we had to do a different kind of a study, which was a randomized controlled trial. So people that met the criteria for all of those vulnerabilities were randomly assigned to either getting housing first or the treatment first approach. And so then our people were their people, you know. And in that study, same results. 80% stably housed after two years compared to 40% for business as usual treatment and housing. Then it was published in, you know, the American Journal of Public Health was, you know, peer reviewed.

And so the people that were saying, you know, years ago, there's no way it can work here, were saying, could you come to Detroit and talk to us about how to start a housing first program? There was a shift culturally, really, I think. In the provider community. Yeah. And the evidence definitely helped to change minds. And now this model is spreading across the country, isn't it? This model has been spreading across the United States. This model is spreading, has been spreading across the United States. I would say the most spectacular implementation of Housing First in the United States was the Veterans Initiative.

And why the Veterans Initiative was interesting and informative because it was under the Obama administration. And on those one-night counts, they classify veterans, non-veterans. So of the half million that were on the street or in shelter, there were 70,000 veterans, 76,000, something like that. That administration persuaded Congress to allocate rent vouchers, the section eight vouchers, and the VA got a lot of money to do all the social work follow-up. So they called it, and it was a collaboration between two federal agencies, which was unprecedented because they typically don't. Yeah, they hate each other usually.

Yeah, compete in some way. But this was HUD and the VA. So they call it the HUD VA, HUD-VASH program. And that program was going to use a housing-first approach so that the veteran would be identified by outreach, offered an apartment with the voucher, and the VA would help people. No one complained about that program. Oh, you're giving people with mental illness or addiction a home. It was like somehow the veteran population was worthy, and it took away the judgment. That program today has ended veterans' homelessness

in over 60 cities in the United States. Wow. Yeah. And it's the most spectacular, really, implementation of a housing-first approach. What incredible results. Well, we have to take a really quick break, but we'll be right back with more Sam's Embarrass.

I don't know anything. I don't know anything. Okay, we're back. So, Sam, you had great success pioneering this housing first model. But let's talk about a couple kinds of pushback that it would maybe get. For one thing, it certainly sounds expensive, right? You said earlier you had these folks in housing, 80-some percent of them would stay in housing after a year. But then my next thought is like, okay, but they're going to be there for many years.

And you said you're referring to your grant money. You only had so much. So this certainly sounds like it would be an expensive approach, is it? Right. Well, this was a side effect because I'm really a clinician. My training and my values are if we have a cure for something, we should actually apply it no matter what it costs. Yeah, fair point. And I'm not implying that, hey, we want to apply a cost metric to this. No, no, but everybody does. So I think your question is completely

on the money, so to speak, which is, you know, what is this costing us compared to what? And there have been many, many, many cost studies on this very issue. Probably the most famous one was in Seattle, University of Seattle researcher Mary Latimer. And she looked at pre and post, that's the usual way. You look at the person's costs a year before or two years before, and then they're housed, and what are their costs? And by their costs, how many times were they in detox? How many times did they go to the emergency room? How many times did the police have to intervene? Either intervene, bring them to the station, bring them to jail, have them go to court, see the judge, you know, spend time in jail, released. How many times were they inpatient, youpatient, psychiatric inpatient, medical inpatient?

ER visits. ER visits. Yeah. All of that data, which they call the service utilization data. In Washington, it was in the millions of dollars saved for the cohort of about 150 people that were homeless on the street and frequent users.

And a year after housing, the state saved and Medicare saved, you know, Medi-Cal here, millions and millions of dollars. Wow. Because. Wow. Because- Rent supplement for an apartment, a modest apartment with support services, anywhere between $16,000 to $22,000 to $24,000 per person per year. So I think it's easiest to imagine why that works, at least when I'm thinking through it, in terms of emergency room visits. If someone is on the street, they're going to be subject to so many more. I mean, the weather is beating down on them obviously it's going to create more medical issues um and hydrated yeah and so they're going to have more emergency room visits we know emergency room visits are the most expensive

kind of care but also they are they must emergency rooms must treat anyone who comes in as we want them to do so there's like this necessary cost that everybody has to bear for leaving a person on the street that way. Whereas, because they're constantly having emergency problems that need to be treated, police visits, as you said, versus when they actually have a stable home, those problems aren't as acute or maybe even have a chance to improve and that emergency care isn't needed. You know, in the groups that I had the most experience with people with severe mental illness, they would often get hospitalized.

