WEBVTT 00:00:14.189 --> 00:00:17.609 Hello and welcome to Listen.Up.People., a podcast 00:00:17.609 --> 00:00:20.489 of the USC Suzanne Dworak-Peck School of Social Work. 00:00:20.489 --> 00:00:23.350 I'm Dr. Holly Priebe Sotelo, Associate 00:00:23.350 --> 00:00:26.190 Teaching Professor of Practicum Education. We 00:00:26.190 --> 00:00:29.329 have a special episode today because it is not 00:00:29.329 --> 00:00:32.390 often that my guests have literally written the 00:00:32.390 --> 00:00:35.829 book on the subject we are covering, but indeed 00:00:35.829 --> 00:00:39.549 my two guests have, along with Deborah Padgett 00:00:39.549 --> 00:00:43.140 at NYU Silver School of Social Work. So we have 00:00:43.140 --> 00:00:46.000 an opportunity to take a deep dive into the model 00:00:46.000 --> 00:00:49.119 that has been at the forefront of efforts to 00:00:49.119 --> 00:00:52.399 end homelessness. Yet these results are now being 00:00:52.399 --> 00:00:55.140 challenged by the federal government and Housing 00:00:55.140 --> 00:00:58.719 First has become a somewhat controversial subject. 00:00:58.909 --> 00:01:01.450 I'd like to welcome my social work colleague, 00:01:01.750 --> 00:01:05.209 Dr. Ben Heinwood, the Frances L. and Albert G. 00:01:05.370 --> 00:01:08.189 Feldman Professor of Social Policy and Health, 00:01:08.810 --> 00:01:12.269 and Dr. Sam Tsemberis, who developed the groundbreaking 00:01:12.269 --> 00:01:15.269 Housing First approach and founded the Pathways 00:01:15.269 --> 00:01:18.730 Housing First Institute. Thank you so much for 00:01:18.730 --> 00:01:21.799 joining me today. I'd like to start with a more 00:01:21.799 --> 00:01:24.439 personal question about how you first became 00:01:24.439 --> 00:01:27.640 interested in working with people experiencing 00:01:27.640 --> 00:01:30.319 homelessness and how did your collaborations 00:01:30.319 --> 00:01:33.239 start? So we'll start with you, Sam. Well, thank 00:01:33.239 --> 00:01:35.700 you. Thank you, Holly. It's a pleasure to be 00:01:35.700 --> 00:01:38.799 here. How did the interest in homelessness start? 00:01:39.540 --> 00:01:44.799 I have to back up saying that I'm quite old, 00:01:44.939 --> 00:01:47.900 which means I was around before homelessness 00:01:47.900 --> 00:01:52.379 started. So that you know people have to imagine 00:01:52.379 --> 00:01:57.340 a city where there aren't homeless people and 00:01:57.340 --> 00:02:01.260 There's just you know business and families walking 00:02:01.260 --> 00:02:04.959 around and suddenly a homeless person appears 00:02:04.959 --> 00:02:08.219 Now if people can remember the first time they 00:02:08.219 --> 00:02:10.699 see a homeless person. It's like there's a sense 00:02:10.699 --> 00:02:15.680 of shock disbelief sadness Just confusion like 00:02:15.680 --> 00:02:19.319 what's this person doing on the street? So my 00:02:19.319 --> 00:02:21.939 interest in homelessness started when people 00:02:21.939 --> 00:02:26.280 first began to arrive on the street. And I'm 00:02:26.280 --> 00:02:29.199 a psychologist by training, so I was particularly 00:02:29.199 --> 00:02:32.080 drawn to the people on the street that appeared 00:02:32.080 --> 00:02:34.919 mentally ill. It's like, of all the people that 00:02:34.919 --> 00:02:37.159 are on the street, why are these people on the 00:02:37.159 --> 00:02:40.960 street? And that started me on a journey of questions 00:02:40.960 --> 00:02:44.580 of like, where did they come from? And where 00:02:44.580 --> 00:02:47.759 can we take them to? You know, kind of looking 00:02:47.759 --> 00:02:51.500 for practical, sensible solutions to this issue. 00:02:52.099 --> 00:02:57.780 So I was drawn to wanting to solve that problem. 00:02:57.939 --> 00:03:00.879 And how did your collaboration start? With Ben? 00:03:01.300 --> 00:03:05.860 Yeah. Well, I started this organization to do 00:03:05.860 --> 00:03:11.680 housing first. And Ben was in social work school 00:03:11.680 --> 00:03:16.550 and he appeared, you know, he came to do an internship 00:03:16.550 --> 00:03:19.789 at Pathways to Housing in New York City. And 00:03:19.789 --> 00:03:23.189 it wasn't hard to notice that there's a very 00:03:23.189 --> 00:03:27.289 bright, caring, practical person here. It was, 00:03:27.789 --> 00:03:29.750 you know, Ben was a pleasure to work with right 00:03:29.750 --> 00:03:33.050 from the start. The other thing about our collaboration 00:03:33.050 --> 00:03:38.449 is that I recognized we had a values compatibility, 00:03:38.689 --> 00:03:41.550 you know, this is This is not just a program 00:03:41.550 --> 00:03:45.530 that's practical or just clinical. You have to 00:03:45.530 --> 00:03:48.849 feel a certain way about people. You have to 00:03:48.849 --> 00:03:52.889 believe that they deserve housing, that there's 00:03:52.889 --> 00:03:56.370 a social justice component to it. And it was 00:03:56.370 --> 00:03:59.150 clear that Ben had the kinds of values and the 00:03:59.150 --> 00:04:02.490 clinical smarts and it's like... You know when 00:04:02.490 --> 00:04:04.770 when he finished his internship we immediately 00:04:04.770 --> 00:04:07.250 offered him a job and wanted to keep him You 00:04:07.250 --> 00:04:09.550 know with us and working love that. Thank you 00:04:09.550 --> 00:04:12.050 Sam as well I remember that first time seeing 00:04:12.050 --> 00:04:13.889 someone on the street and I had that same kind 00:04:13.889 --> 00:04:17.050 of reaction like wow What just happened so love 00:04:17.050 --> 00:04:19.110 that. Thank you and then what about you? How 00:04:19.110 --> 00:04:21.430 did you become interested in this work for me? 00:04:21.509 --> 00:04:24.230 I don't really ever I didn't think of myself 00:04:24.230 --> 00:04:27.370 as getting into homelessness, because quite frankly, 00:04:27.750 --> 00:04:30.589 by the time I learned about it, which was in 00:04:30.589 --> 00:04:34.589 my first research class in my MSW program, where 00:04:34.589 --> 00:04:36.990 Deborah Padgett was teaching, she was talking 00:04:36.990 --> 00:04:39.350 about this research that was transformative that 00:04:39.350 --> 00:04:42.990 came out on Housing First that