Council member Matt Frumin (left) co-chaired a November 6th roundtable on behavioral health supports for certain housing voucher renters. Sam Tsemberis (right) testified about his Housing First model.

by Marlene Berlin

The “Housing First” policy adopted by Mayor Bowser’s administration is missing a key element, according to the clinical and community psychologist who developed the model for housing the chronically homeless.

Although the unhoused person’s need for intensive case management is an eligibility requirement, DC officials have stated that people who qualify for rental vouchers under its Permanent Supportive Housing (PSH) program can refuse support services. However, “there is no opt-out for case management in Housing First” as Sam Tsemberis designed it. Tsemberis testified at a November 6th roundtable hearing hosted by Ward 3 Council member Matt Frumin and At-Large Council member Christina Henderson.

Frumin chairs the DC Council’s Committee on Human Services. Henderson heads the Committee on Health. Both committees have oversight over DC agencies that provide housing vouchers and behavioral health services to the District’s homeless residents.

Housing First, Tsemberis told them, is “not a program that requires [drug, alcohol and mental health] treatment, but it is a program that requires a home visit so that relationships are built. People need all kinds of things besides treatment.”

To succeed, Tsemberis stressed, Housing First should be treated more as a “services first” model that includes housing as an element.

“The way that the [DC] program – in a hurry to end homelessness – has been implemented is overly focused on the immediate provision of housing and then essentially retrofitting the support services after the person is housed,” Tsemberis said. “Not only is that model challenging in the spirit of relationship forming, but it’s also difficult to establish a relationship once the person is housed and feels like they don’t need services.”

It is also necessary and “mandatory,” he said, for caseworkers to meet frequently and in-person with their clients until they settle into their new surroundings. And, Tsemberis said, the model will not work without a rich services network. He described case managers as the linchpin, with treatment teams backing them up.

Other witnesses invited to speak at the roundtable hearing described DC’s current Housing First system as failing PSH voucher holders and other apartment residents. Marilyn Lanz, a Brandywine Apartments tenants association board member, has been tracking the data on police visits to 4545 Connecticut Avenue since 2018. Prior to that year, Lanz said, MPD would be called to the building once or twice a week, on average. Now, the Brandywine averages one or two police visits per day. Lanz’s data, collected through FOIA requests, showed nearly half of the 362 incidents in 2024 were connected to welfare, behavioral health, domestic violence and child abuse.

“Allow me to share some of the incidents we’ve experienced since 2018,” Lanz told the roundtable. “Calls for suicide attempts. Human feces spread on the corridor walls while the person was screaming profanities. [A] resident deliberately turned on the gas stove, left their apartment and proceeded to walk the hall in the nude…. A dedicated 40-year employee has been verbally threatened – just doing their job. Two mothers stabbed each other – blood everywhere – while their children observed, crying hysterically. Smoking marijuana in the corridors, elevators in the presence of their minor children. Wheelchair-bound resident consumes alcohol publicly, has fallen out of his chair and been found incoherent in the corridor. A significant increase in domestic violence and child abuse incidents.”

“All I and other residents want,” Lanz concluded, “is to reside in a safe and secure community. We cannot continue to put Band-Aids on something this severe.”

Following and reinforcing Lanz’s testimony was Courtney Carlson, the chair of ANC 3F. Carlson recounted what she’s been hearing from constituents, including rising incidents of domestic violence, residents leaving because safety in their buildings was compromised, and an account from a recent ANC meeting about a voucher tenant arriving with only a mattress.

In a statement to Forest Hills Connection following the hearing, Frumin’s office said the Ward 3 Council member would take a “four-part approach to improving conditions for voucher families and their neighbors.”

One component is “fostering an ongoing dialogue with neighbors, service providers, property managers, and public safety partners to explore how the community can better support voucher tenants along Connecticut Avenue, including those facing complex behavioral health and substance use challenges. His goal is to build a collaborative network of stakeholders who can identify issues early, communicate clearly, and coordinate interventions before problems become entrenched.”

Other components are fine-tuning legislation, conducting oversight, and working with the Department of Human Services and service provider partners to evaluate non-legislative policy recommendations that came out of the November 6th roundtable.

During that roundtable, Barbara J. Bazron, the director of the Department of Behavioral Health, announced a new hotline (202-281-2911) that any landlord or tenant can call to report concerns about a resident’s behavior “before it escalates to a crisis.”

Bazron also revealed that the agency had contracted with mental health services provider Community Connections to assign on-site caseworkers to eight apartment buildings along Connecticut Avenue. The buildings, Bazron said, were “identified by tenant associations, property managers and community members with a high number of reported incidents involving individuals whose behavior suggested behavioral health issues.”

The director of the Council’s Committee on Human Services, Dan Passon, later provided a list: 3003 Van Ness, The Brandywine, Connecticut House, Avalon the Albemarle, Connecticut Heights, Sedgwick Gardens, The Kenmore, and 5301 Connecticut.

When Housing First is implemented correctly, Tsemberis said, “This program is very successful. It houses people that other organizations or other models cannot successfully house, and keeps them housed 80 percent of the time.

Other key elements of a successful program include case managers with low client loads, and collaboration between government and law enforcement agencies, landlords, and service providers. Asked by Frumin about Housing First cities that he considers the gold standard, Tsemberis replied: the city and county of Milwaukee. The mayor and the county executive took “a whole community approach” involving the business and faith communities as well as local agencies and law enforcement, Tsemberis said. “They set targets for themselves each year, accountability for the Housing First programs, and they did extremely well.”

“It needs much more coordination than [DC is] actually putting into it.”

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