In fact, the group that I worked with was being taken to the hospital involuntarily if they were endangered themselves or others. So a month in the hospital at that time was about $1,500 a day. So 30 days was like $45,000 in Bellevue Hospital, acute care hospital. Sometimes they go to the state for a longer stay. But at the end of all of that, you know, $45,000 for a month's stay, that's like two years rent with services, you know, spent right there. So it's a tremendous, tremendous cost saving, you know, from that perspective. So when you found out about this dynamic, right, when you did this first trial, and you said,

okay, let's try housing these folks in this way. And after a year, you've got this incredible success rate. And you're realizing it's more cost effective to do it this way. Were you like, holy shit, I just, like, this is the solution to homelessness. Like we can, it's cheaper and more effective and it really works and we can do it. I mean, that's, it feels like it's the magic key that unlocks the door. You know, I think it is that i still i still feel that way i'm actually perplexed why we haven't solved it because i i'm looking every day at the problem you know walking the streets like everybody else and it's like why why are we still

here why are there people on the street when we know actually how to fix this thing? I find it frustrating. And I know that it's had really great success in some cities. And I want to talk about those in a second. I know it's had great success in Utah, for example. But I share that frustration because here in Los Angeles, we all voted for a measure to tax ourselves as the citizens of Los Angeles, Measure HHH and Measure H, to build permanent supportive housing of the type that we're talking about, the housing first model. Literally, this ballot came out, I think, the year after we did our segment on the housing

first model. And I was like, oh, great, terrific, wonderful. And the citizens of Los Angeles voted to tax ourselves. We raised a billion dollars. And it's now three years later, not a single unit has been built. I think they're trying to get the first ones online this year. And the homelessness rate has gone up. And you still have the mayor going out there talking about how, oh, people, homeless folks need to be inspired to finally get their acts together and get off the street.

You know, you still hear that kind of language, that treatment first language that we're talking about. And so I've had the same problem of trying to figure out what is the barrier here? Because we know that it works. The people who wrote the ballot measure know that it works. Everyone in Los Angeles who's actually working on the problem knows that it works. The people who wrote the ballot measure know that it works. Everyone in Los Angeles who's actually working on the problem knows that it works. Presumably the mayor has heard the news, right? But yet we are still not making this progress. And why do you feel that that is still so slow? I think that permanent supportive housing has been the one solution for this population. And I think that's too narrow a definition, too expensive a definition, and too slow a product to put online quickly enough.

Because you have to be also staffed with people and they're meeting all kinds of extra requirements in terms of disability requirements, they're much more expensive, two or three times more expensive than just building regular affordable housing. I see. So the numbers you can create are never going to be anywhere close to the volume we need. We need a different type of housing model. I'll tell you where my favorite example is in a country where they've solved homelessness. Oh, I want to hear this. Yeah, tell me about it. They've solved homelessness in Finland.

I don't know if you're a Michael Moore fan. They've solved the educational system. I'm just laughing because the Scandinavian countries are always used as our example here. And there's a certain skepticism I have about that because I went to Norway, visited Norway for an event that my partner Lisa was invited to. So I got to spend a week in Norway. And I was like, oh, this is wonderful. First of all, I have Norwegian heritage. And I was like, oh, for the first time, I feel comfortable in a climate. I was like, this feels right to me.

What's a Norwegian doing in Los Angeles? It's long descent, of long descent, and only on one side. But also going there, they have so much oil money in Norway that the government owns. And so going there, I was like, well, of course, everything is nice here. This is like going to your rich friend's house and saying oh you know my rich friend oh man they've got a nice fridge and they've got a nice pool why can't everyone live like this well let me let me ask you though i mean don't you think that uh do you think that norway is more uh is richer than the united states it's not it's not yeah we are by far the richest country, by far. Fair enough. The problem we have that they don't have is disparity. We have billionaires in Seattle alone between the major companies, the Amazons and Gates and Boeing.