sort of flipped 00:04:42.990 --> 00:04:46.089 the homeless service system on its head, where 00:04:46.089 --> 00:04:48.949 you were providing people, you know, immediate 00:04:48.949 --> 00:04:53.029 access to a home. and then providing them support 00:04:53.029 --> 00:04:57.110 services as opposed to making them go jump through 00:04:57.110 --> 00:04:59.629 hoops and treatment programs before they could 00:04:59.629 --> 00:05:03.230 ever get there. And I think I was really struck 00:05:03.230 --> 00:05:07.069 by that approach. And then to hear about the 00:05:07.069 --> 00:05:09.889 research that showed how effective it was, it 00:05:09.889 --> 00:05:12.910 really got my interest. And so I ended up talking 00:05:12.910 --> 00:05:16.389 to Professor Padgett after my class said I was, 00:05:16.389 --> 00:05:18.470 you know, super interested to learn more. And 00:05:18.470 --> 00:05:22.610 she directed me up to Pathways to Housing, which 00:05:22.610 --> 00:05:26.569 was operating in New York and where the study 00:05:26.569 --> 00:05:28.829 was conducted. So that's that's how I sort of 00:05:28.829 --> 00:05:32.110 reached out to Sam to say I'd like to volunteer. 00:05:32.449 --> 00:05:35.250 And so for me, I mean, I just think that's how 00:05:35.250 --> 00:05:37.990 I kind of got into the space. And once I started 00:05:37.990 --> 00:05:41.680 doing the work, right, I think it wasn't Yes, 00:05:41.680 --> 00:05:45.100 it is quite moving to see sort of this transformational 00:05:45.100 --> 00:05:49.199 impact that you can have when someone gets an 00:05:49.199 --> 00:05:51.540 apartment for the first time. That sort of shared 00:05:51.540 --> 00:05:54.079 narrative that you have with them when you watch 00:05:54.079 --> 00:05:56.879 them walk into the door for the first time is 00:05:56.879 --> 00:06:00.240 quite moving. But I think for me, it was really 00:06:00.240 --> 00:06:03.720 understanding that given the history that most 00:06:03.720 --> 00:06:07.199 of my clients had at the time where You know, 00:06:07.399 --> 00:06:10.459 this was years of people looking right past them, 00:06:10.480 --> 00:06:13.720 right through them, not acknowledging them sort 00:06:13.720 --> 00:06:16.259 of as a human being. And how powerful that is 00:06:16.259 --> 00:06:19.319 when you're able to do that. I think for me that 00:06:19.319 --> 00:06:21.699 that was more transformational than the housing. 00:06:22.360 --> 00:06:24.980 And that's what I understood the work to be about. 00:06:25.019 --> 00:06:27.160 And I think that's what Sam sort of instilled 00:06:27.160 --> 00:06:29.579 in everyone working at the agency, which then 00:06:29.579 --> 00:06:32.379 is what I learned. And that's really how I learned 00:06:32.379 --> 00:06:34.860 to become a social worker. So. In that whole 00:06:34.860 --> 00:06:36.939 time, I never thought of myself as doing homelessness 00:06:36.939 --> 00:06:39.439 work. I mean, ending homelessness was the easy 00:06:39.439 --> 00:06:42.060 part. And for me, you know, it was really about 00:06:42.060 --> 00:06:44.139 how do you support people with, you know, very 00:06:44.139 --> 00:06:47.579 complex clinical needs after the fact, but at 00:06:47.579 --> 00:06:49.819 least they're in. in a place where they can start 00:06:49.819 --> 00:06:52.180 addressing these. So I think it wasn't until 00:06:52.180 --> 00:06:55.399 I got to Los Angeles where we didn't have enough 00:06:55.399 --> 00:06:58.980 of housing and Housing First to actually effectively 00:06:58.980 --> 00:07:01.180 address it that I started to actually think of 00:07:01.180 --> 00:07:03.540 myself more as looking at the problem of homelessness, 00:07:03.540 --> 00:07:06.800 because if there's not enough of it, then what 00:07:06.800 --> 00:07:08.439 are we going to do with the people left behind? 00:07:08.560 --> 00:07:11.860 And so I think you know, this identity of my 00:07:11.860 --> 00:07:14.060 own as being a homelessness researcher is kind 00:07:14.060 --> 00:07:18.540 of a more recent in my overall trajectory. Excellent. 00:07:18.720 --> 00:07:21.220 Thank you, Ben. Thank you, Sam. And Sam, you 00:07:21.220 --> 00:07:23.879 know, as the person who developed the evidence 00:07:23.879 --> 00:07:27.199 -based approach we now know as Housing First, 00:07:27.560 --> 00:07:29.819 could you please provide our listeners with an 00:07:29.819 --> 00:07:33.120 overview of how it began and why does it work? 00:07:33.339 --> 00:07:37.959 Well, I think Ben led into that very nicely, 00:07:37.959 --> 00:07:42.959 actually, because I think one of the little understood 00:07:42.959 --> 00:07:46.139 things about housing first is that it's actually 00:07:46.139 --> 00:07:50.300 not about housing. It's actually about listening 00:07:50.300 --> 00:07:55.699 to people and providing people with complex needs, 00:07:56.040 --> 00:07:58.939 mental illness, addiction, health problems, homelessness, 00:07:59.300 --> 00:08:03.259 poverty, the thing that they want most. And when 00:08:03.259 --> 00:08:06.819 you do offer that choice, when you turn to people 00:08:06.819 --> 00:08:10.079 and listen to them and ask them what is the most 00:08:10.079 --> 00:08:15.439 urgent need, they say housing. So we were prepared 00:08:15.439 --> 00:08:19.160 to offer whatever it was, but we were led to 00:08:19.160 --> 00:08:22.139 provide housing first because that was the thing 00:08:22.139 --> 00:08:27.240 that most people wanted. And that was not available. 00:08:27.969 --> 00:08:31.209 in any other organization. You had to be sober, 00:08:31.430 --> 00:08:33.789 you had to be compliant with treatment, you had 00:08:33.789 --> 00:08:36.669 to have curfews. There were all kinds of hurdles 00:08:36.669 --> 00:08:39.789 that were out of reach for the people that we 00:08:39.789 --> 00:08:43.090 saw on the street. So once we started listening 00:08:43.090 --> 00:08:45.950 to people and they wanted housing, we had to 00:08:45.950 --> 00:08:48.549 develop a program that could actually deliver 00:08:48.549 --> 00:08:53.190 what they were asking for because otherwise... 00:08:53.610 --> 00:08:57.210 kind of a breach of the promise that we had offered. 00:08:57.269 --> 00:08:59.590 We're going to help you with whatever it is you 00:08:59.590 --> 00:09:02.929 want. So we get into the housing business by 00:09:02.929 --> 00:09:08.470 default. I also end up in housing conversations 00:09:08.470 --> 00:09:12.750 and I'm not a housing policy person. I'm a clinical 00:09:12.750 --> 00:09:15.289 psychologist. I know how to listen to people 00:09:15.289 --> 00:09:17.970 and you end up in housing because that's what 00:09:17.970 --> 00:09:21.190 people wanted. You end up doing a lot of things 00:09:21.190 --> 00:09:23.629 that you never were trained to do. because people 00:09:23.629 --> 00:09:27.330 have all kinds of needs for, you know, groceries 00:09:27.330 --> 00:09:30.509 and reconnection and finding documents. And, 00:09:30.590 --> 00:09:33.029 you know, you do the whatever it takes approach. 00:09:33.450 --> 00:09:36.169 But I think that in addition to listening to 00:09:36.169 --> 00:09:39.370 people, you have to have the kind of staff, you 00:09:39.370 --> 00:09:42.250 know, that that Ben was talking about, that people 00:09:42.250 --> 00:09:44.830 that have a philosophical approach and provide 00:09:44.830 --> 00:09:48.429 services and treat people with a certain dignity 00:09:48.429 --> 00:09:53.799 and respect so that it's actually the relationship 00:09:53.799 --> 00:09:57.860 with the support services that keeps people housed. 00:09:58.460 --> 00:10:00.600 Yes, offering them an apartment certainly gets 00:10:00.600 --> 00:10:03.279 them off the street, but all of the support that 00:10:03.279 --> 00:10:05.559 they need to stay housed and to begin to have 00:10:05.559 --> 00:10:09.120 a life has to do with the quality of care and 00:10:09.120 --> 00:10:12.259 support that they receive from people so that 00:10:12.259 --> 00:10:15.799 they can succeed. And so it's the housing and 00:10:15.799 --> 00:10:19.580 the support with a certain caring, consumer driven 00:10:19.580 --> 00:10:22.600 philosophy that sort of makes the program. work. 00:10:22.820 --> 00:10:26.179 And then once we were doing that, it was so off 00:10:26.179 --> 00:10:28.080 beat. You know, we were the only program really 00:10:28.080 --> 00:10:30.500 in the country initially doing this thing. And 00:10:30.500 --> 00:10:33.799 it was so wacko compared to what everybody else 00:10:33.799 --> 00:10:36.460 was doing that we thought we better do a study 00:10:36.460 --> 00:10:39.259 to make sure this thing is working at least as 00:10:39.259 --> 00:10:41.539 well as the other program. The other program 00:10:41.539 --> 00:10:44.480 was achieving like 30 or 40 percent success, 00:10:44.480 --> 00:10:47.139 you know, in getting people housed. And when 00:10:47.139 --> 00:10:50.539 we started to do the studies, ours was like 80 00:10:50.539 --> 00:10:53.929 percent successful. And we thought, wow, we're 00:10:53.929 --> 00:10:57.230 onto something here. Yeah, so simply, like you 00:10:57.230 --> 00:11:00.470 said, taking it back to basics of listening first 00:11:00.470 --> 00:11:04.009 when you ask people. And so something as complex 00:11:04.009 --> 00:11:07.870 as homelessness, but starting where the clients 00:11:07.870 --> 00:11:10.730 are, right? And statistically, you know, Ben, 00:11:10.909 --> 00:11:14.110 how has Housing First been successful in reducing 00:11:14.110 --> 00:11:16.889 homelessness across the country? And how does 00:11:16.889 --> 00:11:19.750 Housing First compare with Treatment First or 00:11:19.750 --> 00:11:22.649 non -housing -based approaches? Yeah, I mean, 00:11:22.809 --> 00:11:25.350 I think that's a really important question, and 00:11:25.350 --> 00:11:28.110 maybe a more complicated question than it sounds, 00:11:28.269 --> 00:11:30.549 right? Because, you know, anytime you're talking 00:11:30.549 --> 00:11:33.950 about a complex psychosocial intervention, which, 00:11:34.330 --> 00:11:36.389 you know, which this is, it involves, you know, 00:11:36.549 --> 00:11:39.470 figuring out access to housing and support services, 00:11:39.789 --> 00:11:42.970 often with the interdisciplinary team, you know, 00:11:43.009 --> 00:11:45.450 it's hard to do research in that context. And 00:11:45.450 --> 00:11:48.419 you very rarely can do You know, when we think 00:11:48.419 --> 00:11:50.639 of like, well, what's the best evidence we have? 00:11:50.799 --> 00:11:53.440 We sort of know scientifically doing like a randomized 00:11:53.440 --> 00:11:57.519 control trial is or the apex of, you know, that 00:11:57.519 --> 00:12:00.159 that that really tells us we know it's about 00:12:00.159 --> 00:12:02.779 the intervention and not, you know, not something 00:12:02.779 --> 00:12:05.259 else going on in the environment. But there are 00:12:05.259 --> 00:12:07.639 very few randomized control trials in this context. 00:12:07.639 --> 00:12:10.799 And so typically what you see is a lot of programs, 00:12:10.799 --> 00:12:12.679 you know, they'll be an evaluation and they'll 00:12:12.679 --> 00:12:15.659 tell you how they did. But then how they did 00:12:15.659 --> 00:12:18.460 compared to what? Sam really, I think, had the 00:12:18.460 --> 00:12:21.299 foresight to think about that ahead of time and 00:12:21.299 --> 00:12:23.899 to, you know, when he was starting the program 00:12:23.899 --> 00:12:26.539 to actually implement a randomized control trial. 