I mean, there's like enough money, wealth there to probably cure all of the elements in several continents combined. Yes. So we have tons of money. The problem is the way we distribute it and the way we think about it. The Norwegians have money and the Finns have money, but they have a different way of having a social contract that says, we're all going to share this. Yeah. We're going to share this. share this. We're going to share this. And we're going to take care of the people that don't have enough by, like you described earlier about the Proposition H, by taxing ourselves to help those

that haven't managed as well as we have. And that runs through the fabric of the social contract. That's the major difference. It's about disparity. Fair enough. Well, tell me what they've done in Helsinki. Well, what they did was, the first thing they did was they identified the number of chronically homeless people on the street. There were about 2,000. And then they were like, what do we do about this? And then they quickly came to, oh, this thing, housing first, it seems to make sense. I'll tell you what probably is the theme of this, which is rational and pragmatic. So, okay, housing first. Well, if it's true that we can take people from the streets and bring them right into an apartment, why do we need all of these shelters? They had hundreds and hundreds of shelter beds, 700 or 800.

They began first by converting the shelters, which were massive places, into small apartments. Then they invested, because it was clear there weren't enough shelter beds, because when you take a shelter and make it into apartments, you have 100 shelter beds, but you only have like 20 apartments, right? Because there's more space. They created a foundation called the Y Foundation, the letter Y Foundation. They have a website that describes all of this, what I'm telling you. And that foundation was funded by business, the faith community, and government.

And they began to buy any kind of housing that was on the market for sale. So all of the rental properties were owned by this nonprofit. In eight years, they had bought 12,000 units of housing. They only had 2,000 homeless people. So there was more than enough in the turnover. And what they did with the other units was they rented them out to regular folks. So it wasn't like, oh, this is where the homeless mentally ill live. This is where we all live. And the people that had mental illness or severe addiction would have visits by social workers to help them manage their life. Yeah. So that it was an integrated housing model. It was a housing model that purchased every available affordable housing.

They were not in it for the money, for the stakeholders, so that because it's a nonprofit, profits were reinvested into the housing portfolio. The entire portfolio is no longer government subsidized. It's self-sustaining because the real payers, the market payers, are sustaining those who have less money. It's kind of brilliant and simple at the same time. So that now in Helsinki, they have a shelter, 52 beds. That's all because as people fall out, they are quickly placed into one of those thousands of units that are turning over.

People leave, you know. And so it's really, that's step one. Step one, which is they got everybody off the street effectively. Here's step two. And we haven't even talked about this in this whole conversation. Yeah. And it goes back to the beginning beginning which is it's about poverty and unless we address the poverty we're gonna even if we succeed tomorrow we decide okay we're gonna get vouchers for everybody in los angeles and we're gonna find

housing maybe not downtown but we'll get them housed somewhere next month we're gonna have new people who are homeless because still ssi doesn't pay the bill and the rents are too high you know and there's not enough affordable housing. And that's what I've heard in Los Angeles about the numbers going up that they're doing what they can, or they should be doing more. But the number of people hitting the streets is larger than the number of people coming off of the streets. So what the Finns did was they identified who's at risk. People with mental illness, certainly. People who were paying 60 or 70% of their income, whatever modest income

they have towards the rent, so they're always like a paycheck away. Widows, single parents who had kids over their heads in expenses. And they began a prevention program where they would supplement that group's rent so that they could pay comfortably and bring their rent burden to about 50% so that they wouldn't be at risk for homelessness. 50% of their income? 50% of their income. So those folks are, even though they're receiving supplements, they're still paying 50% of their income on rent, which is high. Yeah. So those are really the most at-risk people.

These are folks who, oh my gosh they're making they're making a hundred dollars a month and their rent is 101 dollars a month let's get that down to 50 a month i know these are made up numbers but yeah yeah but that's exactly the model yeah so they have the prevention piece they have the short term you know one shelter 52 beds they had 607 right years ago and they have everybody housed now there's nothing in that what I'm describing that we don't know here or can't do. Yeah. So why aren't we doing it? That's the frustration.

Why are we not doing this? We did it for the veterans. Is everybody else who's not a veteran not worthy? That's a really, it's such an interesting question because it is, we have this cultural appreciation of veterans, which I think that we should have, that makes our sort of charitable impulses kick in a little bit faster and say, hey, oh, this is something we shouldn't allow to happen. We're a little bit slower about that with everybody else. And especially folks who are mentally ill, for instance, which is so odd because we know that that's an illness. I mean, it's in the name, right?

We had a visit from the guy who was the head of housing and urban development in one of our programs, a veteran program. And when we usually have a visit from government dignitaries after people are housed they sort of see that hey this is really working yeah person has a nice apartment well kept you know it's like they're sort of amazed like uh i'm not sure why but there is always that element of surprise that someone who looks this way on the street can actually you know do all these things yeah they've never had the opportunity to demonstrate it.