00:12:26.759 --> 00:12:29.279 Again, very, very rare in this kind of social 00:12:29.279 --> 00:12:31.360 service space. And that's what I learned about 00:12:31.360 --> 00:12:33.659 in my first class, the results of that of that 00:12:33.659 --> 00:12:36.179 randomized control trial and heard about the 00:12:36.179 --> 00:12:39.259 like the 80 plus percent effectiveness versus, 00:12:39.259 --> 00:12:42.559 you know, 30 percent in treatment first. And 00:12:42.889 --> 00:12:46.169 You know, 80 % success in kind of anything, especially 00:12:46.169 --> 00:12:49.169 something so complicated, I think just for the 00:12:49.169 --> 00:12:52.009 listeners, I mean, that that is, it's kind of 00:12:52.009 --> 00:12:54.169 unheard of, you know, you'd be happy getting, 00:12:54.169 --> 00:12:55.950 you know, the majority of the people that this 00:12:55.950 --> 00:12:57.830 is helpful. But if four out of five people are 00:12:57.830 --> 00:12:59.649 going to do really well by this kind of intervention, 00:12:59.809 --> 00:13:02.409 then then yes, you, you know, you kind of listen 00:13:02.409 --> 00:13:05.889 to that. It wasn't just the one randomized trial 00:13:05.889 --> 00:13:09.120 that Sam did. But I think Based on that work, 00:13:09.360 --> 00:13:11.519 there were other parties that were interested, 00:13:12.080 --> 00:13:14.159 and including the Canadian government, and Sam 00:13:14.159 --> 00:13:15.519 might want to talk more about this because he 00:13:15.519 --> 00:13:18.340 was intimately involved in that too, but to have 00:13:18.340 --> 00:13:21.460 five different cities across Canada all doing 00:13:21.460 --> 00:13:24.580 a randomized controlled housing first, and to 00:13:24.580 --> 00:13:27.259 come up with pretty much the similar results, 00:13:27.539 --> 00:13:30.509 you know, that's what replication of of empirical 00:13:30.509 --> 00:13:32.610 evidence looks like that's how you actually build 00:13:32.610 --> 00:13:36.669 knowledge. So there have been multiple trials, 00:13:37.129 --> 00:13:39.610 experimental trials on, and it always comes back 00:13:39.610 --> 00:13:42.169 looking the same. And so that gives us confidence 00:13:42.169 --> 00:13:44.450 in what we're looking at. But in addition to 00:13:44.450 --> 00:13:47.110 that, there have been dozens and dozens of evaluations 00:13:47.110 --> 00:13:50.110 of the program that also come up with that 80 00:13:50.110 --> 00:13:53.289 % 80 plus percent effectiveness. So We're pretty 00:13:53.289 --> 00:13:55.909 confident in those results, as confident as I 00:13:55.909 --> 00:13:58.590 think one can be as a social scientist. To your 00:13:58.590 --> 00:14:00.769 question, though, right? So that's talking about 00:14:00.769 --> 00:14:03.389 if people end up in housing first, how do they 00:14:03.389 --> 00:14:06.090 do? And I think the short answer is they do quite 00:14:06.090 --> 00:14:08.870 well, right, in terms of not going back to the 00:14:08.870 --> 00:14:11.629 streets. But when you're talking about, oh, is 00:14:11.629 --> 00:14:14.649 that actually reducing homelessness? That's sort 00:14:14.649 --> 00:14:17.350 of a different question, right? And so that's 00:14:17.350 --> 00:14:20.299 about Well, how much capacity do we have and 00:14:20.299 --> 00:14:22.639 how much do we scale the intervention? And if 00:14:22.639 --> 00:14:24.840 you don't scale the intervention, then it is 00:14:24.840 --> 00:14:28.039 true that you can have an effective intervention 00:14:28.039 --> 00:14:30.600 to address homelessness and homelessness can 00:14:30.600 --> 00:14:32.879 also be increasing at the same time. Like there's 00:14:32.879 --> 00:14:34.940 nothing inconsistent about that. Both things 00:14:34.940 --> 00:14:37.039 can be true at the same time. So I just wanted 00:14:37.039 --> 00:14:39.480 to point that out. You know, I think your question, 00:14:39.480 --> 00:14:43.539 I think it's how successful has it been, you 00:14:43.539 --> 00:14:46.350 know, just from a social science point of view, 00:14:46.450 --> 00:14:48.610 I would say very successful. Excellent. Thank 00:14:48.610 --> 00:14:52.029 you, Ben. Sam, would you care to add? Well, a 00:14:52.029 --> 00:14:56.350 couple of things Ben alluded to. Why do a randomized 00:14:56.350 --> 00:14:59.610 control trial? Well, we had done the other trials. 00:14:59.669 --> 00:15:02.029 We had done the pre -post and we had done some 00:15:02.029 --> 00:15:05.389 comparisons. We were compelled to do research 00:15:05.389 --> 00:15:08.350 just to know that what we were doing wasn't harming 00:15:08.350 --> 00:15:12.029 people. And the simpler studies were enough to 00:15:12.029 --> 00:15:17.100 do that. The problem was that I thought we were 00:15:17.100 --> 00:15:20.120 on to an intervention that everybody would want 00:15:20.120 --> 00:15:23.639 to take on. It's like, just figured something 00:15:23.639 --> 00:15:25.639 out. Like, why don't you do it in, you know, 00:15:25.779 --> 00:15:28.240 Washington? Why don't you do it in Detroit, Chicago? 00:15:28.899 --> 00:15:31.679 And I would go to conferences and present this 00:15:31.679 --> 00:15:35.320 and people were like, no way. No way. You're 00:15:35.320 --> 00:15:38.139 taking the easy people off the street. You're 00:15:38.139 --> 00:15:40.139 taking those people that are well organized. 00:15:40.860 --> 00:15:43.360 And just the opposite was true. This program 00:15:43.360 --> 00:15:47.120 targets people that have failed in other programs 00:15:47.120 --> 00:15:49.700 repeatedly. We were taking the people with the 00:15:49.700 --> 00:15:53.519 most complicated needs that other programs either 00:15:53.519 --> 00:15:56.860 would not admit or had tried and failed with. 00:15:57.460 --> 00:16:00.279 So we needed a randomized controlled trial because 00:16:00.279 --> 00:16:03.000 that was the only way that we could legitimately 00:16:03.000 --> 00:16:05.980 say no, the people we're taking are just like 00:16:05.980 --> 00:16:08.639 the people you're serving. Your people are, in 00:16:08.639 --> 00:16:11.600 fact, our people. And I would say publishing 00:16:11.600 --> 00:16:14.980 that changed the conversation from something 00:16:14.980 --> 00:16:17.899 that wasn't acceptable. Housing First initially 00:16:17.899 --> 00:16:20.940 was not acceptable. It was shunned primarily 00:16:20.940 --> 00:16:23.679 by other providers who would not believe in the 00:16:23.679 --> 00:16:26.039 results and didn't want to change their system. 00:16:27.139 --> 00:16:30.000 People are not comfortable with harm reduction. 00:16:30.440 --> 00:16:32.860 They didn't want to put you know, people who 00:16:32.860 --> 00:16:35.759 are actively using or actively psychotic in apartments, 00:16:35.779 --> 00:16:38.879 it was too dangerous because the whole system 00:16:38.879 --> 00:16:42.179 is very risk aversive. This is not a risk averse 00:16:42.179 --> 00:16:44.940 kind of program. You have to be willing to take 00:16:44.940 --> 00:16:49.000 the chance to give people an opportunity to succeed, 00:16:49.379 --> 00:16:52.059 whereas most systems refuse to take the chance 00:16:52.059 --> 00:16:54.440 because they're afraid people will fail, you 00:16:54.440 --> 00:16:57.889 know, but that precludes the opportunity to succeed. 00:16:58.389 --> 00:17:02.409 So it was uphill. It was uphill. And the research 00:17:02.409 --> 00:17:06.269 was a huge part of changing the narrative and 00:17:06.269 --> 00:17:08.529 having this thing accepted. And then by the time 00:17:08.529 --> 00:17:12.390 the Canadians did their randomized control trial, 00:17:12.690 --> 00:17:15.829 and it was a similar trial in France, and then 00:17:15.829 --> 00:17:19.390 the thing began to have legs, if you will. People 00:17:19.390 --> 00:17:23.430 stopped saying, you can't do it here. Could you 00:17:23.430 --> 00:17:25.819 come here and show us how to do it? Yeah, wow. 00:17:25.960 --> 00:17:28.220 And you know, I know that in a recent article 00:17:28.220 --> 00:17:31.539 in The Guardian in the UK, you spoke about how 00:17:31.539 --> 00:17:34.519 the current administration has come out against 00:17:34.519 --> 00:17:38.140 housing first approach. And now you feel like 00:17:38.140 --> 00:17:41.500 you're back as an outlaw in the US. Can you talk 00:17:41.500 --> 00:17:43.579 a little bit about what is happening with the 00:17:43.579 --> 00:17:46.740 federal funding and why this administration has 00:17:46.740 --> 00:17:49.519 seemed to target housing first specifically, 00:17:50.200 --> 00:17:52.900 despite all the evidence that it works? The thing 00:17:52.900 --> 00:17:57.309 about Back to being an outlaw is because when 00:17:57.309 --> 00:18:00.789 we were first applying for a grant from the federal 00:18:00.789 --> 00:18:04.210 government It was under the George W Bush administration 00:18:04.210 --> 00:18:07.670 and we couldn't use the word harm reduction in 00:18:07.670 --> 00:18:10.990 the application You know, it was like it was 00:18:10.990 --> 00:18:14.130 an outlaw kind of a program to begin with and 00:18:14.130 --> 00:18:16.529 then it got to be mainstream And now here we 00:18:16.529 --> 00:18:20.210 are outlawed again, you know this administration 00:18:20.210 --> 00:18:24.160 and I think this is I'm not sure exactly what 00:18:24.160 --> 00:18:29.799 to say about the rhetoric and how to combat propaganda 00:18:29.799 --> 00:18:33.119 with evidence. Because evidence is what we're 00:18:33.119 --> 00:18:35.480 talking about. There's a kind of a rational discourse 00:18:35.480 --> 00:18:40.319 based on data. Propaganda is free from truth. 00:18:40.740 --> 00:18:44.099 You know, people can lie, say anything they want, 00:18:44.119 --> 00:18:46.759 and as long as it's a compelling narrative or 00:18:46.759 --> 00:18:49.549 said in a particularly catchy way, you know, 00:18:49.670 --> 00:18:52.630 as we witness every single day, you know, in 00:18:52.630 --> 00:18:57.509 the country right now, the battle for our reality 00:18:57.509 --> 00:19:01.089 is at stake here. And, you know, so Housing First 00:19:01.089 --> 00:19:03.710 is no different than any of the other things 00:19:03.710 --> 00:19:07.349 that are being distorted. And now Housing First 00:19:07.349 --> 00:19:10.069 is, you know, not useful because we still have 00:19:10.069 --> 00:19:12.710 homelessness. For example, that's one of their 00:19:12.710 --> 00:19:17.549 arguments. or that it doesn't work because there 00:19:17.549 --> 00:19:20.150 are examples of people moving into housing and 00:19:20.150 --> 00:19:22.769 doing terribly, which is true. I mean there is 00:19:22.769 --> 00:19:25.869 a lot of implementation of Housing First that's 00:19:25.869 --> 00:19:30.569 not well done. So there is some legitimate concern 00:19:30.569 --> 00:19:34.569 about how the program is operating, but to dismiss 00:19:34.569 --> 00:19:39.289 the evidence by using a kind of a rhetorical 00:19:39.289 --> 00:19:44.230 narrative that's completely manipulative of facts 00:19:44.230 --> 00:19:47.730 is really what's going on there. But the thing 00:19:47.730 --> 00:19:49.509 that they're doing also is that they're cutting 00:19:49.509 --> 00:19:52.190 the funding. There's two reasons I think the 00:19:52.190 --> 00:19:54.289 government is pushing back against Housing First. 00:19:55.089 --> 00:19:57.890 They've changed the tax structure so they want 00:19:57.890 --> 00:20:02.130 to not fund any social programs and this would 00:20:02.130 --> 00:20:06.210 be one way of cutting it. It also is pushing 00:20:06.210 --> 00:20:10.079 against the fact that we have systemic problems 00:20:10.079 --> 00:20:12.440 that are causing homelessness. Rents are too 00:20:12.440 --> 00:20:14.980 high, benefits are too low, salaries are too 00:20:14.980 --> 00:20:19.079 low. But rather than talk about that, they would 00:20:19.079 --> 00:20:21.279 rather talk about the fact that homelessness 00:20:21.279 --> 00:20:24.400 is caused by addiction and mental illness. And 00:20:24.400 --> 00:20:26.420 if people are mentally ill and homeless, you 00:20:26.420 --> 00:20:29.250 can't house them. which is exactly the opposite 00:20:29.250 --> 00:20:31.289 of what we've been demonstrating for 30 years. 00:20:31.589 --> 00:20:33.529 In fact, if people are mentally unhomeless and 00:20:33.529 --> 00:20:35.789 you house them, they do much better. But you 00:20:35.789 --> 00:20:38.009 know, we're going back to that early narrative 00:20:38.009 --> 00:20:41.089 because that shifts the blame from the government 00:20:41.089 --> 00:20:44.130 to the individual. See, it's this person's problem 00:20:44.130 --> 00:20:45.950 for being homeless because it's something that 00:20:45.950 --> 00:20:48.490 they're doing. Thank you. Wow. And Ben, would 00:20:48.490 --> 00:20:51.069 you care to add any additional thoughts on that? 00:20:51.289 --> 00:20:55.940 When we in 2016 first published the book that 00:20:55.940 --> 00:20:59.339 was led by our dear friend and colleague, Deborah 00:20:59.339 --> 00:21:02.480 Paget. That was at a time where, right, this 00:21:02.480 --> 00:21:07.599 was a program idea that had empirical results 00:21:07.599 --> 00:21:11.019 that caught the attention of the federal government, 00:21:11.319 --> 00:21:13.759 in part because of those research results, in 00:21:13.759 --> 00:21:16.599 part because what we haven't talked about was 00:21:16.599 --> 00:21:19.619 that actually this was a cost -effective way 00:21:19.619 --> 00:21:21.539 of addressing homelessness because the people 00:21:21.539 --> 00:21:24.279 being targeted You know, if you if you leave 00:21:24.279 --> 00:21:26.500 them on the streets and you don't give them access 00:21:26.500 --> 00:21:28.930 to the housing and the supports. then they will 00:21:28.930 --> 00:21:31.910 end up in the hospital, in the emergency room. 00:21:32.029 --> 00:21:34.009 They will get arrested. They will end up back 00:21:34.009 --> 00:21:36.809 in the hospital. Very, very expensive, right? 