But not unusual for the government people to say, "'Okay, so I see they're housed. "'When are they gonna get a job?' You know, like sort of to get off the dole, you know, is sort of the cultural thing. The only time I saw an exception to that is they were visiting the veteran and the veteran was at home, really nice apartment. it took him a while to get used to it he thought it was being monitored you

know he was struggling but he was keeping it really really neat and when he had the visit he almost canceled but he went through he was managing you know not to be too anxious and he and he was playing some music to calm him down and so so the people come in, there's like music playing in the background, and he talks to them, he manages the visit just fine. And the visitors say, it was so nice to see this veteran comfortable in his own home and listening to music and enjoying himself. They didn't have that questioning impulse. The questioning, like, when's he going to get a job?

They didn't have that questioning impulse. The questioning, like, when's he going to get a job? Well, and that also is such a misconception about people experiencing homelessness because so many of them have jobs. I was just at an event that SELA, an organization in Los Angeles, does called Saturday Supper where we invite folks experiencing homelessness to come have a hot meal, take a shower. There's a big shower truck and watch a movie. And there's clothes as well. And it's a really wonderful organization. Look them up if you live in LA. But I was helping a fella out with looking through clothes. And he was like, oh, great. I need one of these for work. I work in a kitchen kitchen this will be perfect because i wash dishes and that's what i need and the and like the fact is having a job in los angeles as well as in many cities around the country is not enough to earn you a home to to earn enough money to live

it simply there are many many jobs that do not and i've heard people say oh come on you anyone can get a job at mcdonald's yeah maybe so but doesn't pay them it doesn't pay a month's rent that's right there's lots of people living in shelters that have jobs yeah you know and it's uh it is it is it's fundamentally a problem of distribution of income i i also you know, the woman from our Adam Ruins Everything segment on housing, Dorothy Edwards, who is, if you haven't seen that episode, please check it out. She's one of my favorite people I've had on our show. You know, she came on the show and talked about how, you know, she was, had lived on the street for, I think, 15 years, was addicted to drugs. She was put in permanent supportive housing. She was found by Housing

Works because she was one of the most vulnerable people, most at risk of dying in the next year. So they put her in housing. And now a couple of years later, she's clean and sober. She's been living in housing for a number of years. She works for Housing Works California. She lives in one of these residences with other clients and is, clients and is, you know, basically doing social work. And she's, you know, like a pillar of this organization. And she flies around the country, you know, like speaking on this topic. And she told me, despite all of that, despite the fact that she has completely, her life is a complete 180, right? It's the biggest success story you could have. She said said if my income that i make from working

this job was not supplemented i couldn't afford the supportive housing i live in now and she currently pays rent um but she is still receiving you know a subsidy and so uh the idea that oh a job is going to solve you know the the job is the main thing that people are lacking. Well, look, this era of homelessness was created fundamentally by a federal government decision to stop funding programs that would build affordable housing. That's what created homelessness. And we have never gone back to the root of the problem. And we have misattributed the root of the problem to personality characteristics or personal failings or something about the people of the problem. And we have misattributed the root of the problem to personality characteristics or personal failings or something about the people who are homeless.

In fact, this whole safety net, gone. And that's what we're still trying to restore. Now, I know you didn't like the Finnish example, but I can tell you- No, I did like it. I did like it. I can tell you that there's Montgomery County- You turned me around on it.

What's that? You turned me around on the Finnish example. All right, all right. But there's counties, county at the county level here, both in Milwaukee County, Montgomery County, or the two I'm most familiar with, Bergen County in Jersey, where they have, between the cities and the county governments, ended chronic homelessness. And the county governments ended chronic homelessness. So it's possible within even our own framework with the kinds of coalitions and the housing first approach to get to the end of having to walk by people on the street.

Because I think one of the things that's also lost and the misconceptions, you know, like get one more item for that list of misconceptions. Yeah. That homelessness is all about the people who are homeless. But if you walk by homeless people every day and yourself, what you have to shut down, you know, what we were talking about earlier, that what it calls to you and the pain that it causes you and what you have to shut down to walk by just to survive and get to your appointment on time is costing you something personally at a human level

yes and then if you're walking with your kids and you're teaching them to look away because it's sort of rude to stare at people but they can't help themselves because it's so awful they can't not look yeah it's like an accident you know you're telling them, don't. You're teaching the next generation to look away. So I just want to say, again, as I did in the beginning, I'm very grateful that you're bringing attention to this issue. Because if we could raise public awareness that this is a solvable and very manageable problem if we get it right and we have the resources and the model and everything else to do it. I think we could do this quickly. So I want to know what that model is. What is your prescription to tell, if you could go tell,

you know, the president or the next president, if we do ABC, we can solve the problem, even in a place like Los Angeles where it's so acute. The solution is simple. It's a tremendous influx of Section 8 vouchers. You have to freeze the affordable rents so that rent doesn't become a commodity. Real estate doesn't become a commodity to invest in, but becomes a guarantee for people to live.

We have to shift culturally from thinking that housing is something people have to earn to housing is a right. Like healthcare is a right. Yeah. We haven't quite got to that either yet. Well, we're, I mean, we're currently engaged in a cultural conversation about what our rights are and whether those are rights. That's, you know, I think fundamentally it's a question of values and economics. The economics, if the values are aligned, are not that complicated. You know, you have to freeze the rents so that people aren't always priced out of the market. You have to acknowledge that some people need a more affordable rent

and not give up neighborhoods, entire neighborhoods, to the gentrification, the commoditization of housing for profit. Right now, in Los Angeles, there are two vacant middle-class apartments for every homeless people. We keep building these beautiful buildings and it's actually the tax structure is such that you can deduct the rent loss and it's still worth your profit right right you know and to keep them vacant yeah we're building buildings with uh swimming pools and uh interior and you know uh parking private parking and all these things rather than...

Keep them empty. It's still financially worth it because we've set it up that way from our tax base. So if you incentivize the building of affordable housing, give people vouchers, many of the people we're talking about on the street will need support. In addition to that, we already have lots of support services that we can attach them to. It's not that complicated. To say. To say. There it is.

There it is. It's not that complicated to say. And I think there's a perception that, you know, what I was giving you a little bit of a hard time about Finland, right? That there's a perception that for some reason it's easier for them than it is for us. That there's something special about that society, right? That made it, that makes it, okay, well, they can do it, but oh, well, no, this is America where things are really tough. Oh, our homelessness is different. Our people are different. We have more or whatever.

But I'm curious what you say to that. No, it's nothing to do with the people who are homeless. It's all to do with our politics and values, really. I mean, we look at the extreme political climate we're living in now. I mean, I can't remember a time where things were more divisive and conflicted than than they are today yes i mean you do need a consensus you know to move forward we have a congress that's paralyzed and a senate that's nothing but obstructionist you know and it's like but you think that a a solution when we have a clear solution that works to a problem that affects all of us, where, you know, I mean, homelessness does affect all of us because we see it every day,

and that we could save money by making sure people don't die on the street is such a clear win. It's such a clear win. I mean, it's not even like climate change where you have an industry fighting against it, right? An industry that's trying to keep itself rich. I mean, maybe, well, I guess we could talk about the real estate industry, but they're nothing compared to Exxon. No, no. I think that the real estate industry is not interested in solving homelessness because if they had figured out how to solve homelessness and make money, it would have been solved a long time ago. So the sort of capitalist approach to the solution,

which we're totally enamored with, isn't. We bring it up when it's a cost saving, that works in our favor, but that hasn't really persuaded housing industry or the development industry to, that they're looking for ways to figure out how to make money to end homelessness. That would be, we would have ended it. But it might need a different approach, which is housing as a right and government intervention

and sharing resources differently than we do now. Right. intervention and sharing resources differently than we do now. Right. I mean, you hear often people say, well, the problem is, the more capitalist approach to this is, well, no, the problem is it costs too much to build housing. So therefore, we need to reduce regulation. We need to end rent control. We need to reduce all these things that are causing the price of housing to be high. That way it'll be low and the price of rent will go down. Well, but the last 30 years has proven exactly the opposite. Right.

Right. Yeah, fair enough. I mean, we didn't have homelessness when rent control was in place. Housing wasn't a commodity and we weren't building through the roof. Yeah, it's true. Rent control has been demolished since the rise of homelessness. Or, you know, we had more regulations decades ago when we didn't have homelessness. But also, I think it's evidence that that's capitalism saying, well, capitalism can't solve this problem. figure out how to make money at this so let's not do it at all and we could say no okay how about you keep making money and then separately we'll also find a way to make sure people don't die on the street you know capitalism can't figure out a way to do a lot of things that we all want done and that's when we get together and we find a different solution one last piece about the

capitalism it's capitalism that's actually creating this income disparity problem and homelessness and climate change. You know, it's all about that. So, it's hard to imagine that it's going to find a solution to the very problem it's creating. We do need a different approach. Right. problems when in fact it's the cause of many of them is is such a strange thing that you know is an idea that's out there that i'm happy that people seem to be waking up to a bit right well just just tell me uh what is what is your work you're you're you actively try to spread these this solution um how have you been doing that and what success have you had? I've been traveling a lot.

And like our conversation has gone, I think many conversations in many different places, both cities or counties. Recently, I was in Amarillo, Texas, for example, where Housing First is just being introduced. Kansas, I'm going, we have a national conference, a Housing First conference in Seattle coming up where we share ideas among all the Housing First providers. And then I also travel to a lot of different countries. And what's interesting for me in these travels is that I used to work with like one agency at the time. So, you know, some,

an agency like housing works wanted to introduce the program or another agency in another city. And now it's governments that I'm meeting with because now the evidence is very strong and people want to do this at a different scale. Um of the examples, the Canadians, for example, did a randomized control trial a few years ago, 10 years ago. And the results were as spectacular as ours, 80%, 40%. government decided if this is the data and these are the outcomes and these are the cost savings, they made Housing First their national policy. So any organization that was receiving money from the federal government to provide homeless services had to spend 50% of every dollar doing a Housing First program. Wow. That created, as you can imagine, a lot of difficult community conversations. It's like, hey, we really have to change what we're doing here. We've been doing this for years.

Are you saying that what we're doing is not worthwhile or not valued? So no, it's fine, but it's just not achieving the effect of ending homelessness. There's so much in the homelessness sector that is about managing homelessness, serving homeless people endlessly, more meals, more blankets, more emergency care. But it's not actually having an outcome other than more people served. The outcome criteria when you are anywhere in the homeless business should be, have you ended the homelessness? Right. Right. Have you gotten rid of the homeless business should be, have you ended the homelessness? Right, right. Have you gotten rid of the less part? Yeah, yeah, exactly. And so the country, Canada did that.

New Zealand just started a nine-city tour of housing, first in nine cities. Ireland just took on a national thing. France has been doing it for years. So that it's now being implemented country by country. It's kind of gratifying to see. And what it does, you know, like in many places, is that reduces the street population.

But many of the countries in Europe have a stronger safety net than we do, even Canada. You know, like if you're homeless in Canada and Europe have a stronger safety net than we do, even Canada. You know, like if you're homeless in Canada and you have a disability, not only do you get your disability check, just a small example, but people realize that you're going to need more than just your disability check to live somewhere. So they automatically, at the federal government level, add on what's called the shelter allowance of about $300 hundred dollars to help you with the rent wow you know and in here it's you have to try to get ssi three or four times before you're even successful in securing that so that it's a different ethos to

help and you can imagine what look i i was again playing devil's advocate earlier when i was asking what's different about america because i think that all that's different about it is our, so far, housing hasn't been a political or policy issue of importance in America for as long as I can remember. For the first time ever in this election, a couple of the candidates are saying they have a housing plan. But even then, they're not running on it. They're not running on, you know, to me, they should be going to every single city saying no one can afford rent and there's people dying on the street. This is one of our greatest domestic policy problems. I think this and climate change.

And, you know, again, these are my issues. They're all our issues. Yeah, they belong to all of us. And we haven't yet seen that sea change. But imagine if we did. And imagine if HUD made this their national policy. National policy at HUD is housing first, just like you said. It's been done in Canada.

What an enormous effect that would be. Policy and money. Policy and money. Because there's lots of policy lip service paid to Housing First, but the money has not followed. Well, I thank you so much for helping pioneer the solution and for spreading the word about it and for coming on the show. It's incredible work. I appreciate you so much. Adam, thanks very much for inviting me, and thank you very much for all the work that you're doing.

for inviting me and thank you very much for all the work that you're doing. Well, thank you again to Sam Simberis for coming on the show. I hope you enjoyed this interview

as much as I did. That's it for us this week on Factually. I'd like to thank our producer, Dana Wickens, our researcher, Sam Roudman, and I'd like to thank Andrew WK

for our theme song, I Don't Know Anything. You can check it out on his new album. And if you want to follow me on Twitter, you can find me at at Adam Conover or sign up for my mailing list at adamconover.net. Until then,

we'll see you next week on Factually. That was a hate gum podcast.