00:21:36.849 --> 00:21:39.049 And when you provide someone an apartment and 00:21:39.049 --> 00:21:41.509 you give them support services, then guess what? 00:21:41.549 --> 00:21:43.869 You're not spending all those public dollars 00:21:43.869 --> 00:21:48.529 on these emergency systems. And there's research 00:21:48.529 --> 00:21:51.390 on that. I do think, I think back to Malcolm 00:21:51.390 --> 00:21:53.849 Gladwell wrote an article about Million Dollar 00:21:53.849 --> 00:21:57.529 Murray, where he actually was looking at an individual 00:21:57.869 --> 00:22:00.589 the man named Murray in Las Vegas and just sort 00:22:00.589 --> 00:22:04.170 of documenting how much did it cost to watch 00:22:04.170 --> 00:22:06.650 Murray go in and out of systems. And his conclusion 00:22:06.650 --> 00:22:09.089 at the end was sort of, you know, you could have 00:22:09.089 --> 00:22:11.750 bought him a home and got him a private nurse 00:22:11.750 --> 00:22:14.829 for what you spent on all those, you know, the 00:22:14.829 --> 00:22:16.910 tax dollars on all those other emergency services. 00:22:17.410 --> 00:22:20.029 So there was a, you know, a compelling reason 00:22:20.029 --> 00:22:22.910 for sort of, let's say both sides of the aisle 00:22:22.910 --> 00:22:25.349 to want to do this, right? It reduced homelessness, 00:22:25.670 --> 00:22:28.420 it saved money. It's kind of what's not to love 00:22:28.420 --> 00:22:31.579 there. And really at the time when the book came 00:22:31.579 --> 00:22:37.140 out, it was this really unique story of evidence 00:22:37.140 --> 00:22:42.599 -based practices becoming policy and really rewriting 00:22:42.599 --> 00:22:44.900 how we should approach homelessness in this country. 00:22:45.160 --> 00:22:47.980 That was 10 years ago, and a lot has changed. 00:22:48.539 --> 00:22:51.250 And I don't want to just put it on. the current 00:22:51.250 --> 00:22:54.390 administration right because I do think that 00:22:54.390 --> 00:22:57.049 you know we did have this intervention that worked 00:22:57.049 --> 00:22:59.670 there were a lot of promises that were made like 00:22:59.670 --> 00:23:02.009 there were all these like you know 10 -year plans 00:23:02.009 --> 00:23:05.230 and homelessness and in a lot of places homelessness 00:23:05.230 --> 00:23:07.190 kept getting worse I think of like in Los Angeles 00:23:07.190 --> 00:23:09.869 when I got here in 2012 you know our homeless 00:23:09.869 --> 00:23:12.710 population has doubled since then and I think 00:23:12.710 --> 00:23:16.069 there's look I understand if you're not following 00:23:16.069 --> 00:23:19.339 this issue you think how I'm hearing all about 00:23:19.339 --> 00:23:21.519 these, you know, effective practices and yet, 00:23:21.779 --> 00:23:23.519 you know, now I'm seeing more and more people 00:23:23.519 --> 00:23:25.880 on the streets. So I think that there was lots 00:23:25.880 --> 00:23:28.460 of frustration. There was sort of no explanation 00:23:28.460 --> 00:23:30.900 for it. And so when the current administration 00:23:30.900 --> 00:23:32.500 came along and said, you know what, that stuff 00:23:32.500 --> 00:23:35.400 doesn't work. People were, you know, tend to 00:23:35.400 --> 00:23:37.140 tend to believe what they were hearing because 00:23:37.140 --> 00:23:39.549 that's what reflected what they were seen on 00:23:39.549 --> 00:23:42.250 the streets, right? And I think to Sam's point, 00:23:42.549 --> 00:23:44.150 right, there's nothing inconsistent about that. 00:23:44.250 --> 00:23:46.710 If you have these structural issues where people 00:23:46.710 --> 00:23:48.930 more and more people are becoming homeless, if 00:23:48.930 --> 00:23:51.670 there's not enough affordable housing, you know, 00:23:51.690 --> 00:23:53.309 not just for people at the very low. I mean, 00:23:53.529 --> 00:23:56.170 everyone feels that housing is very expensive. 00:23:56.309 --> 00:23:59.900 And if you get priced out of a basic need, What 00:23:59.900 --> 00:24:01.819 does that mean? That means that you're going 00:24:01.819 --> 00:24:04.440 to end up without a home. And lots of people 00:24:04.440 --> 00:24:06.539 are ending up on the streets. Some people have 00:24:06.539 --> 00:24:08.940 capitalized on that confusion and that change 00:24:08.940 --> 00:24:13.579 and that over -promising that has led us to this 00:24:13.579 --> 00:24:17.230 current situation. which I agree is very, it's 00:24:17.230 --> 00:24:19.309 very challenging when you have the evidence in 00:24:19.309 --> 00:24:21.990 one hand and rhetoric in the other. And the evidence 00:24:21.990 --> 00:24:24.569 is not counteracting that rhetoric. Yeah. And 00:24:24.569 --> 00:24:27.170 you know, Ben, this is a really excellent opportunity 00:24:27.170 --> 00:24:29.750 for us to talk about the book because I understand 00:24:29.750 --> 00:24:32.329 that you've been writing another book on housing 00:24:32.329 --> 00:24:35.289 first with Sam and Deborah Padgett. Can you tell 00:24:35.289 --> 00:24:38.569 us more about the book? Happy to so this is a 00:24:38.569 --> 00:24:40.750 it's a work in progress. The first book that 00:24:40.750 --> 00:24:43.490 came out was 2016 So we're 10 years later and 00:24:43.490 --> 00:24:47.170 it seems like you know a particularly apt time 00:24:47.170 --> 00:24:50.210 to revisit the story because where the story 00:24:50.210 --> 00:24:52.829 ended last time was hey, we have the success 00:24:52.829 --> 00:24:55.910 story and you know, we were looking at housing 00:24:55.910 --> 00:24:58.930 first expansion internationally and thinking 00:24:58.930 --> 00:25:01.990 about how to bring it to scale and imagining 00:25:01.990 --> 00:25:04.349 the future in which actually we were going to 00:25:04.349 --> 00:25:06.539 get a hold of this situation, but you know, the 00:25:06.539 --> 00:25:08.779 cracks and the structural issues were there. 00:25:08.900 --> 00:25:11.940 We sort of knew it. But imagining we'd get to 00:25:11.940 --> 00:25:14.359 a place where affordable housing would be back 00:25:14.359 --> 00:25:17.500 on the on the table to talk about as a sort of 00:25:17.500 --> 00:25:20.200 a necessary issue that we have to address in 00:25:20.200 --> 00:25:22.759 society. But we never did. Right. And I think 00:25:22.759 --> 00:25:25.420 and so here we are 10 years later. And I think 00:25:25.420 --> 00:25:29.000 what this book is looking at is it's a continuation 00:25:29.000 --> 00:25:31.339 of the story to some extent, but it's really 00:25:31.339 --> 00:25:34.529 starting with a simple question, which is you 00:25:34.529 --> 00:25:36.549 know one that I think a lot of people in the 00:25:36.549 --> 00:25:38.509 public have that if we have this evidence -based 00:25:38.509 --> 00:25:41.369 practice and it's been widely adopted and the 00:25:41.369 --> 00:25:43.509 federal government says oh let's do housing first 00:25:43.509 --> 00:25:47.390 then why is homelessness getting worse and again 00:25:47.390 --> 00:25:50.109 I think current administration is using that 00:25:50.109 --> 00:25:52.589 to to say it doesn't work I think as you've heard 00:25:52.589 --> 00:25:54.990 in this conversation that's that's not our take 00:25:54.990 --> 00:25:57.890 right I think we argue the problem isn't the 00:25:57.890 --> 00:26:00.670 idea it's not the intervention there's lots of 00:26:00.670 --> 00:26:04.150 evidence it's you know one it was implemented 00:26:04.150 --> 00:26:06.950 in a system of scarcity where there was not enough 00:26:06.950 --> 00:26:09.450 housing and that was sort of never addressed. 00:26:09.869 --> 00:26:12.430 I think we over promised in terms of right it 00:26:12.430 --> 00:26:14.609 became housing first was going to solve everything 00:26:14.609 --> 00:26:17.569 which was not you know never going to be the 00:26:17.569 --> 00:26:20.250 case. There were we you kind of had to talk that 00:26:20.250 --> 00:26:23.009 idea through how does providing access to housing 00:26:23.009 --> 00:26:25.089 to people who need it going to reduce homelessness. 00:26:25.410 --> 00:26:27.109 That is something we should be talking about 00:26:27.109 --> 00:26:29.269 and I think we just lost the kind of conceptual 00:26:29.269 --> 00:26:32.329 clarity along the way of what is and isn't housing 00:26:32.329 --> 00:26:35.950 first. And even though Sam has, over the years, 00:26:36.089 --> 00:26:40.450 done a lot to work on a fidelity instrument to 00:26:40.450 --> 00:26:42.789 say, this is housing first. And if you're not 00:26:42.789 --> 00:26:44.930 doing this particular intervention, then you're 00:26:44.930 --> 00:26:47.150 actually not doing it the model the way it's 00:26:47.150 --> 00:26:50.349 intended. We've gone pretty far afield in terms 00:26:50.349 --> 00:26:52.450 of that. And so you have a lot of programs saying 00:26:52.450 --> 00:26:55.109 they're housing first. But if you're not practicing 00:26:55.109 --> 00:26:57.609 that person -centered approach and listening 00:26:57.609 --> 00:26:59.289 and helping people solve the problems that they 00:26:59.289 --> 00:27:01.960 have, You know, you're not actually doing Housing 00:27:01.960 --> 00:27:03.900 First, even if you may have provided someone 00:27:03.900 --> 00:27:06.900 access to the park. I'm looking forward to reading 00:27:06.900 --> 00:27:09.940 the book. And I understand there's a that you 00:27:09.940 --> 00:27:13.019 did a conference in Berlin last November and 00:27:13.019 --> 00:27:15.980 that you have another one coming up in May. So 00:27:15.980 --> 00:27:18.200 can you both talk a little bit about your experience 00:27:18.200 --> 00:27:21.180 at the conference and how Housing First is being 00:27:21.180 --> 00:27:23.660 received in Europe and around the world? Well, 00:27:23.740 --> 00:27:26.579 the conference in November was in Berlin. The 00:27:26.579 --> 00:27:29.619 one coming up in May is in San Francisco. May 00:27:29.619 --> 00:27:32.920 12 to 14 up in San Francisco, Ben will be presenting 00:27:32.920 --> 00:27:35.759 Ben's last comment about why Housing First got 00:27:35.759 --> 00:27:40.460 into a problem here. And the scarcity is not 00:27:40.460 --> 00:27:42.339 only the housing as far as I'm concerned, but 00:27:42.339 --> 00:27:45.640 the level of support people get. In Housing First, 00:27:45.880 --> 00:27:48.319 you're providing housing for people often with 00:27:48.319 --> 00:27:50.400 severe mental illness and addiction and health 00:27:50.400 --> 00:27:54.400 problems. You can't have one well -intentioned 00:27:54.400 --> 00:27:57.359 case manager taking care of 30 people like that. 00:27:57.660 --> 00:28:01.240 You know, you need much lower caseload ratios, 00:28:01.420 --> 00:28:04.299 you need an interdisciplinary team, people knocking 00:28:04.299 --> 00:28:07.619 on the door and offering the help because often 00:28:07.619 --> 00:28:09.819 people are reluctant to seek it on their own. 00:28:10.079 --> 00:28:12.400 So it's interesting to see this intervention 00:28:12.400 --> 00:28:15.160 in different countries, I have to say. Everything 00:28:15.160 --> 00:28:17.240 we've been talking about has been the United 00:28:17.240 --> 00:28:19.920 States context. So when you go over to Europe, 00:28:20.089 --> 00:28:23.470 Now, not all of Europe, but let's say especially 00:28:23.470 --> 00:28:26.250 the Western and Northern countries, all of the 00:28:26.250 --> 00:28:29.809 Scandinavian countries down through Denmark, 00:28:30.250 --> 00:28:35.289 Holland, Belgium, France, Spain, Italy, England, 00:28:36.130 --> 00:28:39.029 the United Kingdom and Ireland, all of them. 00:28:39.430 --> 00:28:42.250 At the Berlin conference, we had 21 different 00:28:42.250 --> 00:28:44.470 countries showing up. It was the first time we 00:28:44.470 --> 00:28:47.650 had a Housing First Partners Conference, although 00:28:47.819 --> 00:28:52.240 They've been doing Housing First for years. There's 00:28:52.240 --> 00:28:55.519 something called the Housing First Hub there 00:28:55.519 --> 00:28:58.839 that does technical assistance. But Ben and I 00:28:58.839 --> 00:29:02.619 and others had organized this conference just 00:29:02.619 --> 00:29:06.240 for the Housing First community of Europe. So 00:29:06.240 --> 00:29:08.839 in Europe, they have something called a national 00:29:08.839 --> 00:29:11.779 health plan. They have something called social 00:29:11.779 --> 00:29:14.730 housing. they have something called a taxation 00:29:14.730 --> 00:29:17.910 system that people pay according to what they 00:29:17.910 --> 00:29:21.950 earn. So all of their infrastructure is completely 00:29:21.950 --> 00:29:26.269 different. What that means immediately is that 00:29:26.269 --> 00:29:29.250 there are many fewer per capita people who are 00:29:29.250 --> 00:29:33.269 homeless in Europe than we have here in the United 00:29:33.269 --> 00:29:35.390 States. We have the highest number of people 00:29:35.390 --> 00:29:39.069 per capita homeless because of all of the failed 00:29:39.069 --> 00:29:42.809 non -safety net programs that don't exist here. 00:29:43.109 --> 00:29:45.970 Also, it was kind of incredible to me at this 00:29:45.970 --> 00:29:48.109 conference, everyone talks about housing being 00:29:48.109 --> 00:29:50.750 a basic human right, and no one's calling them 00:29:50.750 --> 00:29:54.049 a socialist or a communist. It's like, of course 00:29:54.049 --> 00:29:56.170 housing is a basic human right. Most countries 00:29:56.170 --> 00:29:58.730 have it in their social contract that we're going 00:29:58.730 --> 00:30:00.930 to take care of people in terms of their health, 00:30:01.349 --> 00:30:04.690 their education, their housing as a matter of 00:30:04.690 --> 00:30:08.799 right, not as something to be earned. So context 00:30:08.799 --> 00:30:12.299 and the conversation is very different. The countries 00:30:12.299 --> 00:30:15.740 have, for the most part, implemented housing 00:30:15.740 --> 00:30:19.500 first programs as best they can. I mean, in terms 00:30:19.500 --> 00:30:23.720 of the housing is a little less challenging for 00:30:23.720 --> 00:30:25.859 them, although there's a housing shortage everywhere. 00:30:26.480 --> 00:30:30.579 But what they tend to do is to increase either 00:30:30.579 --> 00:30:33.960 their portfolio of social housing programs or 00:30:33.960 --> 00:30:37.190 make room for people who are homeless in the 00:30:37.190 --> 00:30:41.109 social housing program. The health systems are 00:30:41.109 --> 00:30:44.730 quite well established. They don't have a lot 00:30:44.730 --> 00:30:48.089 of community health or mental health. So one 00:30:48.089 --> 00:30:50.309 of the challenges is to get people out of the 00:30:50.309 --> 00:30:53.950 clinic to make house calls. So there's conversations 00:30:53.950 --> 00:30:56.630 about that. Things like harm reduction are not 00:30:56.630 --> 00:31:00.150 at all controversial. It's a very common practice 00:31:00.150 --> 00:31:03.890 in Europe to have a harm reduction practice. 00:31:04.250 --> 00:31:09.730 So in many ways, a model like this fits better, 00:31:09.990 --> 00:31:13.390 fits easier within the European context than 00:31:13.390 --> 00:31:16.190 it does here. Thank you, Sam. Ben, would you 00:31:16.190 --> 00:31:18.670 care to add? You know, I agree. I mean, I think 00:31:18.670 --> 00:31:21.069 it was just a different tone being in Berlin 00:31:21.069 --> 00:31:23.599 and listening to the way people talk about, you 00:31:23.599 --> 00:31:27.319 know, housing as a right. It just it wasn't controversial. 00:31:27.640 --> 00:31:30.799 You know, they had it in place. So to do housing 00:31:30.799 --> 00:31:33.420 first there, there's, you know, it's not an uphill 00:31:33.420 --> 00:31:36.319 battle in the same way. Thank you so much. And 00:31:36.319 --> 00:31:39.019 and Sam, can you talk a little bit about Pathways 00:31:39.019 --> 00:31:42.119 Housing First Institute? The Pathways Housing 00:31:42.119 --> 00:31:44.599 First Institute is pretty much a consultancy. 00:31:45.059 --> 00:31:49.920 So I work with a bunch of experts in homelessness. 00:31:50.430 --> 00:31:53.430 certainly including Ben who's on the board. I 00:31:53.430 --> 00:31:57.029 would say that we help in different ways. We 00:31:57.029 --> 00:31:59.630 help communities locally to implement Housing 00:31:59.630 --> 00:32:04.369 First. We advocate. We do training. We do program 00:32:04.369 --> 00:32:06.710 fidelity. Those are the primary things. I mean, 00:32:06.769 --> 00:32:10.750 I think we work with cities or states or organizations 00:32:10.750 --> 00:32:14.769 or countries to implement the model. Wow, I have 00:32:14.769 --> 00:32:17.089 just learned so much and I'm so grateful for 00:32:17.089 --> 00:32:20.630 the two of you. Unfortunately, we've run out 00:32:20.630 --> 00:32:23.009 of time, but I want to thank you Ben and Sam 00:32:23.009 --> 00:32:25.930 for joining us for a great discussion. 00:32:25.930 --> 00:32:28.349 If you want to learn more about the 00:32:28.349 --> 00:32:31.829 Pathways Housing First Institute, please visit pathwayshousingfirst.org. 00:32:31.829 --> 00:32:36.640 And the book Housing First: Ending Homelessness, 00:32:36.900 --> 00:32:40.380 Transforming Systems, and Changing Lives is available on Amazon. 00:32:40.380 --> 00:32:43.480 And if you would like to network with 00:32:43.480 --> 00:32:46.319 our guests regarding their work or want to support 00:32:46.319 --> 00:32:49.019 our transformative research and programs, please 00:32:49.019 --> 00:32:53.980 email us at listenuppeople@usc.edu. 00:32:53.980 --> 00:32:56.180 We would love to hear from you and thanks